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2019 Aurora CompleteCare Annual Notice of Changes

Plans
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Plan Information

2019 Aurora CompleteCare Provider-Pharmacy Directory Updated 10.30.19

Plans
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Provider Directories

2019 Aurora CompleteCare Summary of Benefits-Updated 5.15.19

Plans
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines

2019 Aurora-Lakeland-iCare Medicare-Evidence of Coverage-Updated 6.7.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • Lakeland Care + Health
Document Types
  • Benefit Information
  • Plan Information

2019 Comprehensive Formulary-iCare FCP Medicaid Only-Updated 10.31.19

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization

2019 Comprehensive Formulary-iCare FCP Plan-Updated 10.31.19

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization

2019 Comprehensive Formulary-iCare Medicare Plans-Updated 10.31.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • Lakeland Care + Health
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization

2019 Family Care Partnership Medicaid Only Member Handbook

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2019 FCP Provider-Pharmacy Directory Updated 10.31.19

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Provider Directories

2019 iCare Family Care Partnership Summary of Benefits-Updated 5.15.19

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2019 iCare FCP Annual Notice of Changes

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Policies and Guidelines

2019 iCare FCP Evidence of Coverage-Updated 6.7.19

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Policies and Guidelines

2019 iCare Medicare Added Benefits Booklet

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information

2019 iCare Medicare Annual Notice of Changes

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information

2019 iCare Medicare Plan Summary of Benefits-Updated 5.15.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines

2019 iCare Medicare Provider-Pharmacy Directory-Central WI Updated 10.30.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Provider Directories

2019 iCare Medicare Provider-Pharmacy Directory-Milwaukee Updated 10.30.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Provider Directories

2019 iCare Medicare Provider-Pharmacy Directory-Northeast WI Updated 10.30.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Provider Directories

2019 iCare Medicare Provider-Pharmacy Directory-Western WI Updated 10.30.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Provider Directories

2019 Lakeland Annual Notice of Changes

Plans
  • Lakeland Care + Health
Document Types
  • Benefit Information

2019 Lakeland Care Plus Health Provider-Pharmacy Directory Uploaded 7.31.19

Plans
  • Lakeland Care + Health
Document Types
  • Benefit Information
  • Provider Directories

2019 Lakeland Care Plus Health Summary of Benefits-Updated 5.15.19

Plans
  • Lakeland Care + Health
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines

2019 LIS Premium Summary

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines

2019 Medicaid-BadgerCare Provider Directory-Milwaukee Updated 10.30.19

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

2019 Medicaid-BadgerCare Provider Directory-Northeast WI Updated 10.30.19

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

2019 Medicaid-BadgerCare Provider Directory-South-Central WI Updated 10.30.19

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

2019 Medicaid-BadgerCare Provider Directory-Western-WI Updated 10.30.19

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

2019 Part D Prior Authorization Criteria-Updated 11.1.19

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

2019 Step Therapy Rx Drug Criteria-Updated 11.1.19

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

2020 AEP Aurora CompleteCare Provider Directory

Plans
  • Aurora CompleteCare
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 AEP iCare Medicare Advantage Provider Directory

Document Types
  • Formulary/ Pharmacy Documents

2020 AEP iCare Medicare Provider Directory Central WI

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 AEP iCare Medicare Provider Directory Milwaukee

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 AEP iCare Medicare Provider Directory Northeast WI

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 AEP iCare Medicare Provider Directory Western WI

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 AEP Provider Directory Family Care Partnership

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2020 Aurora CompleteCare Annual Notice of Changes-Updated 11.12.19

Plans
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Plan Information

2020 Comprehensive Formulary all Medicare Updated 9.30.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents

2020 Family Care Partnership Evidence of Coverage

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2020 iCare Family Care Partnership Annual Notice of Changes

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2020 iCare Family Care Partnership Summary of Benefits

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information

2020 iCare Medicare 001 007 009 Enrollment Form

Plans
  • ALL
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
Document Types
  • Applications

2020 iCare Medicare Advantage Plan 011 EOC-Updated 11.12.19

Document Types
  • Benefit Information
  • Plan Information

2020 iCare Medicare Advantage Plan Summary of Benefits-Updated 11.12.19

Document Types
  • Benefit Information
  • Plan Information

2020 iCare Medicare Plan ANOC-Updated 11.12.19

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2020 LIS Premium Summary Plan 011

