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2021 iCare Medicare Plan

Are you getting all the benefits you're entitled to from Medicare and State Medicaid?  ARE YOU SURE?

 

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iCare Medicare Plan

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Heard about the iCare Medicare Benefit Card?

This prepaid card lets you buy Over-the-Counter (OTC) items in-store or through your OTC catalog.


Buy in-store or through your OTC catalog, or in-store with the iCare OTC Benefits Card!

Learn More!

 

2021 Benefits and Services

Benefits Include:

  • $0 plan premium
  • $0 plan deductible
  • 90-day supply for a one month co-pay of Tier 1 and Tier 2 formulary medications

 

Services Include:

  • Multi-Level Care Management
  • Care Coordinators and Care Managers
  • Nurse Case Managers
  • Intervention and Outreach
  • Provider Network
 
2021 Added Benefits

As a member of iCare Medicare Plan (HMO D-SNP), you receive FREE added benefits above what Original Medicare covers. 

Over-the-Counter Items

Silver Sneakers® Fitness & WW® (Weight Watchers®)

Dental Benefit

Vision Benefit

Meal Benefit

24/7 Nurse Advice Line

and More!

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Over-the-Counter (OTC) Benefit

iCare Medicare Plan members receive a Health and Wellness benefit called “Over-the-Counter” or OTC. 
iCare will deposit $100 a month ($300 a quarter) into an account that is linked to a prepaid benefits card so you can purchase Medicare-approved OTC items like bandages, pain relievers, cold medicine, toothpaste, vitamins, and much more. Your purchase can be made in several ways!

»    In a retail store or pharmacy.
»    Or, new for 2021, you can make unlimited mail-order purchases up to your available balance with NationsOTC in one of three ways:

  1. Online
  2. By phone
  3. By catalog

The choice is yours! 

Your benefit card also comes with preloaded discounts and coupons to help you stretch your OTC dollars further. No clipping coupons. And when you buy generics vs. brand name products you save even more!

Just swipe at the checkout and save when you shop in-store at participating retailers+ which include: Walgreens, Family Dollar, Walmart, Dollar General, CVS Pharmacy, Rite Aid, and Nations OTC.

+The card cannot be used at CVS pharmacies in Target stores.  
Terms and conditions apply. To learn more call your Care Coordinator at 1-800-777-4376 (TTY: 711).

 

Prescription Drug Benefits

iCare gives members comprehensive coverage for your medications. But did you know your prescription drug coverage also includes the iCare Pharmacy Department’s support and expertise to help ensure that the medicines you take are safe, effective, and delivered conveniently? 
 

Following are a few tips from our Pharmacists on how to best use your prescription drug coverage to keep you healthy and your costs low. 

Make sure your drugs are covered. 

You can look on the Drug List (Formulary) by visiting  www.iCareHealthPlan.org or call the Pharmacy Department at 1-866-938-0406 (TTY: 711).  

Fill your prescriptions and find a pharmacy near you. 

There are hundreds of local pharmacies in our network. You'll need to use a network pharmacy or the plan may not pay for your prescription, except in an emergency. 

Understand your medication(s) and/or perform medication reviews. 

On your drug list, some medications have codes such as PA (Prior Authorization), Step Therapy (ST), and QL (Quantity Limit). This means you or your doctor may need to give the plan more information or try an alternative medication before your drug will be covered. Please call the Pharmacy Department if your drug has one of these codes and we can help. 

Sign up for the 90-Day Supply Program. 

Save time and money by taking advantage of a 90-day supply for a 30-day co-pay for some of your medications. This benefit is available at all in-network retail pharmacies and through NoviXus our mail-order pharmacy. See below for instructions. 

Get your prescriptions delivered to your door!

Save trips to the pharmacy for your maintenance prescriptions — the drugs you take every day. Use our home delivery program. NoviXus, our mail-order pharmacy, can fill your prescription(s) and deliver it to your home.

There are several easy ways to order or to switch to NoviXus: 
 

  • Prescribe

Ask your doctor to send an electronic prescription to NoviXus. They can do it by fax: 1-877-395-4836, phone 1-877-269-1159 (TTY: 711), or by mail to NoviXus Pharmacy Services, P.O. Box 8004, Novi, MI 48376.

  •  Online

Register or sign in at www.NoviXus.com.There is also an enrollment form on the website which can be filled out and mailed to NoviXus.
You can also download the mobile app through Google Play or in the Apple App store.

  • Phone

Call NoviXus Patient Care Center at 1-877-668-4987 (TTY: 711).

Standard delivery to your home is FREE! Once you place an order, please allow 7–10 days for delivery. If there are any issues with the order, one of NoviXus Patient Care Specialists will contact you.

SilverSneakers® Fitness

 


SilverSneakers is more than a fitness program. It gives you the opportunity to connect with your community, make friends, and stay active. The best part? SilverSneakers is included in this plan at $0 cost. 

What does SilverSneakers include? 

