Grievances

What is a Grievance?

A grievance is a formal complaint about us, our providers or the care you get.

The Grievance Process

Phone: 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.

Online: File a grievance by signing into your CareSource MyLife account.

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.

How to Contact Medicare and Medicaid

If have CareSource® MyCare Ohio (HMO D-SNP) for both Medicare and Medicaid coverage, 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, seven days a week. TTY users should call 1-877-486-2048 or 711.

You may also file a complaint with the Ohio Department of Insurance online or request a complaint form and instructions for filing a written complaint be mailed to you.

  • File an online complaint by filling out a complaint form.
  • Request a complaint form and instructions for filing a written consumer complaint by contacting Ohio Department of Insurance Consumer Services at 1-800-686-1526.
  • Mail written complaints to: Ohio Department of Insurance, Consumer Services Division, 50 West Town Street, Third Floor/Suite 300, Columbus, OH, 43215.

Our Commitment to You

After we have reviewed your situation, CareSource will call you with an answer to your grievance within:

  • Two (2) working days for grievances about not being able to get medical care
  • 30 calendar days for all other grievances

If we cannot reach you by phone, we will send you a letter.

Learn more about grievances in your Evidence of Coverage (EOC) or Medicaid-Only Member Handbook.

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.