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...

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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...

...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....

...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 service (Part...

...alcohol or use illegal drugs While You Are Pregnant You can find a network provider at findadoctor.CareSource.com. Seeing your provider on a routine basis while you are pregnant can spot...

...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...

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...

...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...