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Frequently Asked Questions

  • Join CareSource Ohio Medicaid

    • What is CareSource?
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        CareSource is a Medicaid managed health care plan. We serve Ohio Medicaid consumers who receive:

        • Covered Families and Children Medicaid
        • Healthy Start and Healthy Families Medicaid
        • Aged, Blind or Disabled Medicaid

        We work with the Ohio Department of Medicaid to provide services.

    • How can I become a member of CareSource?
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        1. Follow the prompts to check your eligibility. You will answer a few questions about your household size and monthly income. This will help figure out if you may qualify.
        2. If you may qualify, follow the prompts to apply for benefits. You will complete an online application and submit through the Ohio Department of Medicaid portal. 
        You can also enroll by mail, over the phone or in person. You’ll find details at benefits.ohio.gov.
  • Covered Services

    • What are the advantages of being a member of CareSource?
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        CareSource has all the same services as regular Medicaid. And we have more. Some Additional Services may include:

        • Transportation. We offer free rides to doctor visits and more.
        • Our Babies First program. Pregnant members and new parents can earn up to $150 on a reloadable gift card, for use at local stores.
        • Text4Baby. Get support during your pregnancy and your baby’s first year. Get FREE text messages. Learn about prenatal care, baby health, parenting and more! *Standard rates may apply.
        • CareSource24®. This is our free, 24-hour nurse advice line.
        • Member Services. Our friendly staff is here to help you.
        • Case and disease management. We help members manage their conditions such as pregnancy, asthma and diabetes. We can also help you coordinate your care.
        • An expanded selection of eyeglass frames.
        • A personalized member ID card.
        • Health information. We send you news about ways to stay healthy. You can also call and ask us questions about your health care.

        For more information, please see Additional Services.

    • What services does CareSource cover?
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        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. We also have a lot of Additional Services.

        You can get many services without a referral from your Primary Care Provider (PCP). This means that your PCP does not need to arrange or approve these services for you. Just use the Find a Doctor/Provider tool to locate participating providers who offer these services and schedule an appointment yourself. Or, if you need assistance locating a participating provider, call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711).

        Other services require a referral. That means you must get an okay from your PCP before you can receive the service.

        A few services require both a referral from your PCP and prior authorization from CareSource. This means that your PCP has to okay the service and get an okay from CareSource, too.

        For more information, please see Covered Services.

    • What if I get a bill for services?
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        You do not have to pay for any service that CareSource covers. So you should not get a bill for any of those services. If you do get a bill, please call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711).

  • Get an ID Card or Plan Documents or Change Your Doctor

    • How do I get a new CareSource member ID card?
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        You can get a new member ID card by logging in to your My CareSource account and clicking “Request ID Card.”

    • How do I get a new CareSource member handbook or provider directory?
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        CareSource sends a New Member Kit to all new members. Your kit contains a member handbook and a provider directory, if you asked for one when you enrolled with CareSource. If you didn’t ask for a provider directory, you will get a postcard in the mail that asks you if you want to get a printed copy. You can fill out the card and mail it back to us, and we’ll mail you a provider directory.

        To get more copies, please call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711). Materials are also available within the online Find a Doctor/Provider tool and the member handbook.

    • How do I switch to another primary care provider (PCP)?
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        You are not required to see the PCP listed on your card. If you are not happy with your PCP, you can log in to your My CareSource account to choose a new doctor. You can change your PCP to another health partner who participates with CareSource. You can change up to once a month, if needed.

        CareSource will send you a new member ID card to let you know that your PCP has changed and the date you can start seeing the new PCP. The Member Services department can also help you schedule your first appointment, if needed. For the names of the PCPs that serve CareSource members, please use the Find a Doctor/Provider tool.

  • Contact Us

    • How can I reach CareSource?
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        You can call CareSource Member Services at 1-800-488-0134 (TTY: 1-800-750-0750 or 711). Member Services is open from 7 a.m. to 7 p.m., Monday through Friday. We are closed on certain holidays.

        For more information, please see Contact Us.

    • What if I have a question after hours?
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        If you have a health or medical question, you can call CareSource24®, our nurse advice line, at the number on your member ID card. CareSource24 is available 24 hours a day, 7 days a week, including holidays.

        For more information, please see CareSource24.

    • What if I or someone in my family speaks Spanish or another language?
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        Call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711). We can get someone who can sign or speak your language to help you talk with us or your doctor. And it is free.

        We can also give you some printed materials in some other languages. Let us know. We can help.

  • Your Rights

    • What are my rights and responsibilities as a CareSource member?
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        CareSource members have a lot of rights. You have the right to be treated with respect. You have the right to get health services in a timely manner. You can take part in how your health is treated.

        CareSource members also have a few responsibilities. You need to be on time for your appointments. If you have to cancel, you should call 24 hours in advance. You should always carry your CareSource member ID card.

        For more information, please see Member Rights and Responsibilities.

    • How do I file a complaint?
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        We hope you are happy with CareSource. If you are unhappy with anything, call us right away. Call Member Services at 1-800-488-0134 (TTY 1-800-750-0750 or 711). We want you to let us know so we can help.

        For more information about grievances and appeals, please see My Right to File a Grievance or Appeal.

    • How does CareSource protect my health information?
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        CareSource protects our members' health information in many ways. This is called Protected Health Information. This can be written or spoken. We also protect health information that you give to us online. We protect member health information by following Health Insurance Portability and Accountability Act of 1996 (HIPAA) guidelines in which we authenticate callers by asking for identifying information and will only discuss a member’s plan information with the individual or an on-file representative.

        Here is what we do:

        • We train our employees to protect member information.
        • We talk with you about your health information where others cannot hear us.
        • We use firewalls and passwords on our company computers.
        • We only let employees who have a business reason see or share your information.
        • We keep all printed copies of your health information locked in a file drawer or cabinet.