Document Types
  • Benefit Information

2020 LIS Premium Summary Plans 001 007 009

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
Document Types
  • Benefit Information

2020 OTC List

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information

2020 Part D Prior Auth Criteria 10.1.19

Document Types
  • Formulary/ Pharmacy Documents

2020 Plan 001 and 009 Summary of Benefits Updated 11.12.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
Document Types
  • Benefit Information

2020 Plans 001 and 009 EOC - Updated 11.12.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Plan Information

2020 Step Therapy Rx Drug Criteria 10.1.19

Document Types
  • Formulary/ Pharmacy Documents

Appeals Request Form

Document Types
  • Claims
  • Policies and Guidelines

Aurora CompleteCare Over-the-Counter Catalog

Plans
  • Aurora CompleteCare
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information

BadgerCare Plus & Medicaid SSI Mom & Baby Program

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Health Education

BadgerCare Plus Member Handbook

Plans
  • iCare BadgerCare Plus

BC Plus Welcome Guide

Plans
  • iCare BadgerCare Plus
Document Types
  • Benefit Information
  • Plan Information

Claim Form - LTC Professional

Plans
  • iCare Family Care Partnership
Document Types
  • Claims
  • Provider Forms

CMS Appointment of Representative Form-English

Document Types
  • Applications
  • Claims
  • Policies and Guidelines

CMS Appointment of Representative Form-Spanish

Plans
  • ALL
Document Types
  • Applications
  • Claims
  • Policies and Guidelines

Consent to Receive Electronic Communications-7-2018

Plans
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines

Family Care Partnership Added Benefits Booklet

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information

Family Care Partnership Program Brochure

Plans
  • iCare Family Care Partnership

FCP Medicaid Only Member Handbook

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

FCP Self-Directed Supports Brochure

Plans
  • iCare Family Care Partnership
Document Types
  • Self-Directed Supports

FCP Self-Directed Supports Guidebook

Plans
  • iCare Family Care Partnership
Document Types
  • Self-Directed Supports

Fraud Waste and Abuse Training

Document Types
  • Policies and Guidelines

iCare Limited English Proficiency Policy Statement

Document Types
  • Policies and Guidelines

iCare Medicaid SSI Member Handbook

Plans
  • iCare Medicaid SSI

iCare Medicare Program Brochure

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

Incident Reporting Guide for Members

Plans
  • ALL
Document Types
  • Health Education

Inpatient Notification Form

Plans
  • iCare Medicare Plan
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Policies and Guidelines
  • Provider Forms

Letter regarding changes to Family Care Partnership Appeals and Grievances.pdf

Plans
  • iCare Family Care Partnership
Document Types
  • Grievances & Appeals
  • Policies and Guidelines

Medicaid Interpreter Services

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Medicaid SSI Welcome Guide

Plans
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Plan Information

Medicare Multi-Language Interpreter Services

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health

Medicare Part D Transition Process

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information
  • Policies and Guidelines
  • Prior Authorization

Medicare PartD Coverage Determination Request Form-Updated 1.1.19

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization
  • Provider Forms

Medicare Star Ratings

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
Document Types
  • Policies and Guidelines

Medication Reconciliation Post-Discharge Form

Plans
  • ALL
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Forms

Notice of Nondiscrimination

Plans
  • ALL
Document Types
  • Policies and Guidelines

Nurse Advice Line Brochure

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education

Ombuds Information (English)

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education
  • Policies and Guidelines

Ombuds Information (Hmong)

Document Types
  • Health Education
  • Policies and Guidelines

Ombuds Information (Spanish)

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education
  • Policies and Guidelines

OTC Network Medicare Catalog

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Formulary/ Pharmacy Documents
  • Plan Information

Part D Transition Process

Plans
  • ALL
Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

Part_D_Redetermination_Request_Form.pdf

Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

Policy-Limited English Proficiency

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Request for a State Fair Hearing

Document Types
  • Applications
  • Policies and Guidelines

Request for Redetermination of Medicare Rx Drug Denial form

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health

Scope of Sales Appointment Confirmation Form

Plans
  • ALL
Document Types
  • Plan Information
  • Policies and Guidelines

Understanding Abuse Neglect and Exploitation

Plans
  • ALL
Document Types
  • Behavioral Health
  • Health Education

What to do in Case of an Emergency

Plans
  • iCare Medicare Plan
  • Aurora CompleteCare
  • iCare Family Care Partnership
  • Lakeland Care + Health
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

H2237_IC2203_M
Last Updated 10/1/19

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