Where To Get Care

CareSource offers a focused network of health care providers. In order to have your health care services covered by your CareSource plan, you must get them from a network provider. The only exceptions are:

  • In cases of emergency;
  • If you need medically necessary, covered urgent care services when traveling out of our service area; or
  • When specifically authorized by CareSource.

You can use our Find a Doctor/Provider search tool to find a network provider or care location near you. Use the filters in the right column to find providers in network for your plan, as well as search by specialty and more.

CareSource wants you to be happy with your doctor and the network of providers we offer. If you have suggestions that would improve our network, we want to hear from you. Share your ideas with us on the Access Opportunity Form. The Access Opportunity Form gives you a chance to suggest a doctor for our network, tell us about things like if it is easy to schedule appointments, and more.

Your Primary Care Provider (PCP)

Each CareSource member has a primary care provider (PCP). Your PCP is a doctor, group practice, advanced practice nurse or advanced practice nurse group practice trained in family medicine (general practice), internal medicine or pediatrics. Your PCP will:

  • Work with you to direct your health care
  • Treat you for most of your health needs
  • Send you to a specialist, if needed
  • Admit you to the hospital

Going to the same PCP each time you need care will help your PCP get to know you and your needs. The better your PCP get to know you and your medical history, the better your PCP will be able to treat you.

If you haven’t chosen a PCP yet, you can call Member Services or log on to MyCareSource to find one. If you are a new patient for your PCP, you should call to schedule a visit. This will help your PCP get to know your health needs right away. You should go for your first visit within 90 days of joining CareSource.

Appointments

It is important to go to your planned PCP visits. Call the doctor’s office at least 24 hours before if you need to change or cancel a visit.

Preventive Care

Your PCP will play a big role in your preventive care. Routine health exams, tests, and screenings can help find and treat problems early before they get worse.

Where to Get Care After Hours

We want you to get the right care from the right health care provider when you need it. If your doctor’s office is closed or if you are very sick or hurt, you have options.

CareSource24® Nurse Advice Line

CareSource24 provides around-the-clock access to a caring and experienced staff of registered nurses.

Our nurses can help you:

  • Decide when self-care, a doctor visit or the emergency room is needed
  • Understand a medical condition or recent diagnosis
  • Find out more about prescriptions or over-the-counter medicines

You can call CareSource24 toll-free 24 hours a day, 7 days a week, 365 days a year at: 1-844-206-5944 (TTY: 1-800-255-0056 or 711). The number is also on your ID card.

Telehealth

Telehealth uses your phone, computer, or tablet to speak to a provider. Telehealth is a convenient option for care, and may lower your chance of being exposed to illnesses like the flu. It can also give you quick medical advice that can prevent your condition from getting worse. There is no cost to use telehealth and it removes the stress of needing transportation to and from the doctor’s office.

Your PCP may offer telehealth services on your phone or computer. You can talk to your PCP from wherever you are. Please check with your PCP for available options and to learn more.

Learn more about the options CareSource offers for telehealth visits.

Convenience Care Clinics and Urgent Care Centers

The CareSource network includes urgent care centers and retail health clinics inside drug and grocery stores to help you get care when and where you need it. These clinics often have evening and weekend hours and allow walk-ins. You can find these network providers through Find a Doctor/Provider.

Urgent care is for non-emergencies. They are for when you can’t see your PCP right away. They help keep an injury, sickness, or mental health issue from getting worse. If you think you need to go to urgent care, you can:

  • Call your PCP for advice.
  • Call CareSource24, our nurse advice line.
  • Go to a network urgent care center listed in our Find a Doctor/Provider tool.

After you go, always call your PCP to schedule follow-up care.

When you are outside the service area, you might not be able to get care from a network provider. In that case, our plan will cover urgently needed care you get from any provider within the United States or its territories.

Emergency Services

If you have an emergency situation now, call 911 or go to the nearest ER. Emergency services are for severe health issues that must be treated right away. Examples of medical issues needing emergency care are:

  • Miscarriage/pregnancy with vaginal bleeding
  • Severe chest pain
  • Loss of consciousness
  • Uncontrolled bleeding
  • Major burns

Emergency care is covered both in and out of our service area, within the United States. You do not have to contact CareSource before you get emergency services. If you are not sure whether you need to go to the emergency room, call your primary care provider or the CareSource24 Nurse Advice Line or your doctor.

When You Are Outside of Our Service Area

If you have more questions about where to get care after hours or outside the service area, refer to the Navigatemember handbook.

Member Services: 1-855-202-0729 (TTY: 1-800-255-0056 or 711), Monday – Friday 7 a.m. – 7 p.m.