...waste and abuse situations. Program Integrity uses proactive and reactive controls to verify procedures and payment mechanisms are compliant. Our proactive monitoring includes prepay review edits, prior authorization monitoring, analytic...

Administrative Law Hearing Not happy with an internal appeal decision? You may ask for an Administrative Law Hearing. This is the next formal step. It involves you or your representative,...

...Request Form – If you think you should get payment or benefits on a certain drug, you can request a coverage determination. Fill out this form: online or hard copy....

...hard copy (Updated 03/01/2021) – If you believe you are entitled to payment or benefits on a certain drug, you can request a coverage determination by completing this form. Coverage...

CareSource covers services that are medically necessary. We also offer rewards and incentives for you. Some services have a small cost to you. This is called a copayment or copay....

...of the Hoosier Healthwise program and serves children up to the age of 19 whose families have slightly higher income. There is a small monthly premium payment and co-pay for...

The Public Health Emergency (PHE) for COVID-19 ended. Most services like vaccines, treatment, and testing are still available. Some rules changed, stopped, or started again. CareSource continues to watch COVID-19...

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...

CareSource knows that understanding health care can be confusing. We strive to make it easy for doctors, members and the community to work with us, whether online or over the...