In 2022, iCare Medicare Plan (HMO D-SNP) members earn rewards 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. Any unused balance will automatically expire at the end of each quarter or upon disenrollment from the plan.
New for 2022! iCare Medicare Plan members receive $50/month towards the purchase of Healthy Foods. Amounts do not roll over and expire at the end of each month or if you disenroll from the plan. Learn more!
Prescription Drug Savings Benefit
$0 co-payment for all Medicare covered prescription drugs for all formularies, on all tiers. Benefit begins in the Deductible Stage (whwen applicable) and continues through the Initial Coverage Stage only. Because you are eligible for “Extra Help” you qualify for this benefit.
You will pay nothing—that’s $0—out of pocket for all of your Medicare-eligible Part D drugs up to $4,430 paid on your behalf. Then, your cost will be the typical Extra Help co-pay amount.
For more information, refer to the plan’s Evidence of Coverage (EOC) on icarehealthplan.org.
Plus, 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 our mail-order pharmacy.
iCare Medicare Plan members receive 24 one-way trips, up to 25 miles, to plan approved locations.
Wellness and Health Planning
As an iCare member, you have access to an online advance care planning resource on iCareHealthPlan.org. This resource helps you to create an advance directive where you can combine the elements of a living will, medical power of attorney, do not attempt resuscitation, and an organ donation form.
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.
» Mobile App: SilverSneakers GO™ mobile app with workout programs, location finder and more.
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 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 $2,500/year towardsdental 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.
»Oral Exams: Up to two (2) per calendar year.
»Prophylaxis (Cleaning): Up to two (2) per calendar year.
»Fluoride Treatment: Up to two (2) per calendar year.
»X-Rays are limited to either 1 panoramic, 1 full set, or 1 bitewing set per calendar year.
»Diagnostic Services — Up to two (2) visits per calendar year.
»Restorative Services — Simple restorations are limited to Amalgams/Resins, one (1) restoration per tooth, per calendar year.
»Extractions — Simple extractions only. No surgical extractions.
»Prosthodontics/Oral or Maxillofacial Surgery/Other services:
•Crowns — Limited to one (1) per tooth per 60 months.
•Basic Partials and basic dentures are covered, one (1) every 60 months. No coverage for repair.
•No coverage for oral/maxillofacial surgery.
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 added vision benefit provides you with $300 a year to use towards:
- One (1) routine eye exam
- One (1) contact fitting
- Contact lenses
- One (1) set of eyeglasses lenses and/or frames, upgrades combined
There's no monthly vision premium, $0 co-pay, $0 deductible and no waiting period for members, and you can choose from an extensive network of National Vision Administrators (NVA) care providers.
The benefit cannot be combined with your Medicaid benefit. Please refer to your iCare Medicare Plan Evidence of Coverage or EOC for more information or call your Care Team. You can also call iCare Customer Service at 1-800-777-4376 (TTY: 711).
There may be limits on how much the plan will provide. Please contact the plan for more information.
About the Vision Network:
You must use National Vision Administrators (NVA) network providers for your Medicare vision benefit. Friendly, helpful NVA representatives are available 24 hours a day, 7 days a week, 365 days a year. If you have a vision network question or need help finding a provider, call the NVA Customer Service Department at 1-888-287-0116 (TTY: 711). You can also visit www.e-nva.com or use the “Find a Provider” search tool on the iCare web site: www.iCareHealthPlan.org/findprovider
Personal Emergency Response System (PERS)
24/7 Nurse Advice Line