We want to help you. Call us if you have questions.Customer Service: 1-800-777-4376 | TTY: 711Our customer service is open 24 hours a day, 7 days a week. Our office hours are Monday – Friday, 8:30 a.m. – 5:00 p.m.

Non-Emergency Medical Transportation: 1-866-907-1493 | TTY: 711

Please keep your Member Handbook. DO NOT THROW IT AWAY. You will need to refer to it as long as you are a member of iCare BadgerCare Plus. This includes if you join the plan, leave, and then return.

1555 North RiverCenter DriveSuite 206Milwaukee, Wisconsin 53212www.iCareHealthPlan.org

iCare BadgerCare PlusWELCOME GUIDEBadgerCare Plus brings together medical, social, and community service needs.

Welcome to iCare!Welcome to Independent Care Health Plan (iCare)! We are glad you decided to have iCare meet you and/or your children’s health needs under the BadgerCare Plus program. BadgerCare Plus is a State and Federal program that provides access to health care services for adults and children. We pledge to provide you with superior service. Please take advantage of the many different services that we offer.

FORWARDHEALTH ID CARD Your ForwardHealth ID card is how your doctor or pharmacist will know you are a BadgerCare Plus program member. You may have problems getting care or your medicine(s) if you do not have your ID Card with you. It is important to always carry your ForwardHealth ID card with you and show it every time you get care. Tell your doctor or pharmacist that you are a member of iCare.

OTHER INSURANCEIf you have other insurance in addition to iCare, you must tell your doctor or other health care provider. Your doctor or other health care provider must bill your other insurance before billing iCare. If your iCare doctor or other health care provider does not accept your other insurance, call the HMO Enrollment Specialist at 1-800-291-2002 (TTY: 711). The HMO Enrollment Specialist can tell you how to use both insurance plans.

CHOOSING A PRIMARY CARE PROVIDER AND REQUESTING A PROVIDER DIRECTORY At iCare, we want to help you stay healthy through regular visits to your Primary Care Provider (PCP). It is required that you choose a PCP or clinic that will best meet your health care needs. You can choose a primary care physician from the list of doctors accepting new patients. These doctors will have “accepting new patients” written under their name. Our doctors are also sensitive to the needs of many cultures. The list of doctors accepting new patients is called the iCare Medicaid/BadgerCare Plus Provider Directory. The directory is a resource that can help you select or change your Primary Care Provider. It can also help you choose a specialist, hospital, urgent care center, clinic, imaging center and more. You can request a FREE paper copy of the Provider Directory by: » Calling Customer Service at 1-800-777-4376 (TTY: 711), 24 hours a day, 7 days a week. Our office hours are Monday – Friday, 8:30 a.m. – 5:00 p.m.

» Emailing info@icarehealthplan.org » Requesting online at https://www.icarehealthplan.org/Contact/InfoRequest.aspx

» View, download or print our searchable directory on the “Find a Provider” page of the iCare web site: www.iCareHealthPlan.org. When you land on the home page click on the “Find a Provider” button.

WHAT SERVICES ARE COVERED BY THE BADGERCARE PLUS PROGRAM?In addition to the benefits listed in this Welcome Guide, iCare health insurance covers many other benefits like hospital services, behavioral health and substance abuse treatment and medications. There are more covered services than listed in this Welcome Guide. Please refer to your Member Handbook for more information. Covered services may change. You may have limits on a service. You should always check with iCare. You can also check with ForwardHealth Member Services.

CO-PAYMENTSUnder BadgerCare Plus, iCare’s providers and subcontractors may bill you small service fees called

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subcontractors may bill you small service fees called co-payments. If you receive a bill from a provider or subcontractor for a co-payment do not pay it. If this happens, please contact iCare first before you pay so we can help you determine if you need to pay the bill, or not, and provide instructions on what to do next. After you contact iCare and we determine you don’t need to pay the bill, mail a copy of the bill to:

Independent Care Health Plan1555 North RiverCenter Drive, Suite 206Milwaukee, Wisconsin 53212

Questions? Please call Customer Service at 1-800-777-4376 (TTY: 711), 24 hours a day, 7 days a week. Our office hours are Monday – Friday, 8:30 a.m. – 5:00 p.m.iCare will not bill you for co-payments. iCare BadgerCare Plus members DO NOT have to pay co-payments for medical or prescription drug services. The following members also do not have to pay co-payments: » Nursing home residents. » Pregnant women. » Members younger than 19 years old who are members of a federally recognized tribe.

» Members younger than 19 years old with incomes at or below 100 percent of the federal poverty level.

CARE COORDINATIONAs a BadgerCare Plus member, you can speak with a Care Coordinator (CC) that can: » Help you find a PCP / Behavioral Health Provider that is right for you.

