Members get all covered Medicare and Medicaid benefits directly from VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP), including Long-term Services and Supports (LTSS) and prescription drugs. In addition, you get extra benefits that are not covered by Medicare or Medicaid. Your Care Manager will work with you, your family and a team of providers to help determine what services will best meet your needs.
Benefits
You pay no co-pays, deductibles or monthly premium for covered services.
You will pay nothing for benefits such as:
Cost sharing and deductibles may vary based on the level of Medicaid & Extra Help that the beneficiary receives. Food & produce (grocery items), utilities, gas-at-the-pump, rent/mortgage assistance, and transportation for non-medical needs are a part of Special Supplemental Benefits for the Chronically Ill (SSBCI). Generally, members enrolled in VillageCareMAX Total Advantage Plan will qualify. Some dental service limits and prior authorization requirements apply.
You can learn more about the services that are available to VillageCareMAX Medicare Total Advantage members, by downloading and reviewing the following booklets or contacting us at 1-855-296-8800 (TTY users call 711). We are available from 8:00 a.m. to 8:00 p.m. to answer your questions.
2025 Summary of Benefits
2025 Evidence of Coverage
This information is available for free in other languages. Please call our member services number at 1-855-296-8800 (TTY: 711) during the hours of 8:00 am to 8:00 pm, 7 days a week. You can get this information for free in other formats, such as large print, braille, or audio. You must continue to pay your Medicare Part B premium. This information is not a complete description of the benefits.
Benefits Updates
Durable Medical Equipment, Prosthetic, Orthotics, and Supplies (DMEPOS) Medical Supply Quantity Update
- This DME Medical Supplies Monthly Quantity Update for urinary catheter with insertion supplies (A4353) are effective for dates of service beginning March 1, 2022.
- The DME Procedure Code Manual has been updated for June 1, 2022. Any changes reflected in the manual are effective for dates of service beginning June 1, 2022.
- Changes include update to the maximum monthly amounts for reusable incontinence protective underpad (T4537) and reusable incontinence protective chair underpad (T4540).
Who Can Join
You can join VillageCareMAX Medicare Total Advantage Plan if you:
- Are 18 years of age or older
- Have full Medicaid, Medicare Part A, and Part B
- Live in Brooklyn, Bronx, Manhattan, Queens, Staten Island, Nassau, Westchester, or Putnam
- Eligible for nursing home level of care (as of the time of enrollment)
- Require community-based long term care services for a continuous period of more than 120 days
How To Join
Call VillageCareMAX to schedule an appointment with an assessment nurse and licensed marketing representative.
Call us at 1-855-296-8800 (TTY 711), 7 days a week 8 am to 8 pm for more information.
Contract Statement
VillageCareMAX is an HMO plan with Medicare and New York State Medicaid contracts. Enrollment in VillageCareMAX depends on contract renewal.
VillageCareMAX complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-296-8800 (TTY: 711).
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-855-296-8800 (TTY: 711)。