Check Eligibility
CareSource MyCare Ohio allows individuals to select Medicaid only coverage from the plan managing their CareSource MyCare Ohio benefits. Individuals may choose to have CareSource MyCare Ohio either:
- Provide their Medicare benefits, or
- Opt out of the Medicare portion of the program and stay with traditional Medicare
Providers need to confirm the CareSource MyCare Ohio member’s option for Medicare coverage.
| Important Tools | |
| Provider Portal | Member ID Card |
You can easily verify member eligibility by accessing the provider portal or through an eligible Electronic Data Interchange (EDI) clearinghouse. | The CareSource MyCare Ohio HMO-DSNP ID cards display information for office visits. The member ID number must be included when billing for services to avoid claim rejection. |
If a member chooses a different plan for their Medicare benefits, CareSource will only manage Medicaid benefits and will only reimburse claims for Medicaid services. Claims for Medicare must be submitted to the plan managing the member’s Medicare benefits.
Therefore, we recommend that you check member eligibility each and every time a member presents for services, as member eligibility can fluctuate. Changes in health status such as certain medical conditions may also cause changes in plan eligibility and coverage status.
Quick Tips: Member Consent
- When you check eligibility on the provider portal, you can also determine if a member has granted consent to share sensitive health information (SHI).
- The Member Consent/HIPAA Authorization Form can also be used to designate a person to speak on the member’s behalf.
- Please encourage CareSource members who have not consented to complete the Member Consent/HIPAA Authorization (coming soon)
Form so that all providers involved in their care can effectively coordinate their care