» Make a care plan. » Connect you to community resources. » Answer questions and speak with you about your health concerns.

As a follow-up, the CC will mail you information and reminders regarding important health screenings and tests that you may need throughout the year. The CCs will also call you or mail health education information to you to help you manage and improve your health.

MEMBER NEEDS ASSESSMENTYou may be asked to talk with your CC about your health care needs. Your CC will contact you within the first 60 days of you joining iCare to schedule a time to talk about your medical history and the care you need. It is very important that you talk with us so that you can get the care and services you need. If you have questions or would like to contact iCare directly to schedule a time to talk about your health care needs, please call 1-800-777-4376 (TTY: 711) to speak with the iCare BadgerCare Plus Team to complete your assessment.

VISION (EYE) BENEFITiCare’s vision benefit provides covered services, including eyeglasses; however, some limitations apply. Please call your CC or iCare Customer Service for more information. » To find an eye doctor near you visit “Find a Provider” on the iCare web site (www.icarehealthplan.org) or call 1-800-672-7723 (TTY: 711).

» To make an appointment with a vision provider, call 1-800-672-7723 (TTY: 711). A representative is available to answer your call 24 hours a day, 7 days a week, 365 days a year.

DENTAL (TEETH) BENEFITiCare provides all covered dental services in Kenosha, Milwaukee, Ozaukee, Racine, Washington, and Waukesha counties, but you must go to an iCare dentist. See the iCare Medicaid SSI / BadgerCare Plus Provider Directory or call Customer Service at 1-800-777-4376 (TTY: 711) for the names of our dentists. If you live in a county that is not listed, Dental services are a covered benefit under BadgerCare Plus. You may get dental services from a Medicaid-enrolled

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provider who will accept your ForwardHealth ID card. As a member of iCare, you have the right to a routine dental appointment within 90 days of your request either in writing or over the phone to the Customer Service Department. BadgerCare Plus members and BadgerCare Plus children members are eligible for Dental Benefits starting at age 2.To find a Medicaid-enrolled provider:1. Go to www.forwardhealthwi.gov.2. Click on the Members link or icon in the middle

section of the page.3. Scroll down and click on the Resources tab.4. Click on the Find a Provider link.5. Under Program, select BadgerCare Plus.Or you can call ForwardHealth Member Services at 1-800-362-3002 (TTY: 711).

PHARMACY BENEFITSYou may get a prescription from an iCare doctor, specialist, or dentist. You can get covered prescriptions and certain over-the-counter items at any pharmacy that will accept your ForwardHealth ID card. You may have limits on covered medications. Ask your doctor or pharmacist about limits that may affect you. You do not have a co-pay for prescription drugs. If there is a co-payment, please call Customer Service at 1-800-777-4376 (TTY: 711).

MOM AND BABY PROGRAMThe iCare for Mom and Baby Program offers before and after pregnancy services, after delivery care, and

access to community resources. Additional services include family planning, smoking cessation, and behavioral health / addiction treatment. iCare also offers information and follow up calls / resources for age appropriate immunizations. To enroll in the program, call 1-800-777-4376 (TTY: 711) and ask to speak to the iCare for Mom and Baby team.

NURSE ADVICE LINEQuestions about your health or your family’s health can come up any time. Our Nurse Advice Line is here for you 24 hours a day, 7 days a week — at no cost. When you call, a registered nurse will answer health questions or provide health information. Nurses can also tell you how to take care of yourself at home when you do not feel well, but do not need to see a PCP. Call 1-800-679-9874 (TTY: 711).

TELL US ABOUT THE QUALITY OF YOUR HEALTH CAREA grievance is any expression of dissatisfaction about your HMO or health care provider that is not related to a denial, limitation, reduction, or delay in your benefits. Grievance topics include things like the quality of services you were provided, rudeness from a provider or an employee, and not respecting your rights as a member.We would like to know if you ever have a grievance about your care through iCare. Please call iCare’s Member Advocate at 1-800-777-4376, or write to us at the following address if you have a grievance:

Independent Care Health Plan1555 North RiverCenter Drive, Suite 206Milwaukee, Wisconsin 53212

If you want to talk to someone outside iCare about the problem, call the HMO Enrollment Specialist at 1-800-291-2002. The HMO Enrollment Specialist may be able to help you solve the problem or write a formal grievance to iCare, or to the BadgerCare Plus program. The address to file a grievance:

BadgerCare Plus and Medicaid SSI Managed Care OmbudsP.O. Box 6470 Madison, WI 53716-0470Phone: 1-800-760-0001

You may file a grievance at any time. You will not be treated differently from other members because you file a grievance. Your health care benefits will not be affected.

