How to Enroll | VillageCareMAX

Enroll Online

It's easy to join today through our secure website:

(Coming soon)

Enroll by Phone

Call VillageCareMAX today:

Call 1-855-296-8800 Toll-free TTY 711

8 a.m. to 8 p.m., 7 days a week

Speak to an Enrollment Specialist

Use the form below to schedule an appointment to learn more about VillageCareMAX Medicare Advantage Plans and how to enroll.

Enrollee's Information

First Name

Last Name

County

Address 1

Apt/Suite Number

City

State

Zip

Contact Information

Name

Phone

Date of Availability

Time of Availability

By submitting this form, you authorize a VillageCareMAX sales agent to call or contact you. The person that will be discussing plan options with you is either employed or contracted by a Medicare health plan or prescription drug plan that is not the Federal government, and they may be compensated based on your enrollment in a plan. Submitting this form does NOT affect your current enrollment, nor will it enroll you in a Medicare Advantage Plan, Prescription Drug Plan, or other Medicare plan.

VillageCareMAX is an HMO plan with Medicare and New York State Medicaid contracts. Enrollment in VillageCareMAX depends on contract renewal.