2018 Member Materials

The list below includes links to a variety of materials that members receive for each of the Medicare Advantage plans that VNSNY CHOICE offers. Just select the materials you want, and you will be able to view or download them. You may also obtain a printed copy of any CHOICE Medicare Member Materials by calling 1-866-783-1444, 7 days a week, 8 am – 8 pm (TTY for the hearing impaired: 711).

Preferred
Summary of Benefits (English, Spanish, and Chinese
Member Handbook (EnglishSpanish, and Chinese
Annual Notice of Change (English, Spanish, and Chinese
Drug Formulary (English/Spanish/Chinese) - Approved Formulary Submission ID Number: 00018028, Version 9
Step Therapy Requirements
Prior Authorization Requirements

Maximum
Summary of Benefits (English, Spanish, and Chinese
Member Handbook (English, Spanish, and Chinese
Annual Notice of Change (English, Spanish, and Chinese)
Drug Formulary (English/Spanish/Chinese) - Approved Formulary Submission ID Number: 00018028, Version 9 
Step Therapy Requirements
Prior Authorization Requirements

Classic
Summary of Benefits (EnglishSpanish, and Chinese
Member Handbook (English and Spanish
Annual Notice of Change (English and Spanish
Drug Formulary (English/Spanish/Chinese) - Approved Formulary Submission ID Number: 00018025, Version 9 
Step Therapy Requirements
Prior Authorization Requirements

CHOICE Medicare Plan Materials
- VNSNY CHOICE Medicare Brochure (EnglishSpanish, and Chinese)  
- Nutrition Counseling Benefit Brochure (English) - for Preferred and Maximum only
- SilverSneakers® Gym Benefit (English, Spanish, and Chinese)
- Low-Income Subsidy Plan Premiums (English, Spanish, and Chinese) 
- Best Available Evidence: If you believe you qualify for extra help with your prescription drug coverage and want more information about eligibility, you can learn more by clicking here
Prescription Drug Transition Policy
- 2018 Medicare Star Ratings - VNSNY CHOICE Health Plans (EnglishSpanish, and Chinese
 
- Authorization for Release of Health Information (EnglishSpanish, and Chinese)
- Your Prescription Mail Order Form/Brochure (English and Spanish)
Summer 2017 (English and Spanish)
Spring 2017 (English and Spanish)
Fall 2016/Winter 2017 (English
Summer 2016 (English)
Summer 2015 (English and Spanish)
Spring 2015 (English and Spanish)
Summer/Fall 2014 (English and Spanish
Spring 2014 (English and Spanish
Summer 2013 (English and Spanish
Spring 2013 (English and Spanish)
Fall 2012 (English and Spanish

This is a Medicare-related page; some of the links will take you to non-Medicare information or to a different website. 

The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

Last updated 11/17/2017

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