Plan Materials
2024 Annual Notice of Changes (ANOC)
2024 Annual Notice of Changes (ANOC) Errata
2024 Summary of Benefits
2024 Dental Member Handbook Insert
2024 Behavioral Health Handbook Insert
2024 Evidence of Coverage
2024 Formulary
2024 Extra Help Premium Summary Table
Multi-Language Insert
Language Assistance and Notice of Non-Discrimination (LANN)
Appointment of Representative Form
Health Care Proxy Form & Information
Part D Coverage Determination Form
Part D Coverage Re-Determination Form
Member Reimbursement Form
Privacy Notice
Enrollment Form
2024 Medicare Star Ratings
MedImpact Forms
MedImpact Direct Referral Form
MID Mail Order Form English (updated 5/2024)
Plan Resources
Member Resources
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New York Medicaid Choice – Enrollment Broker
CMS Best Available Evidence Policy
Submit a complaint to Medicare
The State of New York has created an ombudsman program called the Independent Consumer Advocacy Network (ICAN) to provide members with free, confidential assistance on any services offered by VillageCareMAX Medicare Total Advantage Plan. ICAN may be reached toll-free at 1-844-614-8800 or online at icannys.org
