...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...

...at any time. It will not affect your benefits or coverage. Go to www.express-scripts.com/mppp and choose the opt-out option. You can also call 1-866-845-1803. After you leave the program, you...

...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...

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...

...covered services. If you have any other health insurance coverage or prescription drug coverage in addition to our plan, you are required to tell us. Tell your doctor and other...

...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...

...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...

...local Women, Infants and Children (WIC) office A pharmacy to pick up prescriptions Renew your Medicaid coverage at your local county Job and Family Services Helpful tips: Call us two...

...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...