EasyCare Forms and Personal Health Materials
Looking for more in-depth information about your VNS Health EasyCare (HMO) plan? You’ll find it here, along with forms and other tools and materials.
If you have questions about any of the materials listed here, call us at 1-866-414-6715, weekdays, 8 am-8 pm (TTY users, call: 711).
Note that this plan’s name changed to VNS Health EasyCare on January 1, 2023.
Forms and Personal Health Materials
Appointment of Representative Form
You may appoint a relative, friend, attorney, or anyone else whom you trust to act on your behalf. A representative who is appointed by the court or who is active in accordance with State law may also file an appeal or grievance for you. To appoint a representative you must complete an Appointment of Representative Form.
You can give us a copy of the form or letter or mail it to: VNS Health Health Plans – EasyCare 220 East 42nd Street, New York, NY 10017