Members

iCare BadgerCare Plus


Welcome

As a member of iCare BadgerCare Plus, you should get all your health care from doctors and hospitals in the iCare network. You can go to www.iCarewi.org/FindDoctor/ or refer to your iCare Provider Directory for a list of providers. You may also call Customer Service at 1-800-777-4376 and request a hard-copy of the Provider Directory if you do not have one. Providers not accepting new patients are marked in the Provider Directory.

IMPORTANT TELEPHONE NUMBERS

  • Customer Service
    • 1-800-777-4376 TDD/TTY 1-800-947-3529
      Call 24 hours a day, 7 days a week
  • Nurse Advice Line
    • 1-800-679-9874
      Call 24 hours-a-day, 7 days-a-week
  • Interpreter Services
    • English – For help to translate or understand this, please call 1-800-777-4376 (TTY 1-800-947-3529)
    • Spanish – Si necesita ayuda para traducir o entender este texto, por favor llame al teléfono 1-800-777-4376 (TTY 1-800-947-3529)
    • Russian – Если вам не всё понятно в этом документе, позвоните по телефону 1-800-777-4376 (TTY 1-800-947-3529)
    • Hmong – Yog xav tau kev pab txhais cov ntaub ntawv no kom koj totaub, hu rau 1-800-777-4376 (TTY 1-800-947-3529)
    • Interpreter services are provided free of charge to you

Transportation

Non-emergency medical transportation (NEMT) is available through the DHS NEMT manager. The NEMT manager arranges and pays for rides to covered services for members who have no other way to receive a ride. Non-emergency medical transportation can include rides using:

  • Public transportation, such as a city bus
  • Non-emergency ambulances
  • Specialized medical vehicles
  • Other types of vehicles, depending on a member’s medical and transportation needs

Additionally, if you use your own private vehicle for rides to and from your covered health care appointments, you may be eligible for mileage reimbursement.

You must schedule routine rides at least two business days before your appointment. You can schedule a routine ride by calling the NEMT manager at 1-866-907-1493 (or TTY 1-800-855-2880), Monday through Friday, from 7:00 a.m. until 6:00 p.m. You may also schedule rides for urgent appointments. A ride to an urgent appointment will be provided in three hours or less.

USING YOUR FORWARDHEALTH ID CARD

Your ForwardHealth ID card is the card you will use to get your BadgerCare Plus benefits. Your ForwardHealth ID card is different from your HMO card. Always carry your ForwardHealth ID card with you, and show it every time you go to the doctor or hospital and every time you get a prescription filled. You may have problems getting health care or prescriptions if you do not have your card with you. Also bring any other health insurance cards you may have. This could include any ID card from your HMO or other service providers.

CHOOSING A PRIMARY CARE PHYSICIAN

When you need care, it is important to call your primary care physician first. It is important to choose a primary care physician to manage all your health care. You can choose a primary care physician from the list of doctors accepting new patients, as marked in the iCare Provider Directory. HMO doctors are sensitive to the needs of many cultures. To choose a primary care physician or to change primary care physicians, call our Customer Service Department at 1-800-777-4376. Your primary care physician will help you decide if you need to see another doctor or specialist and, if appropriate, give you a referral. Remember, you must get approval from your primary care physician before you see another doctor. Women may see a women’s health specialist, such as an Obstetrician and Gynecologist (OB/GYN) or nurse midwife, without a referral in addition to choosing from their primary care physician.

CARE EVALUATION/HEALTH NEEDS ASSESSMENT (BADGERCARE PLUS CHILDLESS ADULTS)

As a member of iCare, you may be asked to talk with a trained staff member about your health care needs. Your HMO will contact you within the first 60 days of your being enrolled with iCare to schedule a time to talk about your medical history and the care you need. It is very important that you talk with your HMO so that you can get the care and services you need. If you have questions or would like to contact iCare directly to schedule a time to talk about your health care needs, please call 1-800-777-4376.

ACCESSING THE CARE YOU NEED

Emergency Care

Emergency care is care needed right away. Some examples are:

  • Choking
  • Convulsions
  • Prolonged or repeated seizures
  • Serious broken bones
  • Severe burns
  • Severe pain
  • Severe or unusual bleeding
  • Suspected heart attack
  • Suspected poisoning
  • Suspected stroke
  • Trouble breathing
  • Unconsciousness

If you need emergency care, try to go to an iCare provider for help. If your condition cannot wait, go to the nearest provider (hospital, doctor, or clinic). Call 911 or your local police or fire department emergency services if the emergency is very severe and you are unable to get to the nearest provider.

