Benefits and Services

At CareSource, we care about you. We know that there is more to health and well-being than just great health care. That’s why CareSource offers benefits and services that go beyond basic care.

As a CareSource member, you get the same necessary medical services that are covered by the regular Ohio Medicaid program. And we never charge a copay for any medical service. You’ll get all medically necessary Medicaid-covered services at no cost to you. With CareSource, you’ll enjoy:

  • No copays for health care visits
  • No copays for prescriptions*
  • A large network of doctors, hospitals, and pharmacies
  • Transportation to and from doctor appointments**
  • Vision and dental care including checkups, teeth cleanings and eyeglasses
  • CareSource24® – Our 24/7 Nurse Advice Line
  • Reward programs, like Babies First®, that reward you for healthy habits
  • Care management – One-on-one care to coordinate your health needs
  • Behavioral health – Linking you to the care they need for your whole self, mind and body
  • Disease management programs to help you manage your asthma and diabetes
  • Consumer Councils – Join us in person to share your thoughts and learn about other community resources

View a full list of covered services through the Benefits At-A-Glance.

*While CareSource covers all medically necessary Medicaid-covered medications, we use a Navigatepreferred drug list (PDL).

**If you must travel 30 miles or more from your home to get covered health care services, CareSource will provide transportation to and from the health partner’s office. CareSource also offers up to 30 one-way trips or 15 round trips per member per year for transportation less than 30 miles.

Covered Services

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.

For a complete list of services, refer to your Navigatemember handbook. If you have further questions, contact Member Services at the number below.

Services Not Covered

CareSource will not pay for the following services that are not covered by Medicaid:

  • All services or supplies that are not medically necessary
  • Experimental services and procedures, including drugs and equipment, not covered by Medicaid
  • Abortions except in the case of a reported rape, incest or when medically necessary to save the life of the mother
  • Infertility services for males or females, including reversal of voluntary sterilizations
  • Voluntary sterilization if under 21 years of age or if legally incapable of consenting to the procedure
  • Plastic or cosmetic surgery that is not medically necessary 
  • Sexual or marriage counseling
  • Drugs not covered by the Ohio Medicaid pharmacy program, including drugs for the treatment of obesity
  • Services for the treatment of obesity unless determined medically necessary
  • Inpatient hospital custodial care or comfort items in the hospital (e.g., TV or phone)
  • Biofeedback services
  • Services to find cause of death (autopsy) or services related to forensic studies
  • Services determined by another third-party payer as not medically necessary
  • Paternity testing

This is not a complete list of the services that are not covered by Medicaid or CareSource. If you have a question about whether a service is covered, please refer to your Navigatemember handbook or call Member Services at the number below.

As an Ohio Medicaid managed care plan (MCP), CareSource provides benefits and covers emergency services obtained in any hospital or urgent care clinic within the United States.  However, CareSource does not provide benefits for or cover emergency services received outside the United States. 

If you need additional assistance or have any further questions, please call Member Services.

Member Services: 1-800-488-0134 (TTY: 1-800-750-0750 or 711), Monday – Friday 7 a.m. – 7 p.m.