»    Fitness Memberships: Thousands of popular locations1 – no need to pick just one.
»    Classes: Classes for all levels and abilities led by instructors who specialize in senior fitness.
»    Online Resources: Fitness location directory, health and nutrition tips, and SilverSneakers On-Demand video workouts at SilverSneakers.com.

At-home kits are offered for members who prefer working out at home or for those who can’t get to a fitness location due to injury, illness, or are homebound. Currently, the following four at home kits are available: walking, toning kit, strength and yoga. The type of kits are subject to change.

SilverSneakers mailed you a membership ID card when you joined iCare Medicare Plan. You need this card in order to use the exercise equipment or attend a class at a SilverSneakers location.

If you did not receive the ID card or misplaced it and need a new one, please call your Care Coordinator. If you have questions regarding your SilverSneakers membership, call 1-888-423-4632 (TTY: 711), Monday – Friday, 8:00 a.m. – 5:00 p.m., ET.

SilverSneakers, the SilverSneakers shoe logotype and SilverSneakers FLEX are registered trademarks of Tivity Health, Inc. © 2020 Tivity Health, Inc. All rights reserved.

WW® (Weight Watchers®)

iCare offers Weight Watchers (WW)iCare will pay the WW membership fee and send you thirteen-weeks’ worth of WW vouchers to attend local meetings. It's easy to get started. Just call your Care Coordinator and ask if you are eligible. Once you are approved to attend meetings, your Care Coordinator will issue you a packet of vouchers. If at the end of the thirteen-week period you find you would like to continue attending meetings, please call your Care Coordinator at 1-800-777-4376 (TTY: 1-800-947-3529) to discuss. Be sure to check with your physician before getting started with any weight loss program.

 

Added Dental Benefits

 

iCare includes added dental benefits like preventive and comprehensive care to help with your basic dental needs. There may be limits on how much the plan will provide so we encourage you to read your plan documents. The dental benefit costs you $0. 

Preventive Care:

  • Oral Exams: Up to 2 per calendar year.
  • Cleanings: Up to 2 per calendar year.
  • Fluoride Treatment: Up to 2 per calendar year.
  • Dental X-rays: Limited to either 1 panoramic or 1 full set per calendar year.

Comprehensive Dental:

  • Diagnostic Services: Up to 2 visits per calendar year.

The benefit cannot be combined with your Medicaid benefit.

You must use DentaQuest’s network of dentists for your Medicare dental services. If you need help selecting a dental provider, please call DentaQuest’s Customer Service at 1-800-508-6758 (TTY: 711). 

These services are in addition to the standard dental benefits provided by Medicaid and Medicare. Contact your Care Coordinator for more information about this benefit at 1-800-777-4376 (TTY: 1-800-947-3529). Please see your Summary of Benefits for additional information about this benefit or call DentaQuest Customer Service for a list of providers and locations at 1-800-508-6758 (TTY:  1-800-947-3529).

Added Vision Benefits

 

Our vision benefit provides you with $250 a year to use towards purchasing contact lenses, one set of eyeglasses (lenses and frames combined) and/or a contact lens exam. 

There's no waiting period for members, and you can choose from an extensive network of National Vision Administrators (NVA) care providers. NVA can be reached by calling 1-888-287-0116 (TTY: 711) or visit www.e-nva.com. 

There may be limits on how much the plan will provide so we encourage you to read your plan documents.

To find an eye doctor near you or to make an appointment call 1-800-672-7723 (TTY: 711). You can also find a vision provider by using the “Find a Provider” tool on the iCare web site www.iCareHealthPlan.org. 

The benefit cannot be combined with your Medicaid benefit. 

 

Meals Benefit

 

If you are transitioning home from an inpatient hospital or skilled nursing facility, you are eligible to receive up to 7 days of meals (1 meal per day, maximum 7 meals provided). 

Contact your Care Coordinator for more information about this benefit at 1-800-777-4376 (TTY: 1-800-947-3529).
Prior authorization is required to receive this benefit.

Personal Emergency Response System (PERS)

Feel more secure at home with access to help 24/7. Your Personal Emergency Response System automatically places a call for help if it detects a fall and you can’t push your help button. If a fall is detected, it’s designed to get you 24/7 access to help. 

Contact your Care Coordinator for more information about this benefit at 1-800-777-4376 (TTY: 1-800-947-3529).
Prior authorization is required to receive this benefit.

24/7 Nurse Advice Line

24/7 Nurse Line — 1-800-679-9874

Staying healthy starts by asking questions and getting up-to-date information. When you need answers the Nurse Advice Line will be there for you 24 hours a day, 7 days a week.

How to ask for a Benefit or Service

Did you know you can ask for a benefit or service by sending iCare an Organization Determination request?
Or that you can appoint a representative?

 Learn how to ask for a benefit or service

 

Contact Us

For full information on iCare Medicare Plan benefits, call our Customer Service Department at 1-800-777-4376 (TTY 1-800-947-3529) 24 hours-a-day, 7 days-a-week (office hours: Monday-Friday, 8:30 a.m. to 5:00 p.m.).

 

 

Find a Provider

Looking for a hospital, doctor or other provider in iCare’s broad network?

Find a Provider

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