iCare

What iCare does

iCare (Independent Care Health Plan) is a Wisconsin-based managed care organization (MCO) and a wholly-owned subsidiary of Humana Inc., headquartered in Milwaukee. Founded in 1994 and serving 44,000 members, iCare specializes in government-sponsored health plans for populations with complex needs, including dual-eligible individuals through the Family Care Partnership HMO D-SNP, low-income adults and children via BadgerCare Plus, and individuals with disabilities through the Medicaid SSI plan. The company integrates Medicare and Medicaid benefits, care coordination across medical, behavioral, long-term care, and social services, and culturally responsive programs — including a dedicated tribal liaison serving Wisconsin's tribal communities.

iCare's technology infrastructure centers on a web-based Provider Portal that supports claims submission, eligibility verification (EDI 270/271), claim status inquiries (EDI 276/277), prior authorization management, and remittance information access. The company uses Electronic Visit Verification (EVV) for personal care services and processes payments through the InstaMed network for electronic remittance advice and funds transfer. Optometry claims are routed to National Vision Administrators. Effective January 2026, pharmacy benefit management for the Family Care Partnership Medicare Part D program will be administered by Humana Pharmacy Solutions, consolidating drug benefit operations within the parent company. iCare holds dual NCQA accreditations: Health Equity Accreditation and Health Plan Accreditation.

iCare generates revenue primarily through capitation payments from CMS for Medicare Advantage members and from the Wisconsin State Medicaid agency for Medicaid enrollees. As an HMO, it contracts with a network of Wisconsin hospitals, physicians, skilled nursing facilities, home health agencies, and over 2,000 independent pharmacies via the IPC partnership. Distribution occurs through direct government program enrollment, a contracted provider network, and a self-service provider portal. Marketing is relationship-driven, relying on provider bulletins, member newsletters, community partnerships (e.g., Feeding Wisconsin, Milwaukee Healthy Start), and press releases rather than traditional consumer advertising.

Name

iCare

Legal name

Independent Care Health Plan

Website

https://icarehealthplan.org

Company type

Private

Founded year

1994

Operating status

Operating

Headcount range

251–500 employees

Short description

iCare (Independent Care Health Plan) is a Milwaukee-based managed care organization and wholly-owned Humana subsidiary that serves 44,000 Wisconsin Medicaid and Medicare members, including dual-eligible individuals, people with disabilities, and low-income residents across BadgerCare Plus, Medicaid SSI, and Family Care Partnership plans.

Ownership category

akta.pro rank

Product category

Managed Care Health Insurance

NAICS

Services for the Elderly and Persons with Disabilities (624120), Continuing Care Retirement Communities and Assisted Living Facilities for the Elderly (62331)

SIC

Hospital & Medical Service Plans (6324), Services-Health Services (8000)

akta.pro primary industry

Medicare Advantage HMOs (HMO/HMO-POS) (HLAEAMAH)

akta.pro secondary industries

Aged, Blind & Disabled (ABD) Managed Care Plans (HLAEAEAC), TANF/CHIP Managed Care Plans (HLAEAEAA), MA Chronic Condition Management & Supplemental Benefits (SSBCI) (HLAEACAI)

Keywords

• Managed care plans
• Medicaid health insurance
• Medicare Advantage plans
• Long-term care services
• Dual eligible programs

Headquarters

HQ city

Milwaukee

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2C

Offering type

Services

Cost components

Personnel, Operations, Healthcare or Provider Services, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Medicare Advantage Premiums: iCare receives capitation payments from CMS for Medicare Advantage plans including HMO D-SNP (Family Care Partnership), covering members eligible for both Medicare and Medicaid.
2. Medicaid Capitation: State Medicaid program payments for BadgerCare Plus and SSI Medicaid members, including care coordination and long-term care services.
3. Pharmacy Benefits Management: iCare manages pharmacy benefits through Humana Pharmacy Solutions, covering Medicare Part D prescription drugs for Family Care Partnership members.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

iCare is a Wisconsin managed care organization that contracts with CMS and the state Medicaid agency to deliver integrated Medicare and Medicaid health insurance plans to approximately 44,000 members with complex health, disability, and long-term care needs. Its core offerings include the Family Care Partnership (HMO D-SNP) for dual-eligible individuals, the BadgerCare Plus Plan for low-income residents, and the Medicaid SSI Plan for individuals with disabilities, with care coordination, pharmacy benefits through Humana Pharmacy Solutions, and a provider portal supporting claims, eligibility verification, and prior authorizations.

Product overview

iCare is a managed care organization offering a portfolio of Medicare and Medicaid health insurance plans for people with disabilities and low incomes. The core offerings include three health plans: the Family Care Partnership (HMO D-SNP) for dual-eligible individuals requiring long-term care, the BadgerCare Plus Plan for low-income Wisconsin residents, and the Medicaid SSI Plan for individuals with disabilities. The Family Care Partnership plan integrates Medicare Part D prescription drug coverage through Humana Pharmacy Solutions. A Provider Portal enables providers to manage claims, authorizations, and member information. The organization also offers care management, population health, and quality improvement programs as part of its service ecosystem.

