Important Update about
Based on a recent legal decision, changes to Medicaid under Kentucky HEALTH will not begin on July 1, 2018 as planned. The Department for Medicaid Services has not changed any policy relating to benefits available for pregnant women, disabled individuals, and children.
Welcome Humana – CareSource Members!
We’re glad you’ve chosen us for your health plan. We look forward to serving you.
Humana – CareSource® is a Medicaid Managed Care Plan (MCP) that provides health care services to Kentucky residents. We know it’s not always easy to understand health care. That’s why we work hard to give you the information and peace of mind you want.
Humana – CareSource is available in all counties across Kentucky.
We’ve included information on this website that will help you understand your Humana – CareSource health plan. You will find:
- Details about your benefits and services
- Your member handbook (English and SPANISH… Coming soon)
- Our Find a Doctor/Provider search tool to help you easily find a health partner
- A list of drugs that are covered on our plan
- And much more
New Copayment Requirement for State Medicaid Plan Members
As our member we want to ensure you are aware of any changes that may impact your health insurance. Starting July 1, 2018, the Commonwealth of Kentucky is requiring that all Medicaid Managed Care Organizations impose cost sharing requirements. On July 1, 2018 you will be subject to copayments for certain services. You will not be required to pay more than five percent of your household’s income in a quarter. Exemptions may apply*. Refer to the copay grid below.
What is a copayment?
A copayment is an amount you are required to pay as your share of the cost for a medical service like a doctor’s visit or a prescription. Benefits that require a copayment are:
|Service or Item||Copayment Amount|
|Preferred and non-preferred generic drug||$1.00|
|Preferred brand name drug that does not have a generic equivalent||$4.00|
|Non-preferred brand name drug||$4.00|
|Dental – for members not enrolled in the Alternative Benefit Plan||$3.00|
|Optometry – for members not enrolled in the Alternative Benefit Plan||$3.00|
|General ophthalmological services – for members not enrolled in the Alternative Benefit Plan||$3.00|
|Office visit for care by a physician, physician’s assistant, advanced registered nurse practitioner, certified pediatric and family nurse practitioner, nurse midwife, or any behavioral health professional||$3.00|
|Visit to a rural health clinic, primary care center, or federally qualified health center||$3.00|
|Outpatient hospital service||$4.00|
|Emergency room visit for a non-emergency service||$8.00|
|All Inpatient hospital admission||$50.00|
|Physical therapy, speech therapy, occupational therapy||$3.00|
|Durable medical equipment||$4.00|
|Ambulatory surgical center||$4.00|
|Laboratory, diagnostic, or x-ray service||$3.00|
*Exemptions may apply but are not limited to:
Foster children, preventive services, pregnant women, terminally ill and hospice care, emergency services, and some family planning services.
You can create your own personal online account to get plan details, update your contact information and more. Click My CareSource Login under the Quick Links to log in or create an account.
When You Can Reach Us
Humana – CareSource is open for business Monday through Friday, 7 a.m. to 7 p.m. Eastern Time.
Humana – CareSource is closed on the following holidays:
- New Year’s Day: Monday, January 1, 2018
- Memorial Day: Monday, May 28, 2018
- Independence Day: Wednesday, July 4, 2018
- Labor Day: Monday, September 3, 2018
- Thanksgiving Day: Thursday, November 22, 2018
- The day after Thanksgiving: Friday, November 23, 2018
- The day before Christmas: Monday, December 24, 2018
- Christmas Day: Tuesday, December 25, 2018
Humana – CareSource will be closed on the days it observes major holidays.
Who to Call
Here’s how to get in touch with us if you have a question or concern.
|If you…||Then call…||When…|
|Need to talk with a nurse for health advice||Members can call the 24-Hour Nurse Advice Line at 1-866-206-9599||24 hours a day, 7 days a week|
|Have a question about your Humana – CareSource benefits||Member Services at 1-855-852-7005 (TTY: 1-800-648-6056 or 711)||7 a.m. – 7 p.m., Monday – Friday|
|Need a ride to a medical appointment or service that Medicaid covers||Kentucky Department for Medicaid Services (KDMS) at 1-888-941-7433 or go to the KDMS website||Any time|
Do you need help understanding this information? Please call Member Services at 1-855-852-7005 (TTY: 1-800-648-6056 or 711). We can explain it to you. We can also read it aloud in English or in another language. And we can help you if you are visually or hearing impaired. This is a service offered at no cost to you.
Se usted prefiere esta informacion en Espanol, favor de llamar a Humana – CareSource al 1-855-852-7005 (TTY 1-800-648-6056 or 711).
The Humana – CareSource trademark is jointly owned by Humana Inc. and CareSource Management Group Co.