Members
2012 iCare Family Care Partnership
Am I Eligible?
- Evidence of Coverage
- Provider Manual
- Provider/Pharmacy Directory
- Annual Notice of Change (ANOC)
- Comprehensive Formulary
- LIS Premium Summary Sheet
- Summary of Benefits
You can join iCare Family Care Partnership Plan (HMO SNP):
- If you are an adult with a physical or developmental disability or are 60 years of age or over
- Live in our service area of Kenosha, Milwaukee or Racine Counties
- Financially eligible for Wisconsin Medicaid
- Functionally eligible as determined by the State of Wisconsin Long-Term Care Functional Screen
- If you are eligible for Medicare you must be enrolled in all the parts of Medicare for which you are eligible (Part A, Part B, and/or Part D)
- You cannot have End Stage Renal Disease (ESRD), with limited exceptions, such as if you develop ESRD when you are already a member of a plan that we offer, or you were a member of a different plan that was terminated.
Please call the Milwaukee County Disabilities Resource Center (people under 60 years of age) at 414-289-6897 (TTY: 414-289-8559) or the Aging Resource Center (ages 60 and over) at 414-289-6874 (TTY: 414-289-8591) to see if you are eligible.
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.
iCare Family Care Partnership 2012 Disclaimers: The iCare Family Care Partnership (HMO SNP) is a Coordinated Care plan with a Medicare Advantage contract and a contract with the Wisconsin Medicaid program. You must use network plan providers except in emergent or urgent care situations. If your preferred provider is not in our plan, we will seek to include them in our network. If you obtain routine care from out-of-network providers, without first contacting your care team and getting prior authorization, neither Medicare, Wisconsin Medicaid or iCare Family Care Partnership (HMO SNP) will pay for these services. You must use network pharmacies to access your prescription drug benefit, except under non-routine circumstances when you cannot reasonably use network pharmacies. Generally, benefits are only available at iCare-contracted network pharmacies. 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. 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. This plan is available to anyone who has both Medical Assistance from the State and Medicare. For more information about Medicare benefits and services, including general information regarding the health or Part D benefit, contact 1-800-MEDICARE (1-800-633-4227) or visit www.Medicare.gov; TTY users should call 1-887-486-2048, 24 hours a day, 7 days a week. For more information about Wisconsin Medicaid benefits call the Department of Health Services at 1-800-362-3002 (TTY 1-888-701-1251) or visit www.dhs.wisconsin.gov/Medicaid. For more information about long-term care options available to you in Milwaukee County, please call the Milwaukee County Disabilities Resource Center (people under 60 years of age) at 414-289-6897 (TTY: 414-289-8559) or the Aging Resource Center (ages 60 and over) at 414-289-6874 (TTY: 414-289-8591). The Resource Center can also assist you with information about eligibility and enrollment.
Last Updated: 11/03/2011
Family Care Partnership
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
- Emergency Room Brochure
- Enrollment Form/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Medicare Plan 2012
- Evidence of Coverage/iCare Partnership 2012
- Family Care Partnership Provider Application
- FCP Provider Reference Manual
- First Tier, Downstream and Related Entities Fraud
- Formulary Change Notice (iCare Medicare Plan)
- Formulary Change Notice (iCare Partnership)
- HCFA Claim Required Fields
- Limited English Proficiency Policy/Procedures
- LIS Premium Summary Sheet 2012
- Member Handbook/BadgerCare Plus Core Plan
- Member Handbook/iCare Medicaid SSI
- Member Recertification Reminder/BadgerCare Plus Core
- Notice of Privacy Practices
- 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
- Plan Comparisons/iCare Partnership 2012
- Power of Attorney brochure
- Primary & Acute Care Information Form
- Prior Authorization List 4/19/12
- Prior Authorization List 4/19/12 pdf
- 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 Medicaid SSI-BadgerCare Plus_Expansion Counties
- Provider Directory/iCare Medicaid SSI-BadgerCare Plus_Original Counties
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Expansion Counties 2012
- Provider Directory/Pharmacy Directory/iCare Medicare Plan Original Counties 2012
- Provider Information Form (other than Partnership Program)
- Provider Reference Manual 2012
- Provider/Pharmacy Directory - iCare Partnership 2012
- Recertification Reminder (flyer)/BadgerCare Plus
- 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
- UB Claim Required Fields
- 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.
