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Special Needs Plan (Medicare Advantage) · HMO D-SNP · Plan ID H2168-002

VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP)

Offered by VillageCareMAX (Village Care of New York, Inc.) · available in 8 counties in NY

Only for people who have both Medicare and Medicaid.

Monthly premium$40.50health + drug coverage
Yearly out-of-pocket max$9,850in network
Drug deductible$700Basic Alternative
Star Rating★★★½ 3.5 out of 52027 CMS rating

Extra benefits listed in the CMS file

DentalPreventive and comprehensive dental
Visionroutine eye exam; eyewear
Hearinghearing aids, plan pays up to $625 per year
Over-the-counter itemsAllowance offered (amount not listed in the CMS file)
FitnessFitness benefit (gym membership or program)

Allowances and limits come from the plan's filing with CMS and are simplified here. Some benefits are only for members with certain chronic conditions. The plan's Evidence of Coverage is the final word.

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