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Please select your state. CareSource plans provide comprehensive, quality coverage that you can afford, understand and use. We offer individual and family plans with adult vision and fitness coverage. Benefits...

...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 service (Part C...

...Find network providers or drug coverage information for your loved one. These resources will help you work with us to make sure your loved one gets the best care possible....

Our Quality Improvement (QI) Program is designed to ensure the organization delivers on all aspects of care delivery for beneficiaries based on their unique needs. We monitor, analyze and identify...

...D E F G H I J K L M N O P Q R S T U V W X Y Z # 340B Drug Pricing A Applied Behavior...

...to talk about changing the drugs if they make you sick or cause an allergic reaction. Don’t stop taking your medication until you talk to your doctor. Questions? Call Member...

...Part B benefits must be obtained at Medicare-certified facilities. Part D covered drugs dispensed at out-of-network pharmacies when enrollees cannot reasonably be expected to obtain covered Part D drugs at...

...Prior Authorization Needed? Preferred Drug List Drugs Yes $3 copay generic, compound and sole source drugs. $10 copay brand-name drugs. Prior authorization is needed for some drugs that require step...

...necessity, investigational and experimental services. The following policies have moved to the Pharmacy Policy page: Medicaid Drug Rebate Program (MDRP) Coverage Rules – AC Reject Medical Necessity – Off Label...