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Check out our library of helpful information, from plan brochures to provider directories.  Filters make it easy to find what you're looking for.  If you have any questions about any of the information in our library or can't find something, give us a call.  We are here to help!

To locate a Medicare Advantage coverage policy referenced in a letter you received, you can type the four-digit policy number (for example WI.PA-1223) in the Keywords search box below. If you cannot locate the policy here, please refer to Medical and Pharmacy Coverage Policies; iCare is a subsidiary of Humana, and coverage policies are also located on this Humana’s Medical and Pharmacy Coverage Policies page. iCare has also prepared some FAQs for Medicare Advantage coverage policies.

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iCare Medicare Provider Directory Family Care Partnership - updated Jan 2025

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicaid Provider Directory - updated Jan 2025

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicare Provider Directory- updated Jan 2025

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 Comprehensive Formulary

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership

iCare Medicare Provider Directory South-Central WI - updated 12/1/2024

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicare Provider Directory Southeast WI - updated 12/1/2024

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicare Provider Directory Northwest WI - updated 12/1/2024

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicare Provider Directory Northeast WI - updated 12/1/2024

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2024 Comprehensive Formulary - updated 12/1/2024

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents

2024 Part D Prior Authorization Criteria - updated 12/1/24

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents

2024 Step Therapy Prescription Drug Criteria - updated 12/1/2024

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents

Medicaid-SSI-BC Plus Provider Directory-Western-WI Updated 12/1/24

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

Medicaid-SSI-BC Plus Provider Directory-South-Central WI Updated 12/1/24

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

Medicaid-SSI-BC Plus Provider Directory-Northeast WI Updated 12/1/24

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

Medicaid-SSI-BC Plus Provider Directory-Milwaukee-Updated 12/1/24

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Provider Directories

iCare Family Care Partnership Provider Directory - Updated 12/1/2024

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 iCare Medicare Evidence of Coverage

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2025 iCare FCP Evidence of Coverage

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

Non-Discrimination Notice

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Policies and Guidelines

Auxiliary Aids and Services Notice

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

2025 Stars Rating

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Plan Information

2025 AEP Oct iCare Family Care Provider Directory

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 AEP iCare Medicare Provider Directory Southeast

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 AEP iCare Medicare Provider Directory Northeast

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 AEP iCare Medicare Provider Directory Northwest

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

2025 AEP iCare Medicare Provider Directory Southcentral Southwest

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Directories

iCare Medicare Enrollment Form

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Applications

2025 iCare Medicare Annual Notice of Change

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2025 iCare Medicare Summary of Benefits

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2025 iCare FCP Annual Notice of Change

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2025 iCare FCP Summary of Benefits

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

Medicare Multi-Language Interpreter Services

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines

Part D Transition Process

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization

Ombuds for BadgerCarePlus and SSI Medicaid HMO Members

Plans
  • ALL
Document Types
  • Claims
  • Grievances & Appeals

iCare Medicaid SSI and BadgerCare Plus Member News (Q2 2024)

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Health Education
  • Plan Information

Family Care Partnership Program Information Brochure

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Health Education
  • Plan Information
  • Programs
  • Self-Directed Supports

BC+ SSI Measure Year 2024 P4P Quality Measures

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education
  • Internal Guidance for Providers
  • Policies and Guidelines

Current iCare Prior Authorization List (PAL) - excel

Document Types
  • Prior Authorization

Current iCare Prior Authorization List (PAL) - pdf

Document Types
  • Prior Authorization

WI.PA.001-Outpatient Skilled Services, Home Health Services, Durable Medical Equipment, and Procedures PA Process

Plans
  • ALL
Document Types
  • Policies and Guidelines
  • Prior Authorization

Scope of Sales Appointment Confirmation Form

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Plan Information
  • Policies and Guidelines

CMS Appointment of Representative Form-Spanish

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Applications
  • Claims
  • Policies and Guidelines

2024 BadgerCare Plus & Medicaid SSI Member Handbook

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Plan Information

Part D Redetermination Request - Medicare

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents
  • Grievances & Appeals
  • Policies and Guidelines

Part D Redetermination Request - Family Care Partnership

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Grievances & Appeals
  • Provider Forms

COVID 19 Vaccine FAQ Flyer

Document Types
  • Health Education

2024 Dental Brochure - SSI/BC+ Medicaid

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information

2024 Vision Brochure - SSI/BC+ Medicaid

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Plan Information

Claim Form - LTC Professional - updated 1/2024

Plans
  • iCare Family Care Partnership
Document Types
  • Claims
  • Provider Forms

iCare Coverage Criteria FAQ Document

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1056-Complementary and Alternative Medicine

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1074-Electric Tumor Treatment Fields

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1166-Negative Pressure Wound Therapy

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1169-Noninvasive Home Ventilators

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1212-Solid Organ Transplants

