Check Member Eligibility

The CareSource ID card is used to identify CareSource members, however, it does not verify eligibility for benefits since members may disenroll from CareSource and retain an old card. Therefore, it is important to verify member eligibility before providing services. Patients must be eligible CareSource members at the time of service in order for services to be covered.

To verify member eligibility, please use one of the following methods:

You can verify member eligibility either online using CareSource's Provider Portal or by calling Provider Services at 1-800-390-7102 and choose the option for member eligibility.  The service center representative will need the member name or member Medicaid ID number to verify eligibility.

• For Provider Portal go to Provider Login and register to use the secured area of our website. You can check CareSource member eligibility up to 12 months after the date of service. You can search by date of service plus any one of the following:
  • Member name and date of birth
  • Case number
  • Medicaid number
  • CareSource member ID number

All CareSource providers should always verify member eligibility before rendering services except in an emergency. CareSource also participates with electronic information exchange service companies to provide member eligibility information online.

Newborn enrollment

Newborns whose mothers are members of our health plan are covered from the date of birth. In most cases, the newborn's name will appear on the PCP's member eligibility list for the month following the birth. Please call Provider Services at 1-800-390-7102 to verify eligibility.

PCP eligibility lists updated

CareSource has updated the format of Member eligibility lists sent to participating PCPs. All new Members are now identified with an asterisk. We hope you find this new format helpful. Thank you for participating with CareSource.