VillageCareMAX Members: Eye, Foot, and Hearing Care at Home

VillageCareMAX is a health plan that is part of VillageCare, an organization that has provided care to older adults and people with chronic diseases and conditions for more than 45 years. VillageCareMAX helps Medicaid and Medicare eligible individuals live safely and independently at home through managed long-term care and Medicare Advantage plans, with care coordination that supports quality of life. Its plans include a Managed Long-Term Care (MLTC) Plan, the Medicare Total Advantage Plan (HMO D-SNP), the Medicare Health Advantage Plan (HMO D-SNP), and the Medicare Select Advantage Plan (HMO). Because many members find travel difficult, Aspire Healthcare Solutions complements VillageCareMAX’s support by bringing eye care, foot care, hearing care, and lab collection directly to members at home.

The VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) is a Medicaid Advantage Plus plan for people who have both Medicare and Medicaid and need community-based long-term care services. It covers Medicare benefits together with Medicaid long-term care services in one plan, and VillageCareMAX lists extra benefits such as dental, vision, and hearing coverage, routine transportation, acupuncture, a fitness membership, and an over-the-counter benefit. Some supplemental benefits are available only to members who meet specific chronic condition criteria. Cost sharing can vary based on the member’s level of Medicaid and Extra Help. The plan’s materials explain all benefits in detail. Aspire Healthcare Solutions brings specialty care to Medicare Total Advantage members at home.

Yes. VillageCareMAX lists dental, eye, and foot care among the long-term care benefits covered by its Managed Long-Term Care Plan, along with in-home care, medical supplies and equipment, a personal emergency response system, adult day health care, and consumer directed personal assistance. As with any managed long-term care plan, these services are generally provided when medically necessary, are usually arranged through the member’s care plan, and may require prior authorization. The member’s care manager and plan materials are the best sources for how each service is approved. Aspire Healthcare Solutions provides mobile optometry and podiatry at home, including eye exams, retinal imaging, glasses, diabetic foot care, treatment for foot pain, and orthotics.

The Medicare Health Advantage Plan (HMO D-SNP) is a Special Needs Plan for members who have both Medicare and Medicaid, offering services and extra benefits at little or no cost, including dental, vision, and hearing coverage and routine transportation. The Medicare Select Advantage Plan (HMO) is a Medicare Advantage prescription drug plan for members who have Medicare and are eligible for Extra Help. It includes low-cost prescription drug coverage, dental, vision, and hearing coverage, diabetic supplies, and an over-the-counter benefit. Both plans are HMO plans that generally use a network of participating providers, and some services may require a referral or prior authorization. Your plan materials explain your specific benefits. Aspire Healthcare Solutions provides at-home specialty care for members of either plan.

VillageCareMAX’s Medicare plans include hearing coverage, and the Medicare Select Advantage Plan’s over-the-counter benefit lists over-the-counter hearing aids among the eligible items. For members of the Managed Long-Term Care Plan, audiology and hearing aids are part of New York’s managed long-term care benefit package. The details, including which providers can be used, how often hearing aids are covered, and whether prior authorization is needed, depend on the specific plan. Reviewing your plan materials or calling VillageCareMAX Member Services is the best way to confirm your benefits. Aspire Healthcare Solutions offers at-home hearing evaluations, hearing aid fittings, and ear wax removal, giving members a comfortable way to address hearing loss without leaving home.