Appeals

What is an Appeal?

An appeal is when you ask us to review a decision that denied a benefit or service.

The Appeal Process

If you believe a decision we have made adversely affects your coverage or benefits, you have a right to file an appeal. You need to ask for an appeal within 65 calendar days from the date you get your Notice of Action. You can submit an appeal in one of these ways:

Online: File an appeal by signing into your CareSource MyLife account.

Phone: Call Member Services at 1-855-475-3163 (TTY: 1-833-711-4711 or 711). 

Mail: Write a letter telling us what you are unhappy about. Please include your first and last name, your member ID number, your address, phone number and any information that helps explain your problem. Mail the form or letter to:

CareSource
Attn: Member Grievance & Appeals
P.O. BOX 1947
Dayton, OH 45401-1947

Fax: You or your provider can send a fax to 937-531-2398.

If you have chosen an authorized representative, remember to fill out the Appointment of Representative Form.

Learn more about appeals in your Member Handbook/Evidence of Coverage.

Questions? Call Member Services at 1-855-475-3163 (TTY: 1-833-711-4711 or 711). We are open Monday through Friday, 8 a.m. to 8 p.m. Eastern Time, and from October 1 through March 31 we are open the same hours, seven days a week.