You have the right to make suggestions about the member rights and responsibilities policy. You, your provider or your designated representative also have the right to receive a copy of iCare’s Member Rights and Responsibilities statement. If you would like to make suggestions or to receive a copy of this statement contact iCare Customer Service at 1-800-777-4376 (TTY: 711). iCare provides free aids and services to people with disabilities to communicate effectively with us. We also provide free language services to people whose primary language is not English. If you need these services to communicate with us, contact Customer Service at 1-800-777-4376 (TTY: 711) 24 hours a day, 7 days a week. Our office hours are Monday through Friday, 8:30 a.m. to 5:00 p.m
You have the right to ask if we have special financial arrangements with our physicians that can affect the use of referrals and other services you might need. To get this information, call our Customer Service Department at 1-800-777-4376 and request information about our physician payment arrangements.
You have the right to information about our providers including the provider’s education, board certification, and recertification. To get this information, call our Customer Service Department at 1-800-777-4376.
You have the right to make decisions about your medical care. You have the right to accept or refuse medical or surgical treatment. You have the right to plan and direct the types of health care you may get in the future if you become unable to express your wishes. You can let your doctor know about your wishes by completing an advance directive, living will, or power of attorney for health care. Contact your doctor for more information. You have the right to file a grievance with the DHS Division of Quality Assurance if your advance directive, living will, or power of attorney wishes are not followed. You may request help in filing a grievance.
If you have moved from ForwardHealth or a BadgerCare Plus HMO to a new BadgerCare Plus HMO, then you have the right to:
You have the right to ask for copies of your medical records from your provider(s). We can help you get copies of these records. Please call 1-800-777-4376 for help. Please note that you may have to pay to copy your medical records. You may correct inaccurate information in your medical records if your doctor agrees to the correction.
The HMO will inform members of any covered Medicaid benefits which are not available through the HMO because of an objection on moral or religious grounds. iCare will inform members about how to access those services through the State.
iCare provides covered services to all eligible members regardless of the following:
All medically necessary covered services are available and will be provided in the same manner to all members. All persons or organizations connected with iCare that refer or recommend members for services shall do so in the same manner for all members.
Responsibilities means the things you are supposed to do. It also means accepting the positive or negative results of your actions. These are your responsibilities as an iCare member:
If you suspect fraud or abuse of the Medicaid program, you may report it. Please go to www.reportfraud.wisconsin.gov
For more information about member rights and responsibilities, plan benefits, and important phone numbers, please see the Member Handbook.
iCare has a Member Advocate (Member Rights Specialist) to help you get the care you need. The Advocate can answer your questions about getting health care from iCare. The Advocate can also help you solve any problems you may have getting health care from iCare. You can reach the Advocate at 1-800-777-4376 or 414-231-1076.
The state has designated Ombuds (people who provide neutral, confidential and informal help) who can assist you with any questions or problems you have as an HMO member. The Ombuds can tell you how to get the care you need from iCare. The Ombuds can help you solve problems or complaints you may have about iCare. Call 1-800-760-0001 to ask to talk to an Ombuds.
If you want to talk to someone outside of iCare about the problem, call the HMO Managed Care Ombudsman at 1-800-760-0001. The Ombudsman may be able to help you solve the problem, or can help you write a formal complaint to iCare or to the BadgerCare Plus/Medicaid SSI program.
Medicaid Appeals
Medicaid in Wisconsin
Wisconsin BadgerCare Plus Information
HMO Ombudsman
Social Security Administration
Disability Rights Wisconsin
Board on Aging and Long-Term Care Ombudsman
IC200 V4 DHS Approved 5/19/23 Last Updated 5/19/23
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