...TO USE Tell Us Use this form when you would like to send us a question or request online. 2025 Enrollment Form (Updated 10/1/2024) 2024 Enrollment Form (Updated 10/1/2023) Use...

...Services at 1-833-230-2050 (TDD/TTY: 711), Monday through Friday, 7 a.m. to 8 p.m. Central Time (CT). Children’s Health Insurance Program (CHIP) members can disenroll or change plans: During the first...

Congratulations on enrolling in our HDHP Preventive Marketplace plan! Now that you have your plan, start right by making an appointment with your in-network family doctor and/or cardiologist. If you...

...persistent mental illness (SPMI). Individual eligibility and program enrollment criteria are detailed in Administrative Code rule 5160-43-02. In addition to full Medicaid coverage, individuals enrolled in the SRS program have...

...and you cannot disenroll from the program. Populations Who May Not Disenroll Ages Supplemental Security Income (SSI) 19-65 Working Disabled 19-65 Breast and Cervical Cancer 19-65 Pregnant Women (below 194%...

...way. Doing this gives you time to talk with your provider about the change in coverage and figure out what to do. During the first 90 days of enrollment, CareSource...

...out-of-pocket drug costs. What Happens If I No Longer Have CareSource MyCare Ohio? If you disenroll from CareSource MyCare Ohio or enroll in a new plan with drug coverage, your...

...credentialing request and provider demographic updates. The PNM module is the single point for providers to complete provider enrollment, centralized credentialing, and provider self-service. The PNM module replaced MITS provider...

...home and community, understanding the Enrollee’s illness, condition, or disability, appreciating the significance of an informal caregiver’s role in the overall health and welfare of the Enrollee, how to identify...

...receive up to a 31-day supply, unless the enrollee presents a prescription written for less than 31 days, and they are entitled to refills (up to a 31-day supply), as...