In 2021, iCare Medicare Plan (HMO D-SNP) members can earn Visa® gift cards for making healthy choices. Learn more!
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:
- By phone
- 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:
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.
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.
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 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.
To take advantage of this benefit, you need your 16-digit SilverSneakers membership ID and a photo ID. You can get your 16-digit SilverSneakers membership ID the following ways:
- If you are new, by visiting SilverSneakers.com/Eligibility
- If you have an account, by logging in to your Member Portal on SilverSneakers.com
- Downloading the SilverSneakers GO™ app
- Calling the SilverSneakers Member Experience Center at 1-888-423-4632 (TTY: 711) Monday – Friday 8:00 a.m. – 8:00 p.m. ET.
SilverSneakers and the SilverSneakers shoe logotype are registered trademarks of Tivity Health, Inc. SilverSneakers GO and SilverSneakers On-Demand are trademarks of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved.
WW® (Weight Watchers®)
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.
- 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.
- 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.
Personal Emergency Response System (PERS)
24/7 Nurse Advice Line