Family Care Partnership Member Rights

iCare Family Care Partnership Member Rights


Your Rights

We must honor your rights as a member of iCare Family Care Partnership.

  1. We must provide information in a way that works for you. To get information from us in a way that works for you, please contact your care team.
  2. We must treat you with dignity, respect, and fairness at all times. You have the right:
    • To get compassionate, considerate care from iCare Family Care Partnership staff and providers
    • To get your care in a safe, clean environment
    • To not have to do work or perform services for iCare Family Care Partnership
    • To be encouraged and helped in talking to iCare Family Care Partnership staff about changes in policy that you think should be made or services that you think should be provided
    • To be encouraged to exercise your rights as a member of iCare Family Care Partnership
    • To be free from discrimination. iCare Family Care Partnership must obey laws that protect you from discrimination or unfair treatment. We do not discriminate based on a person’s race, mental or physical disability, religion, gender, sexual orientation, health, ethnicity, creed (beliefs), age, national origin, or source of payment
    • To be free from any form of restraint or seclusion used as a means of coercion, discipline, convenience or retaliation. This means you have the right to be free from being restrained or forced to be alone in order to make you behave in a certain way or to punish you or because someone finds it useful
    • To be free from abuse, neglect, and financial exploitation
      • Abuse can be physical, emotional, financial or sexual. Abuse can also be if someone gives you a treatment such as medication, or experimental research without your informed consent
      • Neglect is when a caregiver fails to provide care, services, or supervision which creates significant risk of danger to the individual. Self-neglect is when an individual who is responsible for his or her own care fails to obtain adequate care, including food, shelter, clothing, or medical or dental care
      • Financial exploitation can be fraud, enticement or coercion, theft, misconduct by a fiscal agent, identity theft, forgery, or unauthorized use of financial transaction cards including credit, debit, ATM and similar cards

    What can you do if you are experiencing abuse, neglect, or financial exploitation? Your care team is available to talk with you about issues that you feel may be abuse, neglect, or financial exploitation. They can help you with reporting or securing services for safety. You should always call 911 in an emergency.

    If you feel that you or someone you know is a victim of abuse, neglect, or financial exploitation, you can contact Adult Protective Services. Adult Protective Services help protect the safety of seniors and adults-at-risk who have experienced abuse, neglect or exploitation. They also help when a person is unable to look after his or her own safety due to a health condition or disability.

    You may call the following numbers to report incidents of witnessed or suspected abuse:

    Call your Team at 1-800-777-4376 (TTY: 1-800-947-3529) to consult with you regarding issues that you feel may constitute abuse, neglect, or financial exploitation. They will assist you with coordination of reporting or securing services for safety.

    You should always call 911 in an emergency for immediate assistance. The County Health and Human Services Department offers Adult Protective Services which are provided to people with developmental disabilities, degenerative brain disorder, serious and persistent mental illness, or other similar incapacity to keep the individual safe from abuse, neglect, financial exploitation, or misappropriation of property or prevent the individual from experiencing deterioration or from inflicting harm on himself or herself or another person.

    • Dane County
      • ADRC of Dane County
        • 2865 N. Sherman Avenue
        • Northside Town Center
        • Madison, WI 53704
        • 1-608-240-7400, 1-855-417-6892 TTY: 1-608-240-7404
        • www.daneadrc.org
    • Kenosha County
      • Kenosha County Division of Aging & Disability Services
        • 1-262-605-6646
        • 1-800-472-8008 (toll free)
        • TTY: 262-605-6663
    • Milwaukee County
      • For people 60 years of age or over call:
        • Milwaukee Aging Resource Center 1-414-289-6874
        • 1-866-229-9695 (toll free)
        • (TTY/TDD: 414-289-8591)
      • For people under 60 years of age call:
        • Milwaukee Disability Resource Center 1-414-289-6660 (TTY/TDD: 414-289-8559)
    • Racine County
      • ADRC of Racine County
        • 1-262-833-8777
        • 1-866-219-1043
        • TTY: Wisconsin Relay 711

    You may contact the numbers listed above 24 hours a day, 7 days a week.

  3. We must ensure that you get timely access to your covered services. As a member of iCare Family Care Partnership, you have a right to receive services listed in your care plan when you need them. Your care team will arrange for your covered services. Your team will also coordinate with your health care providers. Examples of these are doctors, dentists, and podiatrists. Contact your team for assistance in choosing your providers. As a member of iCare Family Care Partnership, you have the right to choose a primary care provider (PCP) in the provider network and receive the services listed in your care plan when you need them. Call iCare Family Care Partnership to learn which doctors are accepting new patients. If you think that you are not getting your medical care or drugs within a reasonable amount of time, talk to your care team. You may also refer to Chapter 8 which explains what you can do.
  4. We must protect the privacy of your personal health information. If you have questions or concerns about the privacy of your personal health information, please call your team. See Appendix 6 for iCare Family Care Partnership’s Notice of Privacy Practices.
  5. We must give you access to your medical records. Ask your care team if you want a copy of your records. You have the right to ask iCare Family Care Partnership to change or correct your records
  6. We must give you information about iCare Family Care Partnership, our network of providers, and available services. Please contact your Team if you want this information or go to our website (www.icare-wi.org).
  7. We must support your right to make decisions about your care
    • You have a right to know about all of your choices. This means you have the right to be told about all of the options that are available, what they cost and whether they are covered by Partnership. You can also suggest other services or supports that you think would meet your needs.
    • You have the right to be told about any risks involved in your care.
    • You have the right to say “no” to any recommended care or services.
    • You have the right to get second medical opinions.
    • You have the right to give instructions about what you want done if you are not able to make decisions for yourself. Sometimes people become unable to make health care decisions for themselves due to accidents or serious illness. You have the right to say what you want to happen if you are in this situation. This means if you want, you can develop an “advance directive.” There are different types of advance directives and different names for them. Documents called “living will” and “power of attorney for health care” are examples of advance directives. Contact your care team if you want to know more about advance directives
  8. You have the right to file a grievance or appeal if you are dissatisfied with your care or services. Chapter 8 includes information about what you can do if you want to file a grievance or appeal.

