iCare Family Care Partnership Provider Access

iCare Family Care Partnership (HMO D-SNP) has formed a network of doctors, specialists, hospitals and long-term care providers. You must use plan providers except in emergent or urgent care situations. If you obtain routine care from out-of-network providers, without first contacting iCare Family Care Partnership and getting prior authorization, neither Medicare, Wisconsin Medicaid or the plan will pay for these services.

What are "network providers"?

Network providers are the doctors and other health care professionals, medical groups, hospitals, and other health care facilities and long-term care providers that have an agreement with us to accept our payment in full. We have arranged for these providers to deliver covered services to members in our plan.

Why do you need to know which providers are part of our network?

It is important to know which providers are part of our network because, with few exceptions, while you are a member of our plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed care when the network is not available (generally, out of the area), out-of-area dialysis services, and cases in which iCare Family Care Partnership  authorizes use of non-network providers.

If you don’t have a copy of the Provider Directory, you can request a copy from Customer Service. You may ask Customer Service for more information about our network providers, including their qualifications. You can also search for providers using our Find a Provider tool. Both Customer Service and this website can give you the most up-to-date information about changes in our network providers.

What happens if I go to a doctor who is not in your network?

If you choose to go to a doctor outside of our network without first contacting iCare Family Care Partnership and getting prior authorization, you must pay for these services yourself. Neither iCare Family Care Partnership, Original Medicare, or Wisconsin Medicaid will pay for these services. Please view our Find a Provider  page to search for a provider in our network.

Note to Indian members: iCare will permit you to access out-of-region and/or out-of-State Indian health care providers if timely access to an Indian health care provider in your service area cannot be ensured.  Furthermore, upon request, iCare may authorize and arrange for covered services with a non-network Indian health care provider that meets the state’s provider qualifications other than having a provider contract with iCare.

iCare makes every effort to assure that the provider listing is current and accurate as of the time of publishing. However, clerical errors occasionally occur. In addition, providers may change from time to time. Please contact Customer Service or your doctor’s office to find out whether the doctor you want to receive services from is currently in the iCare network. iCare cannot guarantee that the providers you use will be available throughout your coverage under the plan. If a provider terminates his or her participation in the network, we will assist you in selecting an iCare provider, or arrange for you to continue active treatment with an out-of-network provider until the end of your treatment. Network providers may not require services to be rendered via telehealth or remotely if in person service is available.

If you have any questions regarding the status of a particular provider, please contact iCare’s Customer Service department at 1-800-777-4376 TTY at 1-800-947-3529, from 8:30 to 5:00 p.m., Monday through Friday. If you wish to report inaccuracies in the provider listing please contact us at info@icarehealthplan.org. The provider or pharmacy network may change at any time. You will receive notice when necessary.

H2237_IC2203_DHS Approved 10/24/22