Dental
iCare includes $2,500/year towards 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.
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, 1 full set, or 1 bitewing set per calendar year.
Comprehensive Dental:
- Diagnostic Services: Up to 2 visits per calendar year.
- Simple Restorations are limited to Amalgams/Resins 1 restoration per tooth per calendar year.
- Crowns are limited to 1 per tooth per 60 months.
- Simple Extractions - No surgical extractions.
- Basic Partials and Basic Dentures are covered 1 per 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 at 1-800-508-6758 (TTY: 711).
These services are on top of the standard dental benefits provided by Medicaid and Medicare. Contact your Care Team for more info about this benefit at 1-800-777-4376 (TTY: 1-800-947-3529). Please see your Summary of Benefits for more info 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).
Vision
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
Prescription Drug Savings Benefit
Because you receive Extra Help (you have Medicaid and are enrolled in Partnership), YOU HAVE NO CO-PAY ON PRESCRIPTION DRUGS. This includes Tier 1 (Preferred Generic), Tier 2 (Generic), Tier 3 (Preferred Brand), Tier 4 (Non-preferred Brand) and Tier 5 (Specialty Tier) drugs.
YOU ALSO DO NOT ENTER THE FOUR STAGES OF COVERAGE: 1. Deductible Stage, 2. Initial Coverage Stage, 3. Gap Coverage Stage and 4. Catastrophic Coverage Stage.
The formulary lists drugs that require prior authorization, quantity limits, and/or step therapy. Contact your Care Team for details.
Some over-the-counter (OTC) drugs are covered by Medicaid.
Over-the-Counter (OTC) Benefit
iCare Family Care Partnership plan members receive a Health and Wellness benefit called “Over-the-Counter” or OTC.
iCare will deposit $40 a month 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 the year or upon disenrollment from the plan.
You can buy approved OTC items through your OTC catalog. AND you can also buy OTC items at well-known retailers like Walgreens, Walmart, CVS and many more. Learn more about the new iCare Benefit Card for Family Care Partnership members.
To order your OTC medications items: Log on to your MEDLINE Account.
Healthy Foods
NEW in 2022! $50 allowance amount per month for Healthy Foods for members to spend at participating retailers toward the purchase of approved healthy foods.
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.
WW® (Weight Watchers®)
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 Team and ask if you are eligible. Once you are approved to attend meetings, your Care Team 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 Team 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.
Free 24/7 Nurse Advice Line
Staying healthy starts by asking questions and getting up-to-date info. When you need answers the iCare Nurse Advice Line will be there for you 24 hours-a-day/7 days a week.
The Nurse Advice Line can give you peace of mind and help when you:
- Wonder whether you need to book a visit
- Need info about medicines or medical tests
- Want to find ways to talk more clearly with your health care provider
- Want to learn how to take care of a condition
- Have questions about how you or your family can stay healthy
Trusted health info is a phone call away -- just call the toll-free number (1-800-679-9874)!
The Nurse Advice Line service also provides an Audio Health Library that gives you access to hundreds of recorded messages on health care topics ranging from the common cold to heart disease. Each message is about three to five minutes long.
See the complete list of topics in the Nurse Advice brochure.