No Referral Needed

The following services do not require a referral from your PCP. This means that your PCP does not need to arrange or approve these services for you. Just check your Provider Directory for a list of participating Providers who offer these services and schedule an appointment yourself. If you are not sure what types of Providers offer any of these services, please call CareSource for help.

  • Primary Care Provider services - You can make unlimited visits to the participating Provider you choose as your PCP.
  • Yearly well-adult exams
  • Well-child (Healthchek) exams for children under the age of 21
  • Shots (immunizations)
  • Preventive mammogram (breast) and cervical cancer (Pap smear) exams
  • Physical exams - Those required for employment or for the JOBS program if the exam is not provided free of charge by another source
  • Services available at a Federally Qualified Health Center (FQHC) or Rural Health Clinic (RHC)
  • Prescription drugs, including certain prescribed over-the-counter drugs - Health care Providers will write prescriptions for you that can be filled at a participating pharmacy. They are filled with generic drugs, when available, unless your doctor gets prior approval for brand name drugs from CareSource's Pharmacy Benefits Manager.
  • Family planning services and supplies - You may receive services from your PCP or any obstetrician, gynecologist or qualified family planning Provider listed in your Provider Directory such as Planned Parenthood.
  • Obstetrical (maternity care – prenatal and postpartum, including at-risk pregnancy services) and gynecological services - You may go to any participating Obstetrician or Gynecologist (OB/GYN) listed in your Provider Directory.
  • Certified nurse midwife services - You may go to a Certified Nurse Midwife (CNM). Check the Provider Directory or call CareSource for the names of available CNMs.
  • Certified Nurse Practitioner services - If you would like to see a Certified Nurse Practitioner (CNP), check the Provider Directory or call CareSource for the names of available CNPs.
  • Emergency services - Please see Where to get Care.
  • Mental health and substance abuse services - If you need mental health and/or substance abuse services, please call Member Services at 1-800-488-0134, or you may self-refer directly to a Community Mental Health Center or Ohio Department of Alcohol and Drug Addiction Services (ODADAS) facility which is a Medicaid Provider. Please see your Provider Directory, call Member Services or visit our website at www.caresource.com for the names and telephone numbers of the facilities near you.

    You may go to any participating psychologist without a referral. You can make up to 25 visits per year without a referral or Prior Authorization. You need a referral from your PCP to see a psychiatrist except for those at community mental health centers. Please call us if you have questions.
  • Vision (optical) services, including eye glasses - Routine checkups and services from optometrists, as well as eye glasses, do not require a referral. Other services require a referral from your PCP or optometrist and/or Prior Authorization from CareSource.
  • Dental services - Routine checkups and cleanings do not require a referral. We encourage you to get a checkup every 6 months or as often as your dentist tells you. Other services may require a referral from your dentist and/or Prior Authorization from CareSource.
  • Chiropractic (back) services - Members under age 21 can make up to 30 visits per year without a referral or Prior Authorization. Members 21 and older can make up to 15 visits per year.
  • Podiatry (foot) care
  • Speech and hearing services - You can make up to 48 visits per year for speech therapy or hearing testing without a referral or Prior Authorization.
  • Services for children with medical handicaps (Title V) - Services can be obtained from your PCP or from a specialist with a PCP referral.
  • Medical supplies - These require a prescription. Some supplies do require a referral and/or Prior Authorization from CareSource.