Members

iCare FamilyCare Partnership (HMO)
Plan Overview

What is iCare Family Care Partnership (HMO)?

iCare's Family Care Partnership (HMO) is a managed care program that integrates Medicare and Medicaid services, and is designed to meet the long-term care needs of frail older adults and people who are physically or developmentally disabled.

If you become a member of iCare Family Care Partnership (HMO), you will have No Plan premium (your Medicare Part B Premium is paid by the State if you have Medicare) and No Plan deductible. If you have Medicare, you will have access to our Medicare Part D Prescription Drug benefit. If you do not have Medicare, your prescription drugs will be covered by Wisconsin Medicaid.

The iCare Family Care Partnership (HMO) is a Health Plan with a Medicare Contract. iCare also contracts with Wisconsin Medicaid.

Service Area

The service area for this plan includes: Milwaukee County, WI. You must live in this area to join the plan.

Eligibility

  • Live in the Milwaukee County service area
  • People with physical/developmental disabilities (18 years of age or older)
  • Frail elderly adults 60 years of age or older
  • Must be eligible for full Medicaid
  • Must have long-term care (LTC) service needs as determined by the State of Wisconsin Long-Term Care Functional Screen
  • Must not have End Stage Renal Disease (exceptions apply)

Member-Centered Care Teams

A circle of care provides members with extensive support services. iCare's Partnership program offers a member-centered care model, where members are part of a Team of caregivers with various skill-sets, including a nurse practitioner, registered nurse, social services coordinator, and an extensive network of other professionals. Your team is trained to assure you receive coordinated services to help you maintain your independence and remain active in the community.

Members participate in Team decision-making, in a fully integrated plan, where the Team works with your doctor for all medical and LTC supports.

Benefits & Services

The iCare Family Care Partnership (HMO) covers Medicare, Wisconsin Medicaid, and home and community-based LTC services. Member benefits include health and medical services, prescription drugs and LTC services. Most services are covered at 100 percent, except prescription drugs, where you may be responsible for a co-pay if you are on Medicare. The following are examples of services provided through the iCare Partnership program:

Long Term care services coverage

  • Home health and personal care
  • Support home care
  • Assisted living/residential care services
  • Adult day and respite care
  • Home delivered meals
  • Home modifications
  • Transportation
  • Physical, speech and occupational therapy
  • Adult diapers, gloves, and other medical supplies
  • Mental health and drug and alcohol treatment
  • Daily living skills training
  • Communication aids/interpreter
  • Employment services
  • Nursing home services

Health care services coverage

  • Health care services coverage
  • Physician services
  • Hospitalization
  • Prescription medications
  • Over-the-Counter medications
  • Dental care
  • Foot care: Podiatry
  • Hearing care
  • Vision (including glasses)
  • Hospice
  • Emergency response - If you call us with a health-related emergency, we will immediately connect you with someone who will respond to your urgent condition.
  • Prevention and early intervention - Once enrolled in our Partnership program, iCare will help keep you healthy and independent by working with public and private health and social service partners in the community. We can also provide you with information and intervention activities that prevent the risk of disability.

Can I Self-Direct My Supports?

If you choose iCare you will have the option to choose Self-Directed Supports (SDS) as a way of receiving long-term care services. Choosing SDS means making your own decisions about how and from whom you receive your long-term care services. You take the lead in managing your care, having control over resources, including finances; and taking responsibility for personal decisions and actions. Your Team can tell you more about SDS if you are interested in this option.

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. Our mailing and walk-in address is: Independent Care Health Plan, 1555 N. RiverCenter Dr., Suite 206, Milwaukee, WI 53212.

Interpreter and translation services are available free of charge.

The iCare Family Care Partnership (HMO) is a Medicare Advantage Special Needs Plan with a Medicare contract that is fully integrated with the Wisconsin Medicaid Family Care Partnership Program. iCare also contracts with the Wisconsin Department of Health Services. You can join iCare Family Care Partnership Plan (HMO) if you are an adult with a physical or developmental disability or are over the age of 60; live in the service area; financially eligible for Wisconsin Medicaid; functionally eligible as determined by the State of Wisconsin Long-Term Care Functional Screen; and if you are eligible for Medicare you must be enrolled in all the parts of Medicare for which you are eligible (Part A, Part B, and/or Part D). You cannot have End Stage Renal Disease (ESRD), with limited exceptions, such as if you develop ESRD when you are already a member of a plan that we offer, or you were a member of a different plan that was terminated. Please call the Milwaukee County Disabilities Resource Center (people under 60 years of age) at 414-289-6897 (TTY:414-289-8559) or the Aging Resource Center (ages 60 and over) at 414-289-6874 (TTY: 414-289-8591) to see if you are eligible. You must use network plan providers except in emergent or urgent care situations. If you obtain routine care from out-of-network providers, without first contacting your Team and getting prior authorization, neither Medicare, Wisconsin Medicaid or iCare Family Care Partnership (HMO) will pay for these services. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use network pharmacies. Generally, benefits are only available at iCare-contracted network pharmacies. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1, 2011. Please contact iCare for details. Premiums, co-pays, co-insurance, and deductibles may vary based upon your level of Medicaid eligibility. Please call iCare for further details. The benefit information provided herein is a brief summary, but not a comprehensive description of available benefits. Additional information about benefits is available to assist you in making a decision about your coverage. This is an advertisement; for more information contact the plan. For full information on the iCare Family Care Partnership (HMO) (e.g., routine physical exam, pharmacy, eyeglasses, dental) benefits, call our Member Services department from 8:00 a.m. to 8:00 p.m., 7 days-a-week at 1-800-777-4376 (TTY: 1-800-947-3529). For more information about Medicare benefits and services, including general information regarding the health or Part D benefit, contact 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov; TTY users should call 1-887-486-2048, 24 hours a day, 7 days a week. For more information about Wisconsin Medicaid benefits call the Department of Health Services at 1-800-362-3002 (TTY 1-888-701-1251) or visit www.dhs.wisconsin.gov/Medicaid. Or, write to iCare Family Care Partnership (HMO) at: Independent Care Health Plan, 1555 N. RiverCenter Drive, Suite 206, Milwaukee, WI 53212.

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.

 

  
 
More Forms & Publications

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.

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