Am I Eligible for the iCare Medicare Plan?
Eligibility Questionnaire
You must meet certain federal requirements to qualify for the iCare Medicare Plan. Check the boxes that apply to find out if you qualify for the iCare Medicare Plan.
You Qualify! You are eligible for the iCare Medicare Plan.
How do I Enroll?
It is easy. Enroll over the phone by calling us at 1-888-241-9664 (TTY: 1-800-947-3529), from 8:00 a.m. to 8:00 p.m. Our Customer Service department will let you speak with one of our licenced insurance agents about the iCare Medicare Plan (HMO SNP), who will help you to enroll in our plan.
Or you can simply complete our Enrollment Form and after your eligibility has been determined, we will send you a membership packet explaining how to access your iCare Medicare Plan benefits and services.
For more information contact our Customer Service department at 1-800-777-4376 (TTY 1-800-947-3529), 7 days-a-week, 8:00 a.m. to 8:00 p.m.
You must enroll in both the iCare Medicare Plan as well as a full Medicaid HMO plan (including iCare’s or another plan) to receive full benefit coverage. You can also remain in Medicaid Fee-For-Service, but you will be subject to small co-pays if you do so. To find out about a full Medicaid HMO Plan that is best for your health care needs you may contact the Medicaid Managed Care Enrollment Specialist at 1-800-291-2002 (TTY: 1-800-325-0778).
iCare Medicare Plan 2012 Disclaimers* - Independent Care Health Plan (iCare) is a Coordinated Care plan with a Medicare Advantage contract and a contract with the Wisconsin Medicaid program. To be eligible for the iCare Medicare Plan, you must live in our service area of Brown, Kenosha, Manitowoc, Milwaukee, Outagamie, Ozaukee, Racine, Sheboygan, Walworth, Washington, Waukesha, Waupaca and Winnebago counties. In addition, you must be eligible for Medicare and Medicaid benefits or eligible for Medicare cost-sharing assistance under Medicaid. Individuals must have both Part A and Part B to enroll. (Your Medicare Part B premium is paid by the State.) You cannot have End-Stage Renal Disease (exceptions may apply). You must also enroll in a full Medicaid HMO plan (including iCare’s or another plan) to receive full benefit coverage. You must receive all routine care from plan providers. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1, 2013. Please contact iCare for details. You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call: 1-800-MEDICARE (1-800- 633-4227), TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week; the Social Security Administration at 1-800-772-1213 between 7:00 am and 7:00 pm, Monday through Friday, TTY/TDD users should call 1-800-325-0778; or your State Medicaid Office. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. This plan is available to anyone who has both Medical Assistance from the State and Medicare. For more information, contact the plan. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help that you receive, please contact the plan for further details. For full information on iCare benefits, call our Customer Service Department at 1-800-777-4376 (TTY: 1-800-947-3529), from 8:00 am to 8:00 pm, 7 days a week.
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.
Sorry, you do not qualify for the iCare Medicare plan.
In order to qualify for the iCare Medicare plan you must check yes to all of the questions above. If you are at least 19 years of age, live in our service area, and receive Medicaid and Supplemental Security Income (SSI) or SSI related benefits, you are eligible for the program. Medicare beneficiaries or those enrolled in a Medicare HMO are also eligible, as long as you receive Medicaid or SSI benefits.
For more eligibility information:
Call (800)777-4376
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.



