Members

2012 iCare Family Care Partnership
Prescription Drug Information

Are My Medications Covered?

iCare Family Care Partnership (HMO SNP) covers Wisconsin Medicaid drugs, and people with Medicare also receive coverage for Medicare Part B and Medicare Part D prescription drugs. The iCare Family Care Partnership (HMO SNP) covers thousands of prescription drugs.

What is the Cost to Fill My Medicare Part D Prescriptions? (Medicare Members Only)

Initial Coverage

Generic Prescription Drugs (including brand drugs treated as generics):

  • Co-pays are $0, $1.10 or $2.60 (depending upon your income level or institutional status)

Brand Name Prescription drugs:

  • Co-pays are $0, $3.30 or $6.50 (depending upon your income level or institutional status)

Members who only have Medicaid coverage do not have a copayment for generic or brand drugs.

Catastrophic Coverage:

After your yearly out-of-pocket Part D drug costs reach $4,700
  • $0 Co-pay

Extra Help (Low Income Subsidy)

Since you must have Wisconsin Medicaid to enroll in Partnership, you will qualify for extra help with Medicare prescription drug plan costs, and your premium and costs at the pharmacy will be lower. Your monthly premium will be $0. When you join Partnership, Medicare will tell us how much extra help you are getting with costs at the pharmacy. Then we will let you know the amount you will pay. If you are not getting this extra help you can see if you qualify by calling:

  • 1-800-MEDICARE 91-800-633-4227). 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 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call 1-800-325-0778 or
  • Wisconsin Medicaid at 1-800-362-3002. TTY users should call 1-800-362-3002.

What if you believe you have qualified for extra help and you believe that you are paying an incorrect co-payment amount?

If you believe you have qualified for extra help and you believe that you are paying an incorrect co-payment amount when you get your prescription at a pharmacy, our Plan has established a process that will allow you to either request assistance in obtaining evidence of your proper co-payment level, or, if you already have the evidence, to provide this evidence to us. Independent Care Health Plan follows CMS' Best Available Evidence policy (BAE). Please contact Member Services at 1-800-777-4376 (TTY 1-800-947-3529), 7 days-a-week, 8:00 am to 8:00 pm, for assistance with obtaining evidence of your proper co-payment level or for more information on providing this information to us. When we receive the evidence showing your co-payment level, we will update our system or implement other procedures so that you can pay the correct co-payment when you get your next prescription at the pharmacy. Please be assured that if you overpay your co-payment, we will reimburse you. Either we will forward a check to you in the amount of your overpayment or we will offset future co-payments. Of course, if the pharmacy hasn’t collected a co-payment from you and is carrying your co-payment as a debt owed by you, we may make the payment directly to the pharmacy. If a State paid on your behalf, we may make payment directly to the State. Please contact Member Services if you have questions.

Plan Transition Process

Click here to see our plan transition process. This will tell you how iCare will help if your present prescription drug is not on the iCare Partnership formulary or it is taken off of the iCare formulary after you become a member.

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

 

  
  
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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.

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