Frequently Asked Questions

How do I enroll?

Enrollment with CareSource Advantage® (HMO SNP) is simple. Print the 2012 Enrollment Form, complete it, and mail it to us at:

CareSource
P.O. Box 807
Dayton, OH 45401-807
1-877-725-4581
(TTY for the hearing impaired: 1-866-649-3777 or 711)
Monday through Friday, 8 a.m. to 8 p.m.
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Am I eligible to enroll?

You're eligible to enroll with CareSource Advantage if you:

  • Are entitled to Medicare Part A and enrolled in Part B
  • Have full Medicaid benefits
  • Do not have end-stage renal disease (ESRD)
  • Live in our CareSource Advantage service area
  • Make a choice during a valid election period
  • Agree to the rules of the CareSource Advantage plan
  • You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party
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When can I enroll?

You may request enrollment in CareSource Advantage at the following times:

  • When you first become eligible for Medicare (Parts A and B)
  • Any month you are deemed dual eligible (have Medicare Parts A and B and Medicaid)
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What else should I know about CareSource?

CareSource Advantage is a Coordinated Care plan with a Medicare Advantage contract and a contract with the Michigan Medicaid program. Our contract is renewed annually, and coverage beyond the end of the contract year is not guaranteed. If our contract is not renewed, you will be notified in 90 days and given your options for future coverage.

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What happens if I am enrolled with another company?

If you choose to enroll in CareSource Advantage and you are currently enrolled with another Medicare Advantage plan, you will be automatically disenrolled from that plan.

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Why do I have to select my PCP now?

As part of the enrollment process, you will be asked to select a Primary Care Provider (PCP) from our provider network. Your PCP will be responsible for coordinating all of your health care needs while you are enrolled with CareSource Advantage. It is important to know that as a CareSource Advantage member if you receive routine care from providers who are not a part of our network (except in emergencies), neither CareSource nor Medicare will be responsible for the cost of care. To see our list of PCP's, please select the 2012 Provider Directory.

We can help you select a PCP. Call Member Services at 1-877-725-4581, Monday through Friday, 8 a.m. to 8 p.m. (TTY users should call 1-866-649-3777 or 711).

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What should I expect after I mail the form?

A CareSource Advantage Representative will be in contact with you to arrange an appointment to review information regarding the CareSource Advantage plan.

You will receive several notices from us. Those include:

  • A letter that we received your completed enrollment form. It will also give you your coverage effective date.
  • A member identification card (ID card).
  • A request for more information if needed.
  • A letter that says your enrollment was approved.
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What if I would like to have a family member or friend help me manage my CareSource Advantage benefits?

If you would like to appoint a person to file a grievance, request a coverage determination or exception, or request an appeal on your behalf, you and the person you would like to appoint must fill out the Appointment of Representative Form (CMS-1696) and submit it to CareSource.

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How do I find out about CareSource's Quality Assurance Program?

CareSource has a thorough Quality Assurance Program. To find out more, please view the 2012 Quality Assurance Policy.

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What if I have a grievance or appeal?

A grievance is a complaint that shows you are not satisfied with the plan or pharmacy's service. We do have a process to receive grievances, exceptions, and appeals. For information about that process, please view the 2012 Grievances, Exceptions, and Appeals Process. For instructions on how to file a grievance, exception or appeal, please view the 2012 Grievances, Exceptions, and Appeals Filing Instructions.

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How do I contact CareSource?

If you would like more information about CareSource Advantage or have questions about the enrollment process you may contact Member Services at 1-877-725-4581, Monday through Friday, 8 a.m. to 8 p.m. (TTY users should call 1-866-649-3777 or 711).

Written Requests

Our 2012 Evidence of Coverage provides information about how to contact Member Services by fax or mail. This link takes you directly to the specific 2012 fax and address information you need to submit a request to the plan.

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What if I decide CareSource Advantage is not for me?

You can ask to be disenrolled any time. However, it will be effective the first day of the month following receipt of the written request. There are three ways in which you can disenroll from CareSource Advantage:

  • Enroll in a new Medicare or Medicare prescription drug plan.
  • Send us a written request to disenroll.
  • You can also contact Medicare, at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week, and ask to be disenrolled. TTY users should call 1-877-486-2048.

For your 2012 Rights and Responsibilities upon disenrollment.

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H0141_MIMSNP607
CMS Approved 12/20/2011