Differentiator

Problem solved

Functional benefit

Products and services

• iCare Family Care Partnership (HMO D-SNP) A health and long-term care program that fully integrates Medicare and Medicaid benefits for frail older adults and adults with physical, intellectual, or developmental disabilities in Wisconsin.
• iCare BadgerCare Plus Plan Medicaid health program for low-income Wisconsin adults and children providing access to primary and preventive care, prescription drugs, and additional community resources, with care coordination across medical, social, developmental, behavioral, educational, and financial needs.
• iCare Medicaid SSI Plan Managed care plan for individuals with disabilities on Supplemental Security Income that brings together medical, social, and community service needs, with culturally sensitive care from providers in their communities.
• Humana Pharmacy Solutions (Medicare Part D) Medicare Part D Prescription Drug program for Family Care Partnership members, covering thousands of prescription drugs through a formulary managed by Humana Pharmacy Solutions.
• iCare Provider Portal Web-based portal allowing contracted providers to bill LTC professional claims, view service authorizations, and access claim information for iCare members using a personal computer, cell phone, or tablet.

Quantifiable outcome

• Dual NCQA accreditations achieved (Health Equity Accreditation and Health Plan Accreditation)

Named customers1 record

Segments3 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

Feature3 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Uber (Uber Direct)coreStrategic or Co-development Partner · 4 March 2025Uber, through its Uber Direct delivery service, partnered with iCare+ to offer prescription medication deliveries and supplement benefits for members of the Independent Pharmacy Cooperative (IPC). IPC pharmacies using iCare+'s digital healthcare platform gain access to Uber Direct's on-demand delivery network, enabling same-day medication delivery to patients.
• Feeding WisconsinminorStrategic or Co-development Partner · 1 January 2020Humana and iCare associates volunteer with Feeding Wisconsin food banks as part of community outreach and Hunger Action Month initiatives.
• Milwaukee Healthy StartminorStrategic or Co-development Partner · 1 January 2020iCare donated car seats to Milwaukee Healthy Start for program participants supporting maternal and child health outcomes in the community.
• Centers for Independence, Inc. (CFI)minorStrategic or Co-development PartnerFormer co-owner of iCare (50% stake) that sold its remaining interest to Humana. Previously provided joint venture partnership in Wisconsin healthcare market.
• Mr. Bob's Under the BridgeminorStrategic or Co-development PartneriCare supported the organization's homeless outreach efforts with a $6,000 donation to purchase a shower trailer bringing facilities to homeless individuals in Wisconsin.
• Wisconsin TribescoreStrategic or Co-development PartneriCare maintains committed tribal partnerships across Wisconsin with dedicated Tribal Liaison Dr. Tim Fish. Partnerships focus on tribal events, regular consultation, culturally responsive care strategies, executive advisory, and policy input.
• Humana Pharmacy SolutionscoreTechnology or IntegrationPharmacy Benefits Manager for iCare Family Care Partnership Medicare Part D prescription drug program, effective January 1, 2026.

Scale indicators4 records

Recent moves5 records

Expansion highlights4 records

Direct peers

• Centene Corporation: Centene is the largest U.S. Medicaid managed care company, with deep concentration in government-sponsored healthcare (Medicaid, Marketplace, Medicare). Centene serves dual-eligible and SSI populations through plans that closely mirror iCare's product portfolio, including complex populations.
• CareSource: CareSource is a large nonprofit managed care organization focused primarily on Medicaid and dual-eligible populations across multiple states. Operates government-sponsored managed care with similar member demographics and care model.
• Molina Healthcare: Molina is a major publicly-traded Medicaid and dual-eligible managed care organization with significant Medicaid market presence across multiple states, including Medicaid SSI and dual-eligible populations directly comparable to iCare's segment. Both organizations operate government-funded managed care plans with similar member demographics.
• Quartz Health Solutions: Quartz Health Solutions is a Wisconsin-based health plan serving Medicaid and commercial members in overlapping Wisconsin counties. Operates as a regional peer with similar member demographic focus.
• Chorus Community Health Plans: Chorus Community Health Plans is a Wisconsin-based nonprofit managed care organization serving BadgerCare Plus and Medicaid SSI members in the same geographic market as iCare. Direct competitor for Wisconsin Medicaid contracts.
• Network Health (Wisconsin): Network Health is a Wisconsin-based health plan offering Medicare Advantage and Medicaid plans in the same market as iCare. Direct regional competitor for dual-eligible and Medicaid members.

Broad incumbents

• Humana Inc. Humana is iCare's parent company and a top-tier U.S. health insurer with large Medicare Advantage, Medicaid, and group health businesses. Comparable as the broader managed care platform whose Medicare-Medicaid integration capabilities iCare leverages.
• Elevance Health (Anthem): Elevance operates major Medicaid MCO subsidiaries (Anthem Blue Cross Blue Shield plans and Amerigroup) serving dual-eligible and complex populations in multiple states, including Wisconsin-adjacent markets. Comparable as a broad incumbent managed care competitor.

Regional players

• Common Ground Healthcare Cooperative: Common Ground Healthcare Cooperative is a Wisconsin-based health insurer that has historically operated in adjacent markets to iCare. Regional peer with similar Wisconsin member demographics.

Others

• UnitedHealth Group (UnitedHealthcare): UnitedHealth operates the largest U.S. health insurer with substantial Medicaid managed care and dual-eligible D-SNP presence across multiple states, including Wisconsin. Comparable as a broad incumbent competitor with greater scale.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• LinkedInlinkedin.com/company/icare
• Xx.com/icarehealthplan

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles8 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about iCare