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Plan Materials

MLTC Member Materials and Forms

The list below includes links to a variety of materials for VNS Health MLTC members. You can get a printed copy of any member materials by calling 1-888-867-6555 (TTY: 711), Monday–Friday, 9 am–5 pm.

Plan Information

Member Handbook

Last updated: November 6, 2020

Member Handbook Insert:
Non-Emergency Transportation is Now Covered by Medicaid

Last updated: February 21, 2024

Member Handbook Insert
New York Independent Assessor – Initial Assessment Process

Last updated: March 24, 2021

Member Handbook Insert
MLTC Will Remove Service Limits for PT, OT, and ST

Last updated: January 29, 2021

Dental Benefit Insert

Last updated: January 3, 2024

E-Notice Insert

Last updated: January 16, 2024
Provider Information

Online Provider Search Tool

Find an up-to-date list of in-network providers in your community. The search results are printable.

Provider Directory

If you need a directory in a printable format, see the PDF files below.
Forms and Personal Health Materials

CDPAS Recertification – Physician Order Form

MLTC members can have their home care service provided by a consumer directed personal care assistant through Consumer Directed Personal Assistance Services (CDPAS). The physician order form is required during the initial assessment and every six months during CDPAS recertification.
Download PDF: Form

Health Care Proxy

Authorization for Release of Health Information Form (DOH 5032)

Health Information Exchange Fact Sheet and Form

Member Rights and Responsibilities Booklet

This booklet includes information on Member Rights, Patient Self-Determination Act, Making Decisions About Your Medical Care, Planning in Advance for Your Medical Treatment and Consumer Directed Personal Assistance Statement.

Joint Notice of Privacy Practices

Notice of Non-Discrimination Practices

Member Newsletters

MLTC Member Newsletters

See current and past issues of Member Newsletter for health tips and checklists, recipes, and more.