It is important for you to know which providers are a part of the VNSNY CHOICE Total network. In most circumstances, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which VNSNY CHOICE authorizes use of out-of-network providers. Please see your Handbook/Evidence of Coverage
for more information about situations where out-of-network coverage is available.
How can I find out if a doctor is in the VNSNY CHOICE network?
CHOICE has an extensive network of physicians that includes primary care doctors and other specialists. It’s easy to find out if a particular doctor is in our network:
What if my doctor is not part of the VNSNY CHOICE network?
You may be able to continue to use your current provider until you complete your course of treatment. For more information about our process for helping members, please call Member Services at: 1-866-783-1444, Monday – Friday, 8 am – 8 pm (TTY for the hearing impaired: 711).
Do I have to get a referral from my primary care doctor to see a specialist?
No, with VNSNY CHOICE Total you can see a specialist without a referral from your primary care physician. (Remember, VNSNY CHOICE covers services only from specialists who are part of our provider network.)
VNSNY CHOICE Medicare Total is an HMO SNP plan with a Medicare contract. This plan is also a Medicaid Advantage Plus plan, with a contract with the New York State Department of Health. Enrollment in VNSNY CHOICE Medicare depends on contract renewal.
This is a Medicare-related page; some of the links will take you to non-Medicare information or to a different website.
This information is not a complete description of benefits. Contact the plan for more information.
Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. Some plans are available to anyone who has both Medical Assistance from the State and Medicare. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Last updated 2/15/2017