Members

iCare Medicare Plan - Northeast

Plan Overview

What is the iCare Medicare Plan-Northeast?

The iCare Medicare Plan-Northeast is a health care benefits program for all eligible Medicare beneficiaries. Independent Care is a Health plan with a Medicare contract.

When you join our Plan, you will have a zero dollar monthly Plan premium, and a one dollar generic prescription drug co-pay for a one-month supply ($1 generic co-pay applies until you reach the $2,700 annual limit, then you pay 100% until your yearly out-of-pocket drug costs reach $4,350, then you pay the greater of a $2.40 co-pay or 5% coinsurance.) You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. We provide you with all of the benefits offered by the Original Medicare Plan as well as attentive customer service.

iCare Medicare Plan - Northeast 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-Northeast 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-Northeast will be responsible for the costs.

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 for medically necessary services
  • One dollar co-pay for generic prescription drugs (One dollar generic co-pay applies until you reach the $2,700 annual limit, then you pay 100% until your yearly out-of-pocket drug costs reach $4,350, then you pay the greater of a $2.40 co-pay or 5% coinsurance.)

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-Northeast. 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.

Disenrolling

If you choose to leave the iCare Medicare Plan-NE, here are some items to remember: Please remember, if you disenroll and do not enroll in another Medicare Advantage Plan with prescription drug coverage (or Medicare Prescription Drug Plan) or if you do not obtain other creditable coverage as good as Medicare, you may have to pay a penalty if you enroll in Medicare prescription drug coverage in the future.

Please be patient. It will take a few weeks for us to process your disenrollment and update Medicare’s records. If your doctors need to send Medicare claims, you may want to tell them that you just disenrolled from the Care Medicare Plan and there may be a short delay in updating your records.

A NOTE ABOUT MEDIGAP RIGHTS: If you will be changing to the Original Medicare Plan you might have a special temporary right to buy a Medigap policy, also known as Medicare supplement insurance, even if you have health problems. For example, if you are age 65 or older and you enrolled in Medicare Part B within the past 6 months or if you move out of the service area, you may have this special right. Federal law requires the protections described above. Your State may have laws that provide more Medigap protections. For information, you can contact the Wisconsin Board on Aging and Long-Term Care at 1402 Pankratz Street, Suite 111, Madison, WI, 53704 or call the Medigap Helpline, a service of the Board on Aging and Long-Term Care at 1-800-242-1060 or the Medicare Counseling Service, provided by Southeastern Wisconsin Area Agency on Aging at 1-877-333-0202. You can also find the website for the Wisconsin Board on Aging and Long-Term Care at www.medicare.gov on the web. Under "Search Tools," select "Helpful Phone Numbers and Websites." The state of Wisconsin also has Ombuds who can help you with questions or problems. Call 1-800-760-0001 to speak to an Ombuds.

Call 1-800-MEDICARE (1-800-633-4227) for more information about trial periods. TTY users should call 1-877-486-2048. If you need any help, please call us at call (800) 777-4376, Monday through Friday, 8:00 a.m. to 8:00 p.m. TTY users should call (800) 947-3529. We are open Monday through Friday, 8:00 a.m. to 8:00 p.m. Thank you.

Involuntarily Disenrollment

If any of the following situations occur, we will end your membership in our Plan:

  • If you do not stay continuously enrolled in Medicare A and B.
  • If you are no longer considered eligible for both Medicare and full Medicaid.
  • If you move out of the service area or are away from the service area for more than 6 months you cannot remain a member of our Plan. And we must end your membership (“disenroll” you)”. If you plan to move or take a long trip, please call Member Services to find out if the place you are moving to or traveling to is in our Plan’s service area.
  • If you knowingly falsify or withhold information about other parties that provide reimbursement for your prescription drug coverage.
  • If you intentionally give us incorrect information on your enrollment request that would affect your eligibility to enroll in our Plan.
  • If you behave in a way that is disruptive, to the extent that you continued enrollment seriously impairs our ability to arrange or provide medical care for you or for others who are members of our Plan. We cannot make you leave our Plan for this reason unless we get permission first from Medicare.

If you let someone else use your plan membership card to get medical care. If you are disenrolled for this reason, CMS may refer your case to the Inspector General for additional investigation.

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.

 

 
 
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.

Contact Us