Dental care is an important part of your overall health. That’s why we encourage you to schedule regular dental visits. It is never too late to start seeing a dentist....

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...other coverage information? You can obtain the other coverage information that CareSource has on file by reviewing the member’s eligibility information on our Provider Portal. Call 1-855-202-1058 and follow the...

WE GOT YOU. CareSource Marketplace plans are simple and reliable with coverage for pre-existing conditions and no annual or lifetime dollar limits for essential health benefits. Every plan also includes...

...– A decision we make about the payment for a Part D drug or an exception to our formulary. Organization Determination – A decision we make about covering a medical...

...Pharmacy Overview CareSource covers all medically necessary Medicaid-covered drugs. We use a Preferred Drug List (PDL)Preferred Drug List (PDL). These are the drugs we would like your provider to choose....

...can request a coverage determination by completing this form. Coverage Redetermination Request Form online or hard copy If you are unsatisfied with the outcome of a coverage determination request, you...

...to contact us to ask for a coverage decision. Here are examples of coverage decisions you may ask us to make: Asking us to cover a Part D drug that...

...cardiologists and other specialists for comprehensive care, covered with a low copay. Advanced Treatment Options: Coverage for advanced cardiac treatments and procedures. Cardiac Rehabilitation: Regular sessions are essential for recovery...

...Section 9 your Evidence of Coverage for timeframes for CareSource’s review of appeals and expedited appeals. Internal Appeal of Adverse Benefit Determination A decision we make about your coverage or...