Rights & Responsibilities

You have many rights as a CareSource member. The full list of rights is also in your member handbook. You can get a printed copy if you call Member Services at 1-844-607-2829 (TTY: 711).

  • Get information about us, our services, providers, and member rights and responsibilities.
  • Get all services that we must provide.
  • Be treated with respect and with regard for your dignity and privacy.
  • Discuss medically necessary treatment options for your health issues. This is no matter the cost or if it is covered.
  • Be sure that your medical record will be kept private.
  • Get information about your health. It can be given to a person you have legally approved to get it. This person can also be reached in an emergency if you are not able to get it on your own.
  • Ask for information at any time on our physician incentive plan or marketing materials.
  • Take part in decisions about your health care with providers unless it is not in your best interest.
  • Learn about medical care in a way that you can understand.
  • Get care that is culturally sensitive and respectful.
  • Be sure that others cannot hear or see you when getting care,
  • Be free from any form of restraint or seclusion used as a means of force, discipline, ease, or revenge as set in federal rules.
  • Ask and get a copy of your medical records. You can ask that the record be changed if needed.
  • Say yes or no to having information about you given out. This is unless we have to give it out by law,
  • Say no to treatment. You will be told what could happen if you say no. A note will be added to your health record about the refusal.
  • Be able to file an appeal, a grievance (complaint), or State Fair Hearing.
  • Voice complaints or appeals about us or the services we provide.
  • Get all CareSource written member information from us:
    • At no cost to you in the prevalent non-English languages of members in our service area.
    • For members with special needs, get help reading the information for any reason.
  • Get help free of charge from us and our providers if you do not speak English or need help understanding information.
  • Get help with sign language if the member is hearing impaired.
  • Be told if the provider is a student. You can say no to their care.
  • Be told of any experimental care. You can say no to be part of this care.
  • Make an advance directive (a living will).
  • File a complaint with the Indiana Office of Medicaid Policy and Planning (OMPP) if a member’s advance directive is not followed.
  • Be free to carry out your rights. Us, our providers, and OMPP will not hold this against you.
  • Know that we must follow all laws about privacy that apply.
  • Choose a provider who will give you care when able and appropriate.
  • To see a network provider who specializes in women’s health if you are a female.
  • Get a second opinion. We must set up a visit with a provider not in our network if a network provider is not available.
  • Go out of network for care if you cannot get a covered service in our network within 60 miles of your home.
  • Get information about our structure and how we run.
  • Make recommendations about our member rights and responsibilities.

As a member of CareSource you also have the responsibility to:

  • Use providers in the CareSource network.
  • Keep your scheduled provider visits. Be on time and call 24 hours ahead if you need to cancel.
  • Follow the advice and instructions for care you have agreed upon with your doctors and other health care providers.
  • Always carry your ID card and show it when you get care.
  • Never let anyone else use your ID card.
  • Let us know of any suspected fraud or abuse.
  • Notify your county caseworker and us of a change in phone number or address.
  • Contact your provider after you:
    • Go to urgent care.
    • Get physical or mental health and addiction services care outside of our covered counties or service area.
  • Let us and your county caseworker know if you have other health insurance.
  • Give all the information that we and your providers need, to the extent possible, to give you care.
  • Know as much as you can about your health issues and take part in reaching the goals you and your provider agree on.