BENEFITS & SERVICES

Benefits & Services

As a Humana – CareSource® member, you get the same necessary medical services that the regular Kentucky Medicaid program covers. These medical services are available at no cost to you. Some of these services include:

  • Preventive checkups
  • Inpatient and outpatient hospital services (prior authorization required unless you are admitted through the emergency room)
  • Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services

Covered Services

For a complete list of covered services including information on how to obtain hospital, specialty and behavioral health services, refer to your member handbook (NavigateEnglish or Spanish… Coming soon).

You should not be billed for covered services. If you do get a bill, please call us. If you have more questions, call Member Services at 1-855-852-7005 (TTY: 1-800-648-6056 or 711).

Services Not Covered

Humana – CareSource will not pay for the following services that are not covered by Medicaid:

  • All services or supplies that are not medically necessary
  • Experimental services and procedures, including drugs and equipment, not covered by Medicaid
  • Abortions except in the case of a reported rape, incest or when medically necessary to save the life of the mother
  • Infertility services for males or females, including reversal of voluntary sterilizations
  • Voluntary sterilization if under 21 years of age or if legally incapable of consenting to the procedure
  • Plastic or cosmetic surgery that is not medically necessary
  • Sexual or marriage counseling
  • Inpatient treatment to stop using drugs and/or alcohol (In-patient detoxification services in a general hospital are covered.)
  • Drugs not covered by the Kentucky Medicaid pharmacy program, including drugs for the treatment of obesity
  • Services for the treatment of obesity unless determined medically necessary
  • Inpatient hospital custodial care or comfort items in the hospital (e.g., TV or phone)
  • Acupuncture and biofeedback services
  • Services to find cause of death (autopsy) or services related to forensic studies
  • Services determined by another third-party payer as not medically necessary
  • Paternity testing

This is not a complete list of the services that are not covered. To learn more, review your member handbook (NavigateEnglish or Spanish… Coming soon). Please call Member Services at 1-855-852-7005 (TTY: 1-800-648-6056 or 711) if you have a question about whether or not a service is covered.