...of your membership and your medication is not on your new plan’s covered drug list (formulary) or coverage is limited in some way, such as prior authorization, step therapy, or...

...page to find any form when you need it. Other Documents Certificate of Coverage Benefits At-A-Glance Prior Authorization List 2025 Interoperability Prior Authorization Report Member Services: 1-833-230-2053 (TTY: 711), 24...

...information on PASSE services that are offered by CareSource PASSE that include: Covered benefits and how to get them. If any benefits have prior authorization requirements. Take part in decisions...

...And so much more! *Some services need to be approved before you can get them. This is called prior authorization (pre-authorization). It must be medically necessary for your care. Your...

...pregnancy. Michigan’s We Treat Hep C Initiative increases access to necessary medications such as MAVYRET for Medicaid beneficiaries by removing the prior authorization requirements and dispensing the medication in an...

...the process of moving from a child/family-centered health care model to an adult/patient-centered model, starting prior to the age of 14 and continuing into young adulthood for CSHCS enrollees. The...

...given information about your health. This may also be available to someone legally authorized. It may be given to someone you said should be reached in an emergency. To discuss...

...scope The HL7 FHIR (Fast Healthcare Interoperability Resource) standard is used for patient and publicly available provider data Smart on FHIR is utilized for authorization flows related to member authorization...

...Prior Authorization Provider Communications CareSource PASSE supports coordination across all interventions along the continuum of care. Visit these pages for resources to support coordinated care with a holistic, integrated approach:...

...plan generally must: Cover emergency services without requiring you to get approval for services in advance (prior authorization) Cover emergency services by out-of-network providers Base what you owe the provider...