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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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2024 Added Benefits

As a member of iCare Medicare Plan (HMO D-SNP), you receive extra added benefits above what Original Medicare covers, for $0 premium and $0 deductible.

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Hearing Benefit - New for 2024!

  • $0 copay for routine hearing exams up to 1 every year.
  • $0 copay for follow-up provider visits up to unlimited per year.
  • $0 copay for each Advanced level hearing aid up to 1 per ear every 3 years.
    • Note: Includes 80 batteries per aid and 3 year warranty. 
  • Unlimited follow-up provider visits during first year following TruHearing hearing aid purchase.
Added Vision Benefits


There's no monthly vision premium and you can choose from an extensive network of National Vision Administrators (NVA) care providers.

Our added vision benefit provides you with these services in 2024:
» $50 combined maximum benefit coverage amount per year for routine exam.
» $400 combined maximum benefit coverage per year for contact lenses or eyeglasses (lenses and frames) and/or fitting for eyeglasses (lenses and frames).

Eyeglass lens options may be available with the maximum benefit coverage amount up to one (1) pair per year.

Maximum benefit coverage amount is limited to one time use per year.

Please refer to your iCare Medicare Plan Evidence of Coverage or EOC for more information or call your Care
Coordinator. 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 us for more information.

You must use National Vision Administrators (NVA) network providers for your Medicare vision benefit. If you have a vision network question or need help finding a provider, call the NVA Customer Service Department 24/7/365 at 1-888-287-0116 (TTY: 711). You can also visit or use the “Find a Provider” search tool.

Added Dental Benefits


iCare includes preventive and comprehensive dental benefits in your plan with no monthly dental premium and a $4,000 maximum coverage limit per calendar year. You must use dentists and dental specialists in the iCare dental network, DentaQuest. To find a dentist call
DentaQuest's Customer Service at 1-800-508-6758 (TTY: 711). You can also call iCare Customer Service at 1-800-777-4376 or your Care Coordinator. If you have access to the internet, you can find a dentist by using the "Find a Provider" tool. These added benefits are included in the plan at no cost to you:

$0 Co-pay for Preventive Care
» Oral Exams — Up to three (3) per calendar year, includes emergency diagnostic exam up to one (1) per year, and
periodic oral exam up to two (2) per year.
» Prophylaxis (Cleaning): Includes periodontal maintenance up to four (4) per year and prophylaxis (cleaning) up to two (2) per year.
» Fluoride Treatment: Up to two (2) per calendar year.
» Dental X-rays include bitewing x-rays and intraoral x-rays up to one (1) set(s) per year, and panoramic film or
diagnostic x-rays up to one (1) every 5 years.

$0 Co-pay for Comprehensive Care
» Non-routine Services: Two (2) visits included every year.
» Diagnostic Services: One (1) visit included every 3 years.
» Restorative Services: Include fillings up to unlimited per year, re-cementation of crown and re-cementation of dentures up to one (1) every 5 years, crown up to one (1) per tooth per lifetime.
» Endodontics: Include root canal, root canal retreatment up to one (1) per tooth per lifetime.
» Periodontics: Include scaling and root planning (deep cleaning) up to one (1) per quadrant every 3 years, scaling for moderate inflammation up to one (1) every 3 years.
» Extractions: Surgical extractions are covered; Unlimited per year.
» Prosthodontics, Other Oral/Maxillofacial Surgery, Other Services: Include partial dentures and complete dentures up to one (1) set(s) every 5 years, denture adjustment, denture reline, denture repair, denture rebase, tissue conditioning up to one (1) per year, occlusal adjustments up to one (1) every 3 years, oral surgery up to two (2) per year, and bridges up to one (1) every 5 years.

There may be limits on how much the plan will provide. Please contact us for more information.


$0 copay for acupuncture for chronic low back pain visits up to 20 visit(s) per year.

Healthy Options Allowance

iCare Medicare Plan members have the freedom to spend a $150/month allowance on the approved products and services you need with the iCare Spending Account Card!

In 2024, members have the freedom of ONE wallet on ONE card with the $150/month Healthy Options allowance. Watch for your Spending Account Card and OTC catalog in your mailbox. Be sure to read the information on the card carrier, including the instructions on how to activate your new card, so you'll be ready when it's time to purchase eligible items and services.

Learn more about the Healthy Options Allowance below!



Members receive two meals per day for 7 days (up to 14 meals) delivered to member’s home after an inpatient stay in a hospital or nursing facility. Meal delivery must be scheduled within 30 days of discharge event. Limited to four times per year.  Prior Authorization and/or doctor's referral (order) may be required for this benefit.

SilverSneakers® Fitness


SilverSneakers is more than a fitness program, it's a way of life. 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 no additional cost. 


SilverSneakers is a registered trademark of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved. 

Non-Emergency Transportation (NEMT)

iCare Medicare Plan members receive 50 one-way trips, up to 25 miles each way, at a $0 co-pay. To arrange transportation, please call ModivCare at 1-877-813-5602 (TTY: 711). There may be limits on how much the plan will provide. Please contact the plan and/or your Care Coordinator for more information as there may be limits on how much the plan will provide.

Part D Prescription Drug Benefits

$0 Rx Drug Co-Pays

Coverage may include $0 co-pay for all Medicare covered Part D prescription drugs on iCare Medicare Plan’s formulary, for all tiers, and through all drug stages for members who receive “Extra Help” for prescription drug costs.

