Plan Documents

We want you to easily find the documents you need. Explanations of when and why you may need to use a document are also provided below. You can also find these plan documents in CareSource MyLife.

If you would like a printed copy of these documents, please call Member Services and we can mail it to you.

Evidence of Coverage (EOC) and Member Handbook

These documents are a quick reference guide to your health care benefits. You can find your covered benefits and services, where to get care and your rights and responsibilities as a CareSource member.

• Evidence of Coverage (Navigate English | Navigate Spanish)
  Last updated on 12/09/2025
• Navigate Medicaid-Only Member Handbook (10/22/2025) Last updated on 10/22/2025
• MyCare Waiver Member Handbook (Navigate English  |  Navigate Spanish)
• Self-Direction Handbook (Navigate English | Navigate Spanish)

Quick Guide

The Quick Guide (coming soon) is mailed to all new members. It has a high-level overview of benefits and services, and the printed version that is mailed also has the member ID card.

Annual Notice of Change

The Annual Notice of Change outlines the changes to your benefits for the next plan year.

• ANOC  (CareSource Dual Advantage to MyCare Next Generation) Navigate English  |  Navigate Spanish
• ANOC (MyCare Medicare-Medicaid Plan to MyCare Next Generation) Navigate English  |  Navigate Spanish

Summary of Benefits 

The Navigate Summary of Benefits (Last Updated 10/22/2025) is a summary of your covered benefits and any limitations. Your Evidence of Coverage (EOC) or Member Handbook has more information on the full list of benefits.

Provider Directory

The most up-to-date list of providers is available through our Find a Doctor tool. This tool will show you primary care providers (PCPs), specialists, hospitals, and more that are in the CareSource network. Or search all providers in the Ohio Department of Medicaid’s Provider Directory.

• • Navigate MyCare Medicare and Medicaid Provider Directory Vol 1 of 3 (2/13/2026) Last updated on 2/13/2026
  • Navigate MyCare Medicare and Medicaid Provider Directory Vol 2 of 3 (2/11/2026) Last updated on 2/11/2026
  • Navigate MyCare Medicare and Medicaid Provider Directory Vol 3 of 3 (2/11/2026) Last updated on 2/11/2026
  • Navigate MyCare Medicaid-Only Provider Directory Vol. 1 of 3 (2/11/2026) Last updated on 2/11/2026
  • Navigate MyCare Medicaid-Only Provider Directory Vol. 2 of 3 (2/11/2026) Last updated on 2/11/2026
  • Navigate MyCare Medicaid-Only Provider Directory Vol. 3 of 3 (2/11/2026) Last updated on 2/11/2026
  • Download the Machine Readable Provider Directory here (json)

  Pharmacy Directory

  The most up-to-date list of network pharmacies is available through our Find a Pharmacy tool.

  Prior Authorization List

  Some services require approval from CareSource MyCare Ohio before you can get them. We call this prior authorization. Your provider will take care of this for you. The Prior Authorization list shows which services you need approval for before you can get them.

  • Navigate 2026 Prior Authorization List

  Your provider can submit a request for a prior authorization using the Prior Authorization Request Form (coming soon). If you are seeing a specialist, they will get approval from your primary care provider (PCP).

  Pharmacy Documents

  • List of Covered Drugs (Formulary) (Navigate English  |  Navigate Spanish) (Updated 02/01/2026)
    This is a list of all drugs covered under your Medicare Part D plan if you get both your Medicare and Medicaid benefits through CareSource.
    • Navigate Prior Authorization Criteria (Last Updated 02/01/2026)
      There are some drugs where your provider will need to tell us before you can fill your prescription.
    • Navigate Step Therapy Criteria (Last Updated 02/01/2026)
      Sometimes we will have you try another drug to treat your medical condition before we will cover the drug your provider initially prescribed.
  • Notice of Formulary Changes
    If changes occur to drugs on our Part D formulary, we will update them in this list.
  • Navigate Preferred Diabetic Supply List (Last Updated 01/01/2026)
    CareSource MyCare Ohio covers these preferred diabetic testing supplies.
  • Navigate Medicaid List of Covered Drugs (Last Updated 02/01/2026) 
    This list shows the OTC items and non-Part D drugs you get as part of your plan.
  • Coverage Determination Request Form
    If you think you should get payment or benefits on a certain drug, you can request a coverage determination. Fill out this form: online  or hard copy (Navigate English | Navigate Spanish).
  • Coverage Redetermination Request Form
    If you are unhappy with the result of a coverage determination request, you can file an appeal. Use this redetermination form: online  or hard copy (Navigate English | Navigate Spanish).

  Star Ratings

  Star Ratings are given to the CareSource Dual Advantage plan by the Centers for Medicare & Medicaid Services (CMS). Plans are rated on a 5-point scale. Go to www.medicare.gov to learn more about Star Ratings.

  • 2026 Ohio Star Ratings (Navigate English | Navigate Spanish)