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Effective January 1, 2009
Plan Overview
What is the
iCare
Medicare Plan?
The
iCare
Medicare Plan is an all-in-one health care benefits program for all eligible
Medicare beneficiaries. Independent Care
is a Health plan with a Medicare contract. We have combined health
care services provided by Medicaid and Medicare to offer you a complete
package of benefits, including the Medicare Part D Prescription Drug
program. You must enroll in both the
iCare
Medicare Plan as well as a full Medicaid HMO plan (including iCare’s
or another plan) to receive full benefit coverage. You can also remain in
Medicaid Fee-For-Service, but you will be subject to small co-pays if you do
so. To find out about a full Medicaid HMO Plan that is best for
your health care needs you may contact the Medicaid Managed Care Enrollment
Specialist at 1-800-291-2002.
Except for a small co-pay for brand-name drugs, most of these
benefits are at no cost to you. You must continue to pay your Medicare
Part B premium if not otherwise paid for under Medicaid or by another third
party.
Visits to your doctor and dentist, emergency
care, hospital services, mental health and substance abuse treatment,
medical equipment and other services are covered at 100 percent. Our care
management benefits make us different, providing you with a personal level
of care and the ability to reach us 24 hours-a-day.
iCare
Medicare Plan Features
Provider Network - The
iCare
Medicare Plan offers you a wide choice of providers to choose from. We have
over 2,600 providers in our network. The iCare
Medicare Plan provides medical services through Medicare-certified doctors, health care professionals, hospitals and other health care
facilities. You are not required to choose a primary care provider (PCP),
but we strongly encourage your doing so. You must receive all routine
care from plan providers. If you obtain routine care from non-plan
providers, neither Medicare nor iCare
Medicare Plan will be responsible for the costs.
Multi-Level Care Management - We look at your
medical and social services needs. Care management recognizes there are
medical as well as non-medical needs that have to be addressed in order to
maximize your health.
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Care Coordinators and Care Managers.
When you join the iCare
Medicare Plan, you will be assigned a care coordinator or care manager.
We will call you to perform
an assessment, but feel free to call and schedule an appointment.
Your Care Coordinator works with you and your family to help you get the
medical care and community services information you need. This person
provides resources to connect you with available social services. We
also offer information and referrals to programs designed to help you
get the most out of your health care coverage, such as exercise or
smoking cessation programs.
Member Services - Our Member Services
department is your link to everything you want to know about
iCare. You can contact our Member
Services department at 1-800-777-4376 (TTY
1-800-947-3529), 7 days-a-week, 8:00 a.m. to 8:00 p.m.
Benefits Include:
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No premium, no deductible,
no co-pay for medically necessary services
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Zero dollar co-pay for generic
prescription drugs (up to $2,700 annual limit,
then your generic drug co-pay will
increase to $1.10 or $2.40 depending upon your level of income.)
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Free transportation to and from your
medical/dental appointments (limits apply)
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Extra Value Benefits
Independent Care contracts with the
Federal government to offer this Medicare Advantage program.
Independent Care's contract with the Centers for Medicare and
Medicaid Services (CMS) is renewed on a yearly basis and benefit coverage
beyond the end of the current contract year is not guaranteed.
Benefits, formulary, pharmacy, network premium and/or copayments/co-insurance
may change on January 1, 2010. Please contact
iCare for
details.
Notice for Potential Contract
Termination
Independent Care Health Plan (iCare)
is authorized by law to refuse to renew its contract with the Centers for
Medicare and Medicaid Services (CMS). CMS may also refuse to renew its
contract with iCare.
If the contract between
iCare and CMS is not
renewed or terminated, this may result in the termination of your enrollment
in the iCare
Medicare Plan. In addition,
iCare
may reduce its service area and have the right to no longer offer services
in the area where the beneficiary resides.
If this occurs, you will receive another notice and instructions for
continuity of care.
Contact Us
Questions? Call us at 1-800-777-4376 (TTY
1-800-947-3529), 7 days-a-week, 8:00 a.m. to 8:00 p.m.
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