...for all Ohio Medicaid members. They use a preferred drug list (PDL) which is a list of drugs they prefer your provider prescribe. Please call Gainwell Member Services at 1-833-491-0344...

We realize that you perform administrative tasks in addition to tasks directly related to patient care. To assist you with these tasks, we’ve consolidated the information below. Member Billing Providers...

CareSource of North Carolina Co.® is committed to maintaining the quality and appropriateness of health care services provided to our members. The Utilization Management department performs all utilization management (UM)...

Our Provider Manual is a resource for working with our health plan. This manual communicates policies and programs and outlines key information, such as claim submission, and reimbursement processes, authorizations,...

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...

...can be up to a 30-day supply at a network pharmacy if one of the following is true: You are new to CareSource MyCare Ohio in the first 90 days...

...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 team and the...

Earn rewards for keeping your patients healthy! Flu shots can keep people healthy and out of the hospital. With so many misconceptions surrounding the flu shot, we need your help...

...D-SNP) CareSource® MyCare Ohio (HMO D-SNP) With CareSource MyCare Ohio (HMO D-SNP), you get a fully integrated health plan that combines Medicare and Medicaid into a single, easy-to-manage option. Learn...

...pregnancy. We connect you to resources and work with your providers to make sure you are healthy and safe including the Ohio Perinatal Quality Collaborative. We can also help coordinate...