...– A decision 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...

...You leave CareSource. Member Services: 1-855-202-0729 (TTY: 711), open Monday through Friday 7 a.m. to 7 p.m. What is prior authorization? CareSource needs to pre-approve some services and prescription drugs....

...while reserving the right to get back any amounts paid during this period. Reject prescription drug claims during the second and third months of grace period. You are responsible for...

...services including dental and vision, please see your member handbook. Over-the-Counter (OTC) Items You can get many OTC drugs at no cost to you. You will need a prescription from...

...us. We can help you keep your care. Step 5 — Make Sure Your Prescriptions are on the CareSource Drug List. Use Find My Prescriptions tools to see what drugs...

...state to view documents 2026 Prior Authorization List 2025 Prior Authorization List 2025 Prior Authorization List 2025 Prior Authorization List 2026 Prior Authorization List To learn more about prescription drugs...

...and make a healthy home. Medication Assisted Treatment (MAT) MAT helps ease cravings for drugs or alcohol and has two parts. One part is prescription medicine. It is used in...

...plan covers, how much you pay, and more. Summary of Benefits: Summary of key features about your plan like covered benefits and coverage. Comprehensive Formulary: A list of all drugs...

...and coverage. Formulary (List of Covered Drugs): A list of all drugs covered under your plan. Provider and Pharmacy Directory: A list of the participating (in-network) providers and pharmacies. You...

...with a primary care provider (PCP), specialist, dentist, hearing, vision, and other CareSource providers to diagnose and treat problems or issues Inpatient or outpatient hospital care Clinic visits Prescription drugs...