Please select your state from the state selector above to see the available plan brochures. If you would like printed copies of any of these materials, please use PrintSource to...

...ones. Member Consent/HIPAA Authorization Form Gives permission for CareSource to speak with a caregiver about a member’s medical, payment or protected health information. A CareSource member or appointed representative may...

...on behalf of a member, you will need written consent. Member Consent/HIPAA Authorization Form: This form will give us permission to speak with a caregiver about a member’s medical, payment...

...soon after. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your behalf. If...

...a paper copy promptly. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your...

...a paper copy promptly. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your...

...a paper copy promptly. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your...

...a paper copy promptly. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your...

...a paper copy promptly. Give CareSource consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your...

...consent to speak to someone on your behalf You can give CareSource consent to talk about your health information with someone else on your behalf. If you have a legal...