CareSource maintains medical, payment and administrative policies for our health partners. These policies are regularly reviewed, updated, withdrawn or added; and therefore, subject to change. The policies presented on these...

...Formulary Search Tool. Members may be required to pay cost-share, for prescription drugs. Cost-share amounts vary based on plan, medication, and whether a copay or coinsurance applies. Coinsurance may apply...

...Liability (WOL) statement is required. If you do not submit a signed WOL, the appeal will be dismissed. Disputes CareSource pays non-contracted providers as Medicare would have paid for the...

...Provider Preventable Conditions T Three-Day Window Payment The following policies have moved to the Pharmacy Policy page: COVID-19 Vaccination Medicaid Drug Rebate Program (MDRP) Coverage Rules – AC Reject Medical...

...Serum Biomarker Panel Testing Serum Biomarker Panel Testing in Systemic Lupus Erythematosus and Rheumatoid Arthritis Site of Care for Drug Administration T Three Day Window Payment Three-Day Window Payment Three-Day...

...MyCare patients in your practice! Here’s how you can start earning these payments: STEP 1: LEARN ABOUT THE QUALITY ENHANCER PROGRAM To start earning flu shot payments, we recommend you...

Open Enrollment for 2027 Starts November 1 | Ends December 15 Renew Your Plan or Pick a New Plan Do you want to renew your current CareSource plan? Yes, I...

...plans have costs. Besides paying a monthly premium, you will generally have copays, coinsurance and an annual deductible. Learn more about the other costs you’ll have to pay with your...

...Vision Exam Bronze $9600 ($45 PCP Copay) Bronze $9600 ($45 PCP Copay) - Vision Exam Off-Exchange Plans Bronze Plan SBCs for Plan Year 2026 Bronze $0 Ded / $2500 Rx...

To Find a Pharmacy near you, simply type in your city or zip code and follow the prompts. CareSource PASSE pays for all medically necessary, CMS participating, Medicaid-covered FDA-approved products...