If you must go to a non-iCare hospital or provider, call iCare at 1-800-777-4376 as soon as you can and tell us what happened.

Remember, hospital emergency rooms are for true emergencies only. Unless you have a true emergency, call your doctor or our 24-hour emergency number at 1-800-777-4376 before you go to the emergency room. If you do not know if your illness or injury is an emergency, call our Nurse Advice Line at 1-800-679-9874. Call 24 hours-a-day, 7 days-a-week. We will tell you where you can get care.

Urgent Care

Urgent care is care you need sooner than a routine doctor’s visit but it is not emergency care. Some examples of urgent care are:

  • Bruises
  • Minor burns
  • Minor cuts
  • Most broken bones
  • Most drug reactions
  • Bleeding that is not severe
  • Sprains

You must get urgent care from iCare doctors unless you first get our approval to see a non-iCare doctor. Do not go to a hospital emergency room for urgent care unless you get approval from iCare first.

Care When You Are Away From Home

Follow these rules if you need medical care but are too far away from home to go to your regular primary care physician or clinic:

  • For true emergencies, go to the nearest hospital, clinic, or doctor. Call iCare at 1-800-777-4376 as soon as you can to tell us what happened.
  • For urgent or routine care away from home, you must first get approval from us to go to a different doctor, clinic or hospital. This includes children who are spending time away from home with a parent or relative. Call us at 1-800-777-4376 for approval to go to a different doctor, clinic or hospital.

Care During Pregnancy and Delivery

If you become pregnant, please let iCare and your income maintenance (IM) agency know right away, so you can get the extra care you need. You do not have copayments when you are pregnant.

You must go to an iCare hospital to have your baby. Talk to your iCare doctor to make sure you know which hospital you are to go to when it is time to have your baby. Do not go out of area to have your baby unless you have iCare approval. Your iCare doctor knows your history and is the best doctor to help you.

Also, talk to your doctor if you plan to travel in your last month of pregnancy. We want you to have a healthy birth and a good birthing experience, so it may not be a good time for you to be traveling.

Dental Services

Independent Care Health Plan provides all covered dental services in Kenosha, Milwaukee, Ozaukee, Racine, Washington, and Waukesha counties, but you must go to an iCare dentist. See the iCare Medicaid SSI/BadgerCare Plus Provider Directory or call Customer Service at 1-800-777-4376 for the names of our dentists.

If you live in a county that is not listed, you may get dental services from any dentist who will accept your ForwardHealth ID card. Your dental services are provided by the State, not iCare.

As a member of iCare, you have the right to a routine dental appointment within 90 days of your request either in writing or over the phone to the Customer Service Department. If you have a dental emergency, you have the right to obtain treatment within 24 hours of your request. A dental emergency is a need for immediate dental services to treat severe dental pain, swelling, fever, infection, or injury to the teeth. If you are experiencing a dental emergency:

  • If you already have a dentist who is with iCare:
    • Call the dentist’s office.
    • Tell the dentist’s office that you or your child is having a dental emergency.
    • Tell the dentist’s office what the exact dental problem is. This may be something like a severe toothache or swollen face.
    • Call us if you need help with getting a ride to or from your dental appointment.
  • If you do not currently have a dentist who is with iCare:
    • Call iCare. Tell us that you or your child is having a dental emergency. We can help you get dental services.
    • Tell us if you need help with getting a ride to or from the dentist’s office. For help with a dental emergency, call 1-800-777-4376.

Pharmacy Benefits

You may get a prescription from an iCare doctor, specialist, or dentist. You can get covered prescriptions and certain over-the-counter items at any pharmacy that will accept your ForwardHealth ID card.

You may have copayments or limits on covered medications. If you cannot afford your copayments, you can still get your prescriptions.

ADDITIONAL SERVICES COVERED BY iCare

Please review your Member Handbook for services covered by the iCare BadgerCare Plus Program

HEALTH & WELLNESS PROGRAMS

WHEN YOU MAY BE BILLED FOR SERVICES

HELP WHEN YOU HAVE QUESTIONS OR PROBLEMS

IF YOU MOVE

If you are planning to move, contact your current Income Maintenance (IM) agency. If you move to a different county, you must also contact the IM agency in your new county to update your eligibility for BadgerCare Plus.

If you move out of iCare’s service area, call the HMO Enrollment Specialist at 1 800-291-2002. The HMO Enrollment Specialist will help you choose a new HMO that serves your new area.

 

  
 
More Forms & Publications

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.