CareSource uses evidence-based guidelines to ensure health care services and medications meet the standards of excellent medical practice and are the lowest cost alternative for the member. These requirements ensure...

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....

...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...

...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 service (Part C...

...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....

...that should have been covered under your CareSource plan Coverage Determination Request Form online or hard copy If you believe you are entitled to payment or benefits on a certain...

...coverage, a member and the treating provider may not proceed with that service or supply after receiving a denial from CareSource for the requested non-covered service. Existing clinical policies are...

...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...