Members
iCare FamilyCare Partnership (HMO)
Prescription Drug Information
- Evidence of Coverage (EOC)/Member Handbook
- Provider Directory
- Pharmacy Directory
- Comprehensive Formulary
- Summary of Benefits
- LIS Premium Summary Chart
Are My Medications Covered?
iCare Family Care Partnership (HMO) covers Wisconsin Medicaid drugs, and people with Medicare also receive coverage for Medicare Part B and Medicare Part D prescription drugs. The iCare Family Care Partnership (HMO) covers thousands of prescription drugs.
What is the Cost to Fill My Medicare Part D Prescriptions? (Medicare Members Only)
iCare Family Care Partnership (HMO) members have No Plan Premium (your Medicare Part B Premium is paid by the State if you have Medicare) and No Plan Deductible.
Initial Coverage
Generic Prescription Drugs (including brand drugs treated as generics):
- Co-pays are $1.10 or $2.50 (depending upon your income level)
Brand Name Prescription drugs:
- Co-pays are $3.30 or $6.30 (depending upon your income level)
Members who only have Medicaid coverage do not have a copayment for generic or brand drugs.
After $2,830 annual limit
Generic Prescription Drugs (including brand drugs treated as generics):
- Co-pays are $1.10 or $2.50 (depending upon your income level)
Brand Name Prescription drugs:
- Co-pays are $3.30 or $6.30 (depending upon your income level)
Members who only have Medicaid coverage do not have a copayment for generic or brand drugs.
Catastrophic Coversage:
- $0 Co-pay
Extra Help (Low Income Subsidy)
Since you must have Wisconsin Medicaid to enroll in Partnership, you will qualify for extra help with Medicare prescription drug plan costs, and your premium and costs at the pharmacy will be lower. Your monthly premium will be $0. When you join Partnership, Medicare will tell us how much extra help you are getting with costs at the pharmacy. Then we will let you know the amount you will pay. If you are not getting this extra help you can see if you qualify by calling:
- 1-800-MEDICARE 91-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours-a-day/7 days-a-week.
- The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778 or
- Wisconsin Medicaid at 1-800-362-3002. TTY users should call 1-800-362-3002.
What if you believe you have qualified for extra help and you believe that you are paying an incorrect co-payment amount?
If you believe you have qualified for extra help and you believe that you are paying an incorrect co-payment amount when you get your prescription at a pharmacy, our Plan has established a process that will allow you to either request assistance in obtaining evidence of your proper co-payment level, or, if you already have the evidence, to provide this evidence to us. Independent Care Health Plan follows CMS' Best Available Evidence policy (BAE). Please contact Member Services at 1-800-777-4376 (TTY 1-800-947-3529), 7 days-a-week, 8:00 am to 8:00 pm, for assistance with obtaining evidence of your proper co-payment level or for more information on providing this information to us. When we receive the evidence showing your co-payment level, we will update our system or implement other procedures so that you can pay the correct co-payment when you get your next prescription at the pharmacy. Please be assured that if you overpay your co-payment, we will reimburse you. Either we will forward a check to you in the amount of your overpayment or we will offset future co-payments. Of course, if the pharmacy hasn't collected a co-payment from you and is carrying your co-payment as a debt owed by you, we may make the payment directly to the pharmacy. If a state paid on your behalf, we may make payment directly to the state. Please contact Member Services if you have questions.
Plan Transition Process
Click here to see our plan transition process. This will tell you how iCare will help if your present prescription drug is not on the iCare Partnership formulary or it is taken off of the iCare formulary after you become a member.
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. Our mailing and walk-in address is: Independent Care Health Plan, 1555 N. RiverCenter Dr., Suite 206, Milwaukee, WI 53212.
FamilyCare Partnership
PDF Resources
- Abridged Formulary/iCare Medicare Plan 2010
- Abridged Formulary/iCare Partnership 2010
- Anti-Smoking Quit Line (English)
- Anti-Smoking Quit Line (Spanish)
- BadgerCare Plus Core Member Recertification Reminder
- CMS Appointment of Representative Form
- Community Activity Facilities and Programs
- Comprehensive Formulary/iCare Medicare Plan 2010
- Comprehensive Formulary/iCare Partnership 2010
- Coverage Determination Request Form
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2010
- Evidence of Coverage (EOC)/Member Handbook - 2010 iCare Partnership
- Evidence of Coverage/ANOC/iCare Medicare Plan 2010
- Fraud, Waste and Abuse Compliance Training 2010
- Greivance and Appeals Process/iCare Partnership 2010
- iCare BadgerCare Plus Program Brochure
- iCare BadgerCare Plus Program Brochure/Hmong
- iCare Medicaid SSI Program Brochure
- iCare Medicaid SSI Program Brochure/Hmong
- iCare Medicaid SSI Program Brochure/Spanish
- iCare Medicare Plan 2010 Program Brochure
- iCare Medicare Plan 2010 Program Brochure/Spanish
- iCare Road to Independence Video Challenge Package
- iCare/Independent Care Health Plan Scholarship
- Letter of Medical Necessity
- Limited English Proficiency Policy/Procedures
- LIS 2010 Premium Summary Sheet
- Medicare Part D Coverage Determination Form
- Medication Request Form - Partnership Medicaid
- Member Handbook/iCare BadgerCare Plus
- Member Handbook/iCare BadgerCare Plus Core Plan
- Member Handbook/iCare BadgerCare Plus Core Plan/Spanish
- Member Handbook/iCare BadgerCare Plus/Hmong
- Member Handbook/iCare BadgerCare Plus/Spanish
- Member Handbook/iCare Medicaid SSI
- Member Handbook/iCare Medicaid SSI/Spanish
- Notice of Formulary Change/iCare Medicare SNP 2010
- Notice of Formulary Change/iCare Partnership 2010
- Over-the-Counter Drug Program Catalog/iCare Medicare Plan 2010
- Over-the-Counter Drug Program Catalog/iCare Medicare Plan 2010/Spanish
- Over-the-Counter Drug Program Catalog/iCare Partnership Plan 2010
- Parental Consent Form
- Partnership Program Brochure/iCare 2010
- Pharmacy Directory/iCare Medicare Plan/iCare Partnership 2010
- Pharmacy Listing/iCare Medicare Plan 2010
- Pharmacy Listing/iCare Partnership 2010
- Plan Comparison brochure/iCare Partnership 2010
- Power of Attorney brochure
- Prior Authorization Criteria/iCare Medicare SNP 2010
- Prior Authorization Criteria/iCare Partnership 2010
- Privacy Statement
- Provider Directory Supplement/BadgerCare Plus
- Provider Directory/iCare BadgerCare Plus-Medicaid SSI
- Provider Directory/iCare BadgerCare Plus-Medicaid SSI/Spanish
- Provider Directory/iCare Medicare Plan 2010
- Provider Directory/iCare Partnership 2010
- Provider Manual
- Provider Newsletter Fall 2008
- Report to the Community
- Road to Independence Video Challenge Flyer
- Self-Directed Supports Brochure/iCare Partnership 2010
- Self-Directed Supports Guide/iCare Partnership 2010
- Step Therapy Prescription Drug Criteria/iCare Medicare SNP 2010
- Step Therapy Prescription Drug Criteria/iCare Partnership 2010
- Summary of Benefits/iCare Medicare Plan 2010
- Summary of Benefits/iCare Partnership 2010
- Transition Process
Call 1-800-777-4376 (TTY: 1-800-947-3529), from 8:00 a.m to 8:00 p.m.,
7 days-a-week, for further information about iCare.