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Plan Materials

VNS Health MLTC Forms & Materials

Looking for more in-depth information about the VNS Health MLTC health plan? You’ll find it here. If you have questions about any of the materials listed here, call Member Services at 1-855-282-4642 (TTY: 711), Monday – Friday, 9 am – 5 pm.

Plan Information

Member Handbook

Member Handbook Insert:
New York Independent Assessor – Initial Assessment Process

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

Provider Directory

Online Provider Search Tool

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

Provider Directory (PDF)

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

Authorization for Release of Health Information Form (DOH 5032)

Authorization for Access to Patient/Member Information Through a Health Information Exchange Organization

Health Care Proxy

Download PDF: English Spanish Chinese Russian

Member Rights and Responsibilities Booklet

Includes information on Member Bill of Rights and Responsibilities, Patient Self-Determination Policies, Making Decisions About Your Medical Care Planning in Advance For Your Medical Treatment

Notice of Privacy Practices

Notice of Non-Discrimination Practices

Plan Brochure

VNS Health MLTC Plan Brochure