Stay Informed and Explore New Ways to Work with Us CareSource® publishes newsletters so you can stay informed about plan news and explore new ways to work with us to...

...first before CareSource will cover it. This is called Step Therapy. Some medicines require permission (prior authorization) in order for it to be covered by your plan. The health partner...

...our members: Behavioral Health Find behavioral health resources for patients with mental health, substance use and co-occurring medical issues. Behavioral Health Carve-In Get support during the transition to Behavioral Health...

...may be subject to limitations and/or qualifications. Payment will be determined based upon a review of the actual services provided to a member and will be determined when the claim...

These medical policies apply to the CareSource plan. Medical policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are...

...(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...

...Benefit Determination A decision we make about your coverage or benefits is called a benefit determination. If you believe a decision we have made adversely affects you, you have a...

Our Commitment We are committed to improving our beneficiaries’ health by removing barriers to care and working with our community partners and providers to drive meaningful change. Provider Responsibilities Providers...

...Lists Georgia Medicaid and PeachCare for Kids® Planning for Healthy Babies® (P4HB) Family Planning P4HB Inter-Pregnancy Care (IPC) Over-The-Counter (OTC) Product List Find My Prescriptions Do you want to look...

...strength of your bones. If you are between 50 and 65, talk with your provider to see if you need a bone density test. Breast Cancer Screen: Women between the...