Health Partner Policies

CareSource maintains medical, pharmacy, reimbursement and administrative policies for our health partners.

These policies are regularly reviewed, updated, withdrawn or added; and therefore, subject to change. Please check often for updates to health partner policies.

Policies may vary by plan and/or state. Click the links below to access policies for your member's plan.

Medicaid Plans

Marketplace Plans

Medicare Plans

Medical Policies

Medicaid

Medicaid medical policies vary by state:

Marketplace

Marketplace medical policies apply to our Health Insurance Marketplace plans and vary by state:

Medicare

Medicare medical policies vary by plan:

Pharmacy Policies

Medicaid

Medicaid pharmacy policies vary by state:

Marketplace

Marketplace pharmacy policies apply to our Health Insurance Marketplace plans and vary by state:

Medicare

Medicare pharmacy policies apply to Medicare Advantage plans and the MyCare Ohio (Medicare-Medicaid) plan.

Reimbursement Policies

Medicaid

Medicaid reimbursement policies vary by state:

Marketplace

Marketplace reimbursement policies apply to our Health Insurance Marketplace plans and vary by state:

Medicare

Medicare reimbursement policies vary by plan:

Administrative Policies

Medicaid

Medicaid administrative policies vary by state:

Marketplace

Marketplace administrative policies apply to our Health Insurance Marketplace plans and vary by state:

Medicare

Medicare administrative policies apply to Medicare Advantage plans and the MyCare Ohio (Medicare-Medicaid) plan.