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ATTENTION: If you speak English, language assistance services are available to you free of charge. Call 1-800-777-4376 (TTY: 1-800-947-3529). ATENCIÓN: Si habla español, los servicios de asistencia de idiomas están disponibles sin cargo, llame al 1-800-777-4376 (TTY: 1-800-947-3529). CEEB TOOM: Yog koj hais lus Hmoob, kev pab rau lwm yam lus muaj rau koj dawb xwb. Hu 1-800-777-4376 (TTY: 1-800-947-3529). 注意：如果您说中文，您可获得免费的语言协助服务。请致电1-800-777-4376 (TTY: 文字电话: 1-800-947-3529).DIGTOONI: Haddii aad ku hadasho afka Soomaaliha, adeegyada caawimada luqadda waxaa laguu heli karaa iyagoo bilaash ah. Wac 1-800-777-4376 (TTY: 1-800-947-3529).ໝາຍເຫດ: ຖາທານເວາພາສາລາວ, ທານສາມາດໃຊການບລການຊວຍເຫອດານພາສາໄດໂດຍບເສຍຄາ. ໂທ 1-800-777-4376 (TTY: 1-800-947-3529).ВНИМАНИЕ: Если Вы говорите по-русски, Вам будут бесплатно предоставлены услуги переводчика. Позвоните по номеру: 1-800-777-4376 (TTY: 1-800-947-3529).ေကးဇးျပ၍ နားဆငပါ - သငသည ျမနမာစကားေျပာသျဖစပါက၊ သငအတြက အခမျဖင ဘာသာစကားကညေရး ၀နေဆာငမႈမား ရရနငသည။ 1-800-777-4376 (TTY: 1-800-947-3529) တြင ဖနးေခၚဆပါ။PAŽNJA: Ako govorite srpsko-hrvatski imate pravo na besplatnu jezičnu pomoć. Nazovite 1-800-777-4376 (telefon za gluhe: 1-800-947-3529).

Independent Care Health Plan:• Provides free aids and services to people with disabilities to communicate effectively with

us, such as:• Qualified sign language interpreters.• Written information in other formats (large print, audio, accessible electronic formats,

other formats).• Provides free language services to people whose primary language is not English, such

as:• Qualified interpreters.• Information written in other languages.

If you need these services, contact Independent Care Health Plan at 1-800-777-4376. TTY: 1-800-947-3529.

عدة لغویة مجانیة. اتصلوا بالرقمتنبیھ: إذا كنتم تتحدثون العربیة، تتوفر لكم مسا).3529-947-1800-(ھاتف نصي: 1800-777-4376-

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TELL iCARE WHEN YOU MOVE OR CHANGE A PHONE NUMBERIt is important you tell us when you move. It is also important you tell us when you have a new phone number. Why? We want to make sure you get information about your health care plan from iCare. We also need to talk to you about your health care. When you move, report your changes to your local Income Maintenance (IM) agency. If you move to a different county, you must also contact the IM agency in your new county to update your eligibility. If you become pregnant, please call the IM agency to report your pregnancy.iCare is not able to change BadgerCare Plus member’s address and phone number in our own records. To find an IM in your area, visit www.dhs.wisconsin.gov/forwardhealth/imagency/index.htm or call the HMO Enrollment Specialist at 1-800-291-2002 (TTY: 711). The Enrollment Specialist will help you choose a new HMO that serves your new area and/or update your address or phone number.

DON’T LOSE YOUR HEALTH CARE COVERAGE!It is important to renew your health insurance on time. You need to renew it when you get your renewal letter. If you do not renew your coverage, your health care insurance will end. There several ways to renew your health insurance: » Apply online at the ACCESS website: www.access.wisconsin.gov; » Complete the online form at: www.dhs.wisconsin.gov/forms/F1/F10182.pdf; » Call ForwardHealth Member Services at 1-800-362-3002 (TTY: 711); or » Call or go to your county IM agency or tribal agency to complete an application; for a map of the different IM agencies per county, go to: www.dhs.wisconsin.gov/forwardhealth/imagency/index.htm.

CONTACT INFORMATION - IN CASE OF AN EMERGENCY CALL 911iCare Customer Service: 1-800-777-4376 (TTY: 711), 24 hours a day, 7 days a week Office hours are Monday – Friday, 8:30 a.m. – 5:00 p.m.

Medicaid/ForwardHealth (Wisconsin Department of Health Services): 1-800-362-3002 (TTY: 711)

Social Security: 1-800-772-1213 (TTY: 1-800-325-0778)

Wisconsin Department of Health Services: 1-608-266-1865 (TTY: 1-888-701-1251)

Non-Emergency Medical Transportation: 1-866-907-1473 (TTY: 711)

1555 North RiverCenter Drive Suite 206Milwaukee, Wisconsin 53212

Phone: 1-800-777-4376TTY: 711www.iCareHealthPlan.org

Independent Care Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, gender identity, or sex.

IC180 V2 DHS Approved 2/05/2020