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-1233-Varicose Vein Treatments

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-9002-Substance Use Disorder Inpatient Services

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

WI.PA-9003-Substance Use Disorder Partial Hospital Program Services

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines
  • Prior Authorization

2024 iCare Medicare Summary of Benefits

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2024 iCare Medicare Annual Notice of Changes

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

2024 iCare Medicare Plan Evidence of Coverage

Plans
  • iCare Medicare Plan
Document Types
  • Benefit Information
  • Plan Information

Medicare Star Ratings

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines

2024 iCare Family Care Partnership Summary of Benefits

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2024 iCare Family Care Partnership Evidence of Coverage

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

2024 iCare Family Care Partnership Annual Notice of Changes

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

Medicare Medication Reimbursement Claim Form

Plans
  • iCare Medicare Plan
Document Types
  • Formulary/ Pharmacy Documents

Diabetic Supplies FCP Medicaid 2024

Plans
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents

Inpatient Notification Form

Plans
  • iCare Medicare Plan
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Policies and Guidelines
  • Prior Authorization
  • Provider Forms

CMS Appointment of Representative Form-English

Document Types
  • Applications
  • Claims
  • Policies and Guidelines

FCP Medicaid Only Member Handbook-Updated 3/3/23

Plans
  • iCare Family Care Partnership
Document Types
  • Benefit Information
  • Plan Information

Notice of Privacy Practices

Document Types
  • Policies and Guidelines

Medicaid SSI Welcome Guide_Spanish_US

What to do in case of Emergency Spanish-US

Power of Attorney Brochure Spanish

Nurse Advice Line Brochure Spanish-US

Document Types
  • Health Education

Consent to Receive Electronic Communications

Plans
  • iCare Family Care Partnership
Document Types
  • Policies and Guidelines

Medicaid SSI Welcome Guide

Plans
  • iCare Medicaid SSI
Document Types
  • Benefit Information
  • Plan Information

BadgerCare Plus Welcome Guide

Plans
  • iCare BadgerCare Plus
Document Types
  • Benefit Information
  • Plan Information

FCP Self-Directed Supports Brochure

Plans
  • iCare Family Care Partnership
Document Types
  • Self-Directed Supports

FCP Self-Directed Supports Guidebook

Plans
  • iCare Family Care Partnership
Document Types
  • Self-Directed Supports

Medicare Member Reimbursement Request Form

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership

Opioid Education 2022 for iCare Medicare Plan members

Plans
  • iCare Medicare Plan
Document Types
  • Health Education

Opioid Education 2022 for Family Care Partnership members

Plans
  • iCare Family Care Partnership
Document Types
  • Health Education

Advance Directives - Power of Attorney, Living Will brochure

Plans
  • ALL

Medicaid Appointment of Representative Form-Grievence and Appeal.pdf

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare Medicaid SSI

Medicaid Appointment of Representative Form-Organization

Plans
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Medicaid Appointment of Representative Form-Person

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare Medicaid SSI

Incident Reporting Guide for Members

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education

Understanding Abuse Neglect and Exploitation

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Behavioral Health
  • Health Education

Fraud Waste and Abuse Training

Document Types
  • Policies and Guidelines

Wisconsin Tobacco Quit Line Fact Sheet - Spanish

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Wisconsin Tobacco Quit Line Fact Sheet - English

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Part D Coverage Determination Request

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
Document Types
  • Formulary/ Pharmacy Documents
  • Prior Authorization
  • Provider Forms

iCare Limited English Proficiency Policy Statement

Document Types
  • Policies and Guidelines

BadgerCare Plus & Medicaid Mom & Baby Program

Plans
  • iCare BadgerCare Plus
Document Types
  • Health Education
  • Programs

What to do in Case of an Emergency

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Personal Medication List (blank)

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI

Nurse Advice Line Brochure

Plans
  • iCare Medicare Plan
  • iCare Family Care Partnership
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education

iCare Medicaid SSI Intensive Care Management brochure

Plans
  • iCare Medicaid SSI
Document Types
  • Programs

Appeals Request Form

Document Types
  • Claims
  • Policies and Guidelines

Equal Employment Opportunity Affirmative Action Policy Statement

Document Types
  • Policies and Guidelines

Request for a State Fair Hearing

Document Types
  • Applications
  • Policies and Guidelines

Ombuds Information (Hmong)

Document Types
  • Health Education
  • Policies and Guidelines

Medication Reconciliation Post-Discharge Form

Plans
  • ALL
Document Types
  • Formulary/ Pharmacy Documents
  • Provider Forms

Ombuds Information (Spanish)

Plans
  • iCare BadgerCare Plus
  • iCare Medicaid SSI
Document Types
  • Health Education
  • Policies and Guidelines

Disclaimers

H2237_IC2203_M
Last Updated 10/15/22

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