Members
Rights and Responsibilities
As an iCare Member:
- You have the right to ask for an interpreter and have one provided to you during any Medicaid covered service.
- You have the right to receive the information provided in the iCare member handbook in another language or another format.
- You have the right to receive health care services as provided for in Federal and State law. All covered services must be available and accessible to you. When medically appropriate, services must be available 24 hours a day, seven days a week.
- You have the right to receive information about treatment choices including the right to request a second opinion.
- You have the right to make decisions about your health care.
- You have the right to be treated with dignity and respect.
- You have the right to be free from any form of limitation or separation used as a means of force, control, ease or "payback."
- You have civil rights. Independent Care Health Plan provides covered services to all eligible members regardless of:
- Age
- Race
- Religion
- Color
- Differing Ability
- Sex
- Sexual Orientation
- National Origin
- Marital Status
- Arrest or Conviction
- Record
- Millitary Participation
- All medically necessary covered services are available to all members.
- All services are provided in the same manner to all members.
- All persons or organizations connected with iCare who refer or recommend members for services shall do so in the same manner for all members.
- Translating or interpreting services are available for those members who need them. This service is free.
Member Information
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
- Direct Mail Postcard/2012 Additional Benefits/iCare Medicare Plan
- Direct Mail Postcard/2012 OTC/iCare Medicare Plan
- Direct Mail Postcard/2012 Walgreens/iCare Medicare Plan
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Partnership 2012
- FCP Provider Reference Manual
- First Tier, Downstream and Related Entities Fraud
- Formulary Change Notice (iCare Medicare Plan)
- Formulary Change Notice (iCare Partnership)
- Limited English Proficiency Policy/Procedures
- LIS Premium Summary Sheet 2012
- Member Handbook/BadgerCare Plus Core Plan
- Member Handbook/iCare Medicaid SSI
- Member Newsletter Summer/Fall 2011/iCare BadgerCare Plus
- Member Recertification Reminder/BadgerCare Plus Core
- 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
- Power of Attorney brochure
- Privacy Statement
- 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 BadgerCare Plus-Medicaid SSI
- Provider Directory/Pharmacy Directory/iCare Medicare Plan 2011
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Expansion Counties 2012
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Original Counties 2012
- Provider Reference Manual 2012
- Provider/Pharmacy Directory - iCare Partnership 2011
- Recertification Reminder (flyer)/BadgerCare Plus
- Report to the Community
- 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
- 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.



