...(Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. CareSource, Inc. is a not-for-profit, 501(c)(3) entity. Its...

...programs and offers a variety of health insurance plans including: Medicaid Dual Eligible Special Needs Plan Marketplace TRICARE Prime® Demo by CareSource Military & Veterans™ Founded in 1989, CareSource administers...

Susan Aldrich leads CareSource’s New York market, overseeing strategy and operations for programs serving members with long-term services and supports (LTSS) needs across Medicaid Managed Long Term Care, Dual-eligible Medicare-Medicaid...

Administrative Law Hearing Not happy with an internal appeal decision? You may ask for an Administrative Law Hearing. This is the next formal step. It involves you or your representative,...

...1, 2019 12/01/2018 The drug formulary changes noted below are historical. Effective October 1, 2022, the drug formulary and changes are managed by the Ohio Department of Medicaid (ODM) Pharmacy...

Organization Determinations (Decisions) A decision we make about the coverage of a service. If you believe you are entitled to a medical service (Part C or Medicaid) you can request...

As part of our commitment to both health partners and members, we want to provide resources that support your professional practice and encourage best practices in opioid use and pain...

Get Your Prescriptions Delivered to Your Door! You can get many of your Medicare Part D drugs sent to your home through mail. We work with Express Scripts® to offer...

...planning or emergency services, out-of-network health care providers need prior authorization (also called pre-approval). Go to www.caresource.com/in/plans/medicaid/benefits-services/referrals-prior-authorization/ for more details on prior authorization. Office Visits / Hospital Type of Service...

...office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778 (applications); or Ohio Department of Medicaid (applications): https://medicaid.ohio.gov/families-and-individuals/coverage/01-how-to-apply Best Available Evidence If you...