Members
2012 iCare Family Care Partnership
Plan Transition Process
- Evidence of Coverage
- Provider Manual
- Provider/Pharmacy Directory
- Annual Notice of Change (ANOC)
- Comprehensive Formulary
- LIS Premium Summary Sheet
- Summary of Benefits
What do I do before I can talk to my doctor about changing my drugs or requesting an exception?
As a new or continuing member in our plan you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan. For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 30-day supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. After your first 30-day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days.
If you are a resident of a long-term care facility, we will cover a temporary 31-day transition supply (unless you have a prescription written for fewer days). We will cover more than one refill of these drugs for the first 90 days you are a member of our plan. If you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a 31-day emergency supply of that drug (unless you have a prescription for fewer days) while you pursue a formulary exception.
As a continuing member in the plan, we will also cover an emergency supply of medication if you are experiencing a level of care change. This may include unplanned changes in treatment settings such as being discharged from a hospital or being admitted to a long-term care facility. For each of your drugs that is not on our formulary or for situations where your ability to get your drugs is limited, we will cover up to a temporary 30-day supply (up to a 31-day supply if you are a resident of a long-term facility), while you are waiting for an exception request to be processed.
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.
Last Updated: 11/03/2011
Family Care Partnership
PDF Resources
Listing of CMS approved iCare Medicare publications, Medicaid publications, third-party preventive health brochures.
- Abridged Formulary/iCare Medicare Plan 2012
- Abridged Formulary/iCare Partnership 2012
- Annual Notice of Change (ANOC)/iCare Medicare Plan 2012
- Annual Notice of Change (ANOC)/iCare Partnership 2012
- Anti-Smoking Quit Line (English)
- Anti-Smoking Quit Line (Spanish)
- Caregiver Background Check Policy
- Claim Form LTC Professional Services - Trizetto
- Claim Form LTC Residential Services - Trizetto
- CMS Appointment of Representative Form
- Comprehensive Formulary/iCare Medicare Plan 2012
- Comprehensive Formulary/iCare Partnership 2012
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Partnership 2012
- Family Care Partnership Provider Application
- FCP Provider Reference Manual
- First Tier, Downstream and Related Entities Fraud
- Formulary Change Notice (iCare Medicare Plan)
- Formulary Change Notice (iCare Partnership)
- HCFA Claim Required Fields
- Limited English Proficiency Policy/Procedures
- LIS Premium Summary Sheet 2012
- Member Handbook/BadgerCare Plus Core Plan
- Member Handbook/iCare Medicaid SSI
- Member Recertification Reminder/BadgerCare Plus Core
- Notice of Privacy Practices
- Part D Coverage Determination Request Form
- Part D Prior Authorization Criteria/iCare Medicare Plan 2012
- Part D Prior Authorization Criteria/iCare Partnership 2012
- Part D Redetermination Request Form
- Pharmacy Listing/iCare Medicare Plan 2012
- Pharmacy Listing/iCare Partnership 2012
- Plan Comparisons/iCare Partnership 2012
- Power of Attorney brochure
- Primary & Acute Care Information Form
- Prior Authorization List 4/19/12
- Prior Authorization List 4/19/12 pdf
- Program Brochure/Hmong/iCare Medicaid SSI
- Program Brochure/iCare BadgerCare Plus
- Program Brochure/iCare Medicaid SSI
- Program Brochure/iCare Partnership
- Program Brochure/Spanish/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Medicaid SSI
- Program Overview (Spanish)/iCare Partnership
- Provider Directory/iCare Medicaid SSI-BadgerCare Plus_Expansion Counties
- Provider Directory/iCare Medicaid SSI-BadgerCare Plus_Original Counties
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Expansion Counties 2012
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Original Counties 2012
- Provider Information Form (other than Partnership Program)
- Provider Reference Manual 2012
- Provider/Pharmacy Directory - iCare Partnership 2012
- Recertification Reminder (flyer)/BadgerCare Plus
- Self-Directed Supports Program Overview/iCare Partnership
- Step Therapy Prescription Drug Criteria/iCare Medicare Plan 2012
- Step Therapy Prescription Drug Criteria/iCare Partnership 2012
- Summary of Benefits/iCare Medicare Plan 2012
- Summary of Benefits/iCare Partnership 2012
- Transition Process
- UB Claim Required Fields
- Value to the Family
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.
