File a Grievance
How to Contact Us
You can tell us about your complaint or grievance at any time, in a way that’s convenient for you:
- Call Member Services
- Fill out the Member Grievance/Appeal Form.
If you cannot print the form, call Member Services and they can mail you one.
- Write a letter telling us what you are unhappy about.
Include your first and last name, your CareSource® MyCare Ohio (Medicare-Medicaid Plan) member ID number and your address and telephone number. Be sure to tell us any information that helps explain your problem.
- If you have chosen an authorized representative, remember to complete the Appointment of Representative Form.
Mail the form or letter to:
Attn: Member Grievance & Appeals
P.O. Box 1947
Dayton, OH 45401-1947
Or fax the form to 1-855-489-3403.
How to Contact Medicare and Medicaid
You also have the right at any time to file a complaint by contacting the:
Ohio Department of Medicaid
Bureau of Managed Care
P.O. Box 182709
Columbus, Ohio 43218-2709
If you are a MyCare member who is covered by CareSource for both Medicare and Medicaid, you have the right at any time to file a complaint about your health care plan with Medicare. You can complete the online Medicare Complaint Form or call 1-800-Medicare. (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048 or 711.
Have you Received a Bill?
If your grievance is about getting a bill for care, call the telephone number on the bill and:
- Make sure they have your CareSource MyCare Ohio ID number, or
- Give them the primary insurance for the family member who received the care.
If they tell you they have this information, please ask them why you are receiving a bill.
After you have done this, please contact Member Services. Please provide us with the following information from your bill:
- The date you or your family member received services
- The amount of the bill
- The provider’s name
- The telephone number
- The account number
- Tell us why the provider’s office told you they were billing you
Our Commitment to You
After we have reviewed your circumstances, CareSource MyCare Ohio will call you with an answer to your grievance within:
- Two (2) working days for grievances about not being able to get medical care
- Thirty (30) calendar days for all other grievances
If we cannot reach you by phone, we will send you a letter.
Member Services: 1-855-475-3163 (TTY: 1-800-750-0750 or 711), 8 a.m. to 8 p.m., Monday – Friday.
CareSource® MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.
CMS Approved 10/1/2018