Grievances

What is a Grievance?

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

The Grievance Process

Online: Login to 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 grievances in your Evidence of Coverage/Member Handbook.

How to Contact Medicare and Medicaid

If have CareSource® MyCare Ohio (HMO D-SNP) 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, 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: Using the complaint form.
  • Phone: Call the Ohio Department of Insurance Consumer Services at 1-800-686-1526. Ask for a complaint form and instructions for filing a written consumer complaint.
  • Mail: Send 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, we 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.

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.