Medicare Counseling: Dual Eligible Special Need Plans (D-SNP) Plan – iCare Medicare Plan - Full Medicaid
Check what other D-SNPs are available in your county and what Medicaid plans they accept. (Excel)
iCare Medicare Plan (HMO D-SNP, H2237-001) for people with full Medicaid
For calendar year 2024
Contact information
Phone: 800-777-4376
TTY: 711
Website: https://www.icarehealthplan.org/
Eligibility
Who can get this plan
People with:
People with the Specified Low Income Beneficiary (SLMB) and Qualified Individual (called SLMB+ in Wisconsin) tiers of the Medicare Savings Program can also get this plan but will have different costs. View those costs on the iCare Medicare Plan for people with partial Medicaid webpage.
Service area
iCare Medicare Plan service area
- Adams
- Bayfield
- Brown
- Buffalo
- Burnett*
- Calumet
- Clark*
- Columbia
- Crawford
- Dane
- Dodge
- Door
- Douglas
- Florence
- Fond du Lac
- Forest*
- Grant
- Green Lake
- Green
- Iowa
- Iron
- Jackson
- Jefferson
- Juneau
- Kenosha
- Kewaunee
- La Crosse
- Lafayette
- Manitowoc
- Marinette
- Marquette
- Menominee
- Milwaukee
- Monroe
- Oconto
- Outagamie
- Ozaukee
- Pepin
- Pierce
- Racine
- Richland
- Rock
- Sauk
- Shawano
- Sheboygan
- Trempealeau
- Vernon
- Walworth
- Washington
- Waukesha
- Waupaca
- Waushara
- Winnebago
*People with full Medicaid who live in Burnett, Clark, and Forest counties cannot enroll in this plan.
Star rating
3.5 out of 5 stars
Coverage
Check if your doctors are in-network: Provider search
Check if your prescription drugs are covered: Comprehensive formulary
Costs
Doctor visit: No cost
Hospitalization: No cost
Skilled nursing facility: No cost
Emergency department: No cost
Extra benefits
Details: Summary of benefits
Basic dental:
- Up to three oral exams per year
- Up to six cleanings per year
- 2 fluoride treatments
- Dental X-rays: bitewing x-rays and intraoral x-rays up to one set(s) per year and panoramic film or diagnostic x-rays up to one every five years
$4,000 coverage maximum for preventative and comprehensive care
Extra dental: Prior authorization required. There is a $4,000 coverage maximum for preventative and comprehensive care.
Vision:
- One routine eye exam, up to $50
- $400 per year towards contacts or glasses
Hearing:
- $0 for routine hearing exams up to one every year
- $0 for follow-up provider visits (unlimited)
- $0 co-pay for each advanced level hearing aid, up to one per ear every three years
Wellness programs: SilverSneakers
Other:
- $150/month towards groceries, over-the-counter products, home supplies from select retailers, non-medical transportation, utilities, rent, assistive devices, pest control, or pet care; unused funds will roll over to the next month and expire at the end of the plan year or upon disenrollment
- Non-emergency transportation: 50 one-way trips to approved locations (up to 25 miles per trip)
- Post-hospitalization meals: two meals a day for up to seven days; limit four times a year
How to enroll
You can only enroll during a Medicare enrollment period; learn more at Medicare.gov.
Enrollment into this plan will automatically disenroll you from your current Medicare Advantage or Part D plan.
There are multiple ways to enroll:
- Call the plan at 866-790-6503 or icarehealthplan.org
- Medicare.gov
- 1-800-MEDICARE
- Contact the State Health Insurance Assistance Program (SHIP)