Part D Prescription drugs on Tiers 1 through 4 are a $0 co-pay at a 1-month or 3-month supply. Tier 5 (Specialty Drugs) is a $0 co-pay and limited to a 30-day supply. To learn more about the plan’s Medicare Part D prescription drug coverage, the stages and drug tiers, please review the Summary of Benefits.

Verify Your Drugs are Covered
Look for your drug (medication) on the Drug List (Comprehensive Formulary) by visiting or you can call Customer Service at 1-800-777-4376 (TTY: 711). If your drug isn't on the Formulary, it may not be covered, but there will likely be an alternative drug that treats the same condition. Some drugs have codes such as PA (Prior Authorization), Step Therapy (ST), and QL (Quantity Limit) by their names on the drug list. 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 Customer Service if your drug has one of these codes and we can help.

Find a Pharmacy Near You
There are many pharmacies in the plan's network located near you. You'll need to use a network pharmacy, or the plan may not pay for your prescriptions, except in an emergency. Find a pharmacy near you by calling Customer Service at 1-800-777-4376.


Get a 90-Day Supply of Your Prescriptions Delivered Right to Your Door
Save trips to the pharmacy for your maintenance prescriptions — the drugs you take every day — for conditions like high blood pressure and diabetes by getting a 90-day supply of medications. You can use our home delivery program through MedImpact OR your local in-network pharmacy. The choice is yours, but mail-order is very convenient!
Blood Glucose Meter and Test Strips
iCare Medicare members are eligible to receive diabetic testing supplies at no cost from Abbott Diabetes Care. This includes the FreeStyle® brand blood glucose meters and FreeStyle® brand test strips.
Prescription Portal and MedImpact Mobile App
The iCare Prescription Portal and the MedImpact mobile app will help you quickly manage your budget and health from your computer, tablet, or phone.
Medication Therapy Management
Members have the option of enrolling in Medication Therapy Management (MTM) services through myMTMcare. Members who meet the following criteria will be eligible for MTM services and a Comprehensive Medication Review.  To check to see if you are eligible, call Customer Service at 1-800-777-4376 (TTY: 711). Eligible members can opt out of the MTM program — participation is voluntary. Although the MTM program is a special service offered at no cost to our Medicare members, it is not considered a benefit.
Wellness and Health Care Planning

As an iCare member, you have access to an online advance care planning resource called Five Wishes. 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.

Healthy Options Allowance

iCare Medicare Plan (HMO D-SNP) members and iCare Family Care Partnership (HMO D-SNP) members have the freedom to spend a $150/month allowance on the approved
products and services you need with the iCare Spending Account Card!

Buy healthy foods, OTC products, living support such as rent, utilities and internet and much more!

Spending Account Card for OTC, Healthy Foods and more!
Learn More!

Extra programs & services come with your plan!

Your health needs go beyond the benefits you receive. In addition to the health insurance benefits, did you know about the extra programs and services we offer iCare Medicare Plan members? Social programs and services, health and wellness programs, and more — all working with your health care to keep you independent, healthy and happy.


Care Management

There are many people at iCare working together to meet your health care needs:

  • Care Coordinators are available to assist you with your care, should you need it.
  • Clinical Pharmacists, medical doctors, and registered nurses at iCare are trained in reviewing Prior Authorizations and doctor orders.
  • Specialty Services/Medical Disease Management teams are a resource available for you to ensure you receive the level of care you need if you have chronic health needs.
  • Specialty Services/Behavioral Health Disease Management teams including intervention specialists, registered nurses and care managers work together if a member has a condition like depression, anxiety disorder or suffer from alcohol or drug abuse, to name a few.


Community Health Workers

We offer a team of Community Health Workers (CHW) that can help you and your family with your social determinants of health (SDOH). What is SDOH? Many people assume that their health is only a result of their DNA or their family history. It's not just who you are that determines how healthy you are. Where you live, what you eat, how you learn and how you interact with others have an impact on your health, too. The CHW will also provide health education resources and information. They will provide support and guidance to you through face-to-face home or facility visits or by phone. There is no cost for you to work with a CHW.


Health and Wellness: 24/7 Nurse Line 

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. Call 1-800-679-9874.


Food Accessibility

Getting healthy foods can be a challenge for some people and iCare is here to help. In addition to the Healthy Options allowance benefit which allows you to purchase Healthy Foods, our Care Coordinators and Community Health Workers can share resources where you can get nutritious food affordably, safely and conveniently. They can also connect you directly to local organizations offering programs like home delivery, mobile neighborhood-based food trucks, and farmer’s markets accepting food assistance programs such as FoodShare Wisconsin. 

Eviction Control and Housing Relocation Program

If you are facing eviction, iCare may be able to help. Our staff of housing navigators may work with you and your property owner to try and keep you in your home and may connect you to new housing if you must move. We also have resources for our homeless members. For more information, please contact Customer Service.

Diversity and Accessibility

Our multilingual Care Coordinators speak fluently in languages such as Spanish and Hmong to help you understand your benefits and services. We also provide over the phone interpreter services for those members who do not speak English.  This service can be accessed by calling our Customer Service department or our Member Advocates/Member Rights Specialists. All non-English speaking members are directed to network physicians who understand their culture. Our provider network includes primary and specialty care providers who practice in areas where you live and spend time. In addition to a multilingual staff, there is a TTY phone number (711) for the hearing impaired. Special services are available for those who are blind or have limited vision.

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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