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...– For certain drugs, we require you to first try another drug to treat your medical condition before we will cover the drug your physician initially prescribed by your physician....

...our network. Scroll down to Ohio and filter the results under Medicare by selecting Medicare Advantage from the list. Learn more about out-of-network coverage by reviewing your Evidence of Coverage...

...is a nonprofit, mission-driven health plan and care delivery organization designed for individuals with the most significant needs. As an affiliate of CareSource, a nationally recognized nonprofit managed care organization...

...vision coverage. Telehealth Through Teladoc®, you have access to $0 medical and behavioral health telehealth visits*. Other telehealth visits have the same cost share as your Primary Care Physician and...

...Non-Compliance/Termination with Comprehensive or Interceptive Orthodontic Treatment Submit this form to notify CareSource of a patient’s noncompliance/termination during orthodontic treatment. Orthodontic Treatment Plan Acknowledgements Form for Comprehensive Orthodontic Treatment Submit...

...Interpreter Services for information to request plan documents in another language. Non-Discrimination Notice View CareSource’s Notice of Non-Discrimination. Review the plan documents to make sure you get the most from...

...Pharmacy – non-preferred drugs Cost-Based Physician assistant services Cost-Based Physician services Cost-Based Foot care Cost-Based Eye care Cost-Based Cost-Based Copays Cost Copay $10.00 or less $0.50 $10.01 to $25.00 $1...

...to keep information current. 2022 Comprehensive Formulary ( English | Spanish (Updated 12/01/2022) – for Ohio only) For information about changes to our formulary, please review the Notice of Formulary...