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Disclaimers

Independent Care Health Plan (iCare) is an HMO with a Medicare contract. Enrollment in Medicare plans insured by iCare depends on contract renewal.

General Disclaimers – Applies to All Plans Insured by iCare

  • Before making an enrollment decision, it is important that you fully understand our benefits and rules. If you have any questions, you can call and speak to a customer service representative at 1-800-777-4376 (TTY: 1-800-947-3529).
  • Review the full list of benefits found in the Evidence of Coverage (EOC), especially for those services for which you routinely see a doctor. To request a copy of the EOC, click here or call 1-800-777-4376 (TTY: 1-800-947-3529)
  • Review the online Provider/Pharmacy directory (or ask your doctor) to make sure the doctors you see now are in the network. If they are not listed, it means you will likely have to select a new doctor.
  • Review the online Provider/Pharmacy directory to make sure the pharmacy you use for any prescription medicines is in the network. If the pharmacy is not listed, you will likely have to select a new pharmacy for your prescriptions.

Medicare Advantage Prescription Drug Plans (MA-PD) — HMO D-SNP

iCare insures the following Dual Eligible Special Needs Plans (D-SNP):

In addition to holding a contract with Medicare, iCare also has a written agreement with the state Medicaid program to coordinate Medicaid benefits.

iCare Family Care Partnership (Long Term Care Plan) HMO D-SNP is available to anyone who has both medical assistance from the State and Medicare, and is functionally eligible as determined by the State Long-Term Care Functional Screen. For more information about long-term care options available to you contact the Aging & Disability Resource Centers. The Resource Center can also assist you with information about eligibility and enrollment.

Understanding the Important Rules for iCare Medicare D-SNP Plans

  • You must continue to pay your Medicare Part B premium, if you are paying one. The Part B premium is covered (paid for) by the State if you are a full dual member. If you are paying a Part B premium, it is normally taken out of your Social Security check each month.
  • If Medicaid is not paying your Medicare premiums, you must continue to pay your Medicare premiums to remain a member of the plan. Because you get assistance from Medicaid, you pay nothing for your covered services as long as you follow the plan’s rules for getting your care. Refer to your Evidence of Coverage for more information.
  • For most members, Medicaid pays for your Part A premium (if you don’t qualify for it automatically).
  • These plans are Dual Eligible Special Needs Plans (D-SNP). Your ability to enroll will be based on verification that you are entitled to both Medicare and medical assistance from a state plan under Medicaid.
  • Benefits, premiums and/or co-payments/co-insurance may change on January 1, 2020.
  • Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the provider directory).

Medicare Advantage Prescription Drug Plans (MA-PD) — HMO

iCare insures the following Medicare Advantage Prescription Drug plan (MA-PD):

Understanding the Important Rules for iCare Medicare Advantage HMO Plans

  • In addition to our monthly plan premium, you must continue to pay your Medicare Part B premium. This premium is normally taken out of your Social Security check each month.
  • Benefits, premiums and/or co-payments/co-insurance may change on January 1, 2021.
  • Except in emergency or urgent situations, we do not cover services by out-of-network providers (doctors who are not listed in the Provider/Pharmacy directory).

 

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Last Updated 10/01/19

 

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