Your responsibilities

Things you need to do as a member of iCare Family Care Partnership are listed below. If you have any questions, please contact your care team. We’re here to help.

  1. Become familiar with the services in the Partnership benefit package. This includes understanding what you need to do to get your services. See Chapters 3 and 4 for more information.
  2. Participate in the initial and ongoing development of your care plan.
  3. Participate in the Resource Allocation Decision (RAD) process to find the most cost-effective ways to meet your needs and support your outcomes. Members, families and friends share responsibility for the most cost-effective use of public tax dollars.
  4. Talk with your care team about ways your friends, family or other community and volunteer organizations may help support you or ways in which you can do more for yourself.
  5. Follow the care plan that you and your care team agreed to
  6. Tell your doctors and other providers that you are in Partnership so they can work with you and your care team to be a part of your care plan.
  7. Be responsible for your actions if you refuse treatment or do not follow the instructions from your care team or providers.
  8. Use the providers that are part of iCare Family Care Partnership, unless you and your care team decide otherwise.
  9. Show your Partnership membership card whenever you get medical care or prescription drugs. It is important to show your membership card so that providers know to bill Partnership not you.
  10. Follow iCare Family Care Partnership’s procedures for getting care after hours.
  11. Notify us if you move to a new address or change your phone number.
  12. Notify us of any planned temporary stay or move out of the service area.
  13. Provide iCare Family Care Partnership with correct information about your health care needs, finances, and preferences and tell us as soon as possible about any changes in your status. This includes signing a “release of information” form when we need other information you do not have easily available.
  14. Treat your Team, home care staff, and providers with dignity and respect.
  15. Accept services without regard to the provider’s race, color, religion, age, gender, sexual orientation, health, ethnicity, creed (beliefs), or national origin.
  16. Pay any monthly costs on time, including any cost share or room and board charges you may have. Let your care team know as soon as possible if you have problems with your payment.
  17. Complete an “Annual Renewal” for Medicaid eligibility. The Income Maintenance agency uses the annual renewal to determine your financial eligibility. The renewal is to make sure you still meet all of the program requirements. You will be notified by mail the month before your renewal is due. This letter will tell you how to do your renewal. If you do not complete your renewal timely, you will lose your Medicaid and Partnership coverage and there will be a gap or delay in your benefits.
  18. Use your private insurance benefits, when appropriate. If you have any other health insurance coverage, tell iCare Family Care Partnership and the Income Maintenance agency. Let your care team know right away if you enroll in Medicare, or think you may be eligible for Medicare.
  19. Take care of any durable medical equipment (DME), such as wheelchairs, and hospital beds provided to you by iCare Family Care Partnership.
  20. Report fraud or abuse on the part of providers or iCare Family Care Partnership employees.
    If you suspect anyone of misuse of public assistance funds, including Partnership, you can call the fraud hotline or file a report online at:

  21. Do not engage in any fraudulent activity or abuse benefits. This may include:
    • Misrepresenting your level of disability
    • Misrepresenting income and asset level
    • Misrepresenting residency
    • Selling medical equipment supplied by iCare Family Care Partnership

    Any fraudulent activity may result in disenrollment from Partnership or possible criminal prosecution.

  22. Help your Team, doctors and other providers help you by giving them information, asking questions, sharing concerns, and following through on your care
  23. Call your care team for help if you have questions or concerns.
  24. Tell us how we are doing. From time to time, we may ask if you are willing to participate in member interviews, satisfactions surveys, or other quality review activities. Your responses and comments will help us identify our strengths as well as the areas we need to improve. Please let us know if you would like to know the results of any surveys. We would be happy to share that information with you.
Modified: 4/23/2018
 

The iCare Family Care Partnership (HMO SNP) is a Coordinated Care plan with a Medicare contract and a contract with the State Medicaid program. Enrollment in iCare Family Care Partnership depends on contract renewal. This plan is available to anyone who has both Medical Assistance from the State and Medicare and functionally eligible as determined by the State of Wisconsin Long-Term Care Functional Screen. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The Part B premium is covered by the State if you are a full-dual member. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary. You must receive all routine care from plan providers. For more information about Medicare benefits and services, including general information regarding the health or Part D benefit, contact 1-800-MEDICARE (1-800-633-4227) or visit http://www.medicare.gov; TTY users should call 1-887-486-2048, 24 hours a day, 7 days a week. For more information about State Medicaid benefits call the Department of Health Services at 1-800-362-3002 (TTY 1-888-701-1251) or visit http://dhs.wisconsin.gov/medicaid. For more information about long-term care options available to you in your county contact the Aging and Disability Resource Centers. The Resource Center can also assist you with information about eligibility and enrollment.

  • H2237_IC1453 Approved
 
  • Independent Care Health Plan
  • 1555 RiverCenter Drive, Suite 206
  • Milwaukee, WI 53212
  • Customer Service: 1-800-777-4376
    • 24 hours-a-day, 7 days-a-week
    • (Office Hours: Monday-Friday, 8:30 a.m. to 5:00 p.m.)
  • TTY: 1-800-947-3529
  • Fax: 414-231-1092
  • All content and images unless otherwise indicated are
  • Copyright © 2018 Independent Care Health Plan