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Villagecaremax Medicare Total Advantage (HMO SNP) 2019 Provider & Pharmacy Directory

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Villagecaremax Medicare Total Advantage (HMO SNP) 2019 Provider & Pharmacy Directory H2168_MBR19-56_C VillageCareMAX Medicare Total Advantage (HMO SNP) 2019 Provider & Pharmacy Directory This Provider & Pharmacy Directory was updated on 10/12/2018. For more recent information or other questions, please contact VillageCareMAX Medicare Total Advantage (HMO SNP) Member Services at 1-800-469-6292 or, for TTY users, 711, 8:00 am to 8:00 pm, 7 days a week, or visit www.villagecaremax.org. Changes to our provider and pharmacy network may occur during the benefit year. An updated Provider & Pharmacy Directory is located on our website at www.villagecaremax.org. You may also call Member Services for updated provider information. i VillageCareMAX Medicare Total Advantage (HMO SNP) 2019 Provider Directory This directory is current as of 10/12/2018. This directory provides a list of VillageCareMAX Medicare Total Advantage’s (HMO SNP) network providers. This directory is for New York (Manhatan) county. To access VillageCareMAX Medicare Total Advantage’s online provider directory, you can visit www.villagecaremax.org to view the complete directory or providers in another county. For any questions about the information contained in this directory (hardcopy or online), to request a hardcopy, or to get help finding a provider in another county, please call our Member Service Department at 1-800-469-6292, 8:00 am to 8:00 pm, 7 days a week. TTY/TDD users should call 711. ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call 1-800-469-6292 (TTY: 711). ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-469-6292 (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1-800-469-6292 (TTY: 711)。 All providers in this provider directory accept both Medicare and Medicaid. The pharmacy and provider network may change at any time. You will receive notice when necessary. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about VillageCareMAX Medicare Total Advantage network providers in your area, you can visit www.villagecaremax.org or call our Member Service Department at 1-800-469-6292, during the hours of 8:00 am to 8:00 pm, 7 days a week. TTY users should call 711. This information is available for free in other formats, such as large print, Braille, or audio. Call 1-800-469-6292 (TTY: 711), during the hours of 8:00 am to 8:00 pm, 7 days a week. This plan is available to anyone who has both Medicare and Medicaid. ii VillageCareMAX is a HMO plan with Medicare and New York State Medicaid contracts.. Enrollment in VillageCareMAX depends on contract renewal. iii Table of Contents Section 1 – Introduction .................................................................................................................. v What is the service area for VillageCareMAX Medicare Total Advantage? ........................ vi How do you find VillageCareMAX Medicare Total Advantage providers in your area? ..... vi Section 2 – List of Network Providers ............................................................................................ [Primary Care Physicians] (451 Providers) ............................................................................. 1 [Specialists] (2505 Providers) ................................................................................................34 [Hospitals] (10 Providers) .....................................................................................................146 [Skilled Nursing Facilities (SNF)] (11 Providers) ...............................................................147 [Outpatient Mental Health Providers] (2 Providers) ............................................................148 [Ancillaries Services] (131 Providers) .................................................................................149 [Non-Emergent Transportation] ..........................................................................................170 [Dental] (359 Providers) ......................................................................................................171 [Vision] (19 Providers) ........................................................................................................202 [Audiology] (33 Providers) ..................................................................................................204 [Acupuncture] (3 Providers) ................................................................................................206 [Pharmacies] (622 Providers) ...............................................................................................213 Index by Provider Name ....................................................................................................... 247 Index by Specialty................................................................................................................. 284 iv Section 1 – Introduction This directory provides a list of VillageCareMAX Medicare Health Advantage’s network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC). You will have to choose one of our network providers who are listed in this directory or an out- of-network provider to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. Your PCP is a healthcare professional, either a physician or Nurse Practitioner, who gives you routine health care. Your PCP will keep your medical records and get to know your health needs over time. He/she will help in planning your care and ensure that you get necessary services. You can get services from any provider who is in our network and accepting new patients. To choose a PCP go to the list of providers starting on page 1. If you need help in choosing a PCP, please call Member Services at 1-800-469-6292 (TTY: 711), 8:00 am to 8:00 pm, 7 days a week. The call is free. You may change your PCP at any time by calling Member Services. When you change your PCP, we will send you a new Member ID card that includes updated information about your PCP. The network providers listed in this directory have agreed to provide you with your health care services. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to that same provider. You are able to see out-of-network providers for emergency care, urgently needed care, out-of- area dialysis or when a network provider is not available to provide routine care. You do not need a referral from your primary care provider to see a specialist or other providers in our network. However, prior authorization rules must be followed. You may be responsible for paying the full cost of services if prior authorization is not obtained for certain services. Please see your Evidence of Coverage for more information about the services that require prior authorization from VillageCareMAX. If you receive a bill from an out-of-network provider, do not pay the bill. Instead, send the bill to VillageCareMAX for review and we will determine who should be responsible for payment. If the plan is responsible for payment, we will pay the provider directly. If you already paid for the covered services, you can send the bill to us and we will reimburse you for services that are the plan’s responsibility. You may get covered emergency medical care whenever you need it, anywhere in the United States or its territories. If you have an emergency, get help as quickly as possible. Call 911 for help or go the nearest emergency room. You do not need to get prior authorization or referral from your doctor. Contact Member Services within 48 hours to tell us about your emergency v Directorio de Proveedores y Farmacias 2019 de Medicare Total Advantage de VillageCareMAX (HMO SNP) Este Directorio de Proveedores y Farmacias fue actualizado el 10/12/2018. Para obtener la información más reciente acerca de los proveedores de la red de Medicare Total Advantage de VillageCareMAX (HMO SNP) en su área o si tiene otras preguntas, puede visitar www.villagecaremax.org o llamar a nuestro Departamento de Servicios a Miembros de Medicare Total Advantage de VillageCareMAX al 1-800-469-6292 en el horario de 8:00 am a 8:00 pm, los 7 días de la semana. Los usuarios de TTY deben llamar al 711. Cambios a nuestra red de proveedores y farmacias pueden ocurrir durante el año de beneficios, En nuestro sitio web www.villagecaremax.org se encuentra el Directorio de Proveedores y Farmacias actualizado. Si gusta, también puede llamar a Servicios a Miembros para obtener la información actualizada sobre proveedores. i Directorio de Proveedores y Farmacias 2019 de Medicare Total Advantage de VillageCareMAX (HMO SNP) Este Directorio está al corriente a partir del 12 de octubre 2018. Este directorio contiene una lista de los proveedores de la red de Medicare Total Advantage de VillageCareMAX (HMO SNP). Este directorio es para el condado de Nueva York (Manhattan). Para acceder en línea al Directorio de Proveedores de Medicare Total Advantage de VillageCareMAX, puede visitar www.villagecaremax.org para ver el directorio complete o los proveedores en otro condado. Si tiene cualquier pregunta sobre la información proporcionada en este directorio (copia impresa o en línea), solicitar una copia en papel u obtener ayuda para encontrar a
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