Marketplace plans have two types of costs: premium and the cost for care. Premium is the monthly payment you make to keep your coverage and all the benefits and services...

...are no financial incentives for our staff members that encourage them to make decisions that result in underutilization. Our members’ health is always our number one priority. Upon request, CareSource...

...Form Mail your refund check, this form and any other required documentation to HAP CareSource. Overpayment Recovery Form Submit this form to offset overpaid claims against a future payment. Itemized...

...Tax ID number, or update your IRS name, you must make those changes through an amendment to your contract, not through maintenance. You can make those changes using the New...

...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...

...medical information payment information You may need to access protected health information. You may need to find network providers or drug coverage information. We want to make it easy to...

...copayment from you and is carrying your copayment as a debt owed by you, we may make the payment directly to the pharmacy. If the state paid on your behalf,...

...by a pharmacist to discuss your patients’ medications. We also encourage members to talk with their pharmacist about their medications, as we want to make sure they are getting the...

Quick References COVID-19 information Pharmacy information, including our Preferred Drug Lists (PDLs) Medical, pharmacy, reimbursement and administrative policies We Strive to make partnering with us simple. We’re aware things may...

...to ask for repayment for a prescription drug you paid for. Fraud, Waste and Abuse Reporting Form – Use this form when you think a health partner or a CareSource...