...our network. Scroll down to Ohio and filter the results under Medicare by selecting Medicare Advantage from the list. Learn more about out-of-network coverage by reviewing your Evidence of Coverage...

...nation’s largest Medicaid managed care plans. CareSource, headquartered in Dayton, Ohio, has built a legacy of providing quality health care coverage for Medicaid consumers. In addition to Medicaid coverage CareSource...

...accepted guidelines to guide clinical decision making. We do not reward health partners or our own staff for turning down coverage or services. We do not offer financial rewards to...

...Authorization Form Pharmacy Prior Authorization Form Submit this form to request a prior authorization for coverage of certain medications, as outlined in the CareSource Formulary. Specialty Pharmacy Prior Authorization Form...

...appeal. Refer to the plan’s Evidence of Coverage (Chapter 9) for information about how to ask for an appeal. The DMP may not apply to members that have certain medical...

...90 days of your membership and your medication is not on your new plan’s covered drug list (formulary) or coverage is limited in some way, such as prior authorization, step...

...be $0. (This does not include any Medicare Part B premium you may have to pay.) This $0 premium plan includes coverage for both medical services and prescription drug coverage....

BRINGING YOU EVEN BETTER CARE Starting January 1, 2026, your HAP coverage, including Medicare and Medicaid benefits, will automatically continue through the HAP CareSource™ MI Coordinated Health plan. This program...

...formulary that was covered at the beginning of the year, we will not discontinue or reduce coverage of the drug during the coverage year except when a new, less expensive...

As a CareSource member, you can get the same services that are covered by other Georgia Pathways to Coverage health plans. These can include doctor visits, prescription drugs and hospital...