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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 with
physical, developmental or emotional disabilities. iCare
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 Medicaid SSI 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 Medicaid SSI 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.
- Care Coordinators and Care Managers.
When you join the iCare
Medicare Plan, you will be assigned a care coordinator or care manager.
Call your Care Coordinator after you join
iCare to
get a health assessment. This person works with you and your family to help you get the medical
care and community services information you need. Your care coordinator
can help you choose a health care support group, a specific community
center or group housing program in your area. 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.
- Nurse Case Managers.
Nurse case managers work with
iCare staff when dealing with complex
medical, behavioral or social needs. The care coordinator or care
manager will continue to work with you while the nurse case manager is
helping out.
- Intervention and Outreach.
If you are struggling with mental health issues or substance abuse,
iCare’s
intervention specialist may provide support for behavioral change and
assistance locating community resources. Our health outreach works with
members with special needs and assists them in accessing preventive
services.
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:
- No premium, no deductible,
no co-pay for medically necessary services
- Zero dollar co-pay for generic
prescription drugs (up to $2,400 annual limit)
- Free transportation to and from your
medical/dental appointments (limits apply)
- 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, 2008. 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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