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Ohio

My Benefits & Services 

As a CareSource member, you can get the same necessary medical services that are covered by the regular Ohio Medicaid program. And we never charge a copay for any medical service.

Our members get all medically necessary Medicaid-covered services at no cost. Some examples are preventive checkups and inpatient and outpatient hospital services. And, you get more. As a CareSource member, you’ll enjoy:

  • No copays for health care visits
  • No copays for prescriptions*
  • A large network of doctors, hospitals and pharmacies
  • Transportation to and from doctor appointments**
  • Vision and dental care including checkups, teeth cleanings and eyeglasses
  • CareSource24® Speak with a registered nurse 24/7
  • Incentive programs, like Babies First, that reward members for healthy habits
  • Care management – One-on-one care to coordinate your health needs
  • Behavioral health – Linking members to the care they need for their whole self, mind and body
  • Disease management programs to help members manage their asthma and diabetes
  • Consumer Councils – Join us in person to share your thoughts and learn about other community resources

*While CareSource covers all medically necessary Medicaid-covered medications, we use a preferred drug list (PDL).

**CareSource offers up to 30 one-way trips or 15 round trips per member per year.

Covered Services

CareSource covers all medically necessary Medicaid-covered services. These medical services are available at no charge to you. You should not be billed for these services. If you receive a bill, please call us.

For a complete list of these services, refer to your member handbook. If you have further questions, contact Member Services at 1-800-488-0134 (TTY: 1-800-750-0750 or 711).

Services Not Covered

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 Ohio 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 by Medicaid or CareSource. If you have a question about whether a service is covered, please refer to your member handbook or call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711).