Members
Coverage Limitations
By law, certain types of drugs or categories of drugs are not covered by Medicare Drug Plans. These drugs or categories of drugs are called "exclusions" and include:
- Nonprescription drugs, unless they are part of an approved step therapy
- Drugs when used for anorexia, weight loss, or weight gain
- Drugs when used to promote fertility
- Drugs when used for cosmetic purposes or hair growth
- Drugs when used for the symptomatic relief of cough or colds
- Prescription vitamins and mineral products, except prenatal vitamins and fluoride preparations
- Outpatient drugs for which the manufacturer seeks to require that associated tests or monitoring services be purchased exclusively from the manufacturer as a condition of sale
- Barbiturates
- Benzodiazepines
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.
Medicare
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.