Members

2017 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):

  • $0 Co-pay

Brand Name Prescription drugs:

  • $0 Co-pay

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

Catastrophic Coverage:

  • You pay nothing.

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 Customer Service 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 Customer Service 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.


Notification:
By clicking the links above, you may be leaving the icare-wi.org website. Independent Care Health Plan (iCare) only provides these links and pointers for your information and convenience. When you select a link to an outside website, you are leaving the iCare-wi.org website. These external links are not the responsibility of, or under the control of iCare. Independent Care Health Plan disclaims responsibility for the content and privacy policies of the owners/sponsors of the outside websites.


iCare Family Care Partnership (HMO SNP) 2016 Disclaimers: The iCare Family Care Partnership (HMO SNP) is a Coordinated Care plan with a Medicare contract and a contract with the Wisconsin Medicaid program. Enrollment in iCare Family Care Partnership depends on contract renewal. The benefit information provided herein is a brief summary, not a comprehensive description of available benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. 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. You must receive all routine care from plan providers. Limitations, copayments, and restrictions may apply. This plan is available to anyone who has both Medical Assistance from the State and Medicare and functionally eligible as determined by the State of Wisconsin Long-Term Care Functional Screen. For more information, contact the plan. 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 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 dhs.wisconsin.gov/medicaid. For more information about long-term care options available to you in your county contact the Aging & Disability Resource Centers. The Resource Center can also assist you with information about eligibility and enrollment.

Modified: 3/29/2017

 

  
  
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.