...initially prescribed. 2026 Step Therapy Criteria Prior Authorization Criteria For certain drugs, your prescriber will need to contact us before you can fill your prescription. Prior Authorization Criteria Visit the...

...limitations. This may include requiring a prior authorization, step therapy, or quantity limit. The prior authorization requirements for your medicines may change. Questions? Call Member Services. The comprehensive formulary, pharmacy...

...mental illness (SMI) have a high smoking prevalence, low quit rates, and may not have tobacco treatment considered a priority within the Behavioral Health setting. These materials are intended for...

...locations on a case-by-case basis. Priority is given to organizations, collaboratives and initiatives that deploy innovative solutions. We select groups that address root problems rather than treats symptoms, engage the...

...in the first 90 days of your membership and your medication is not on our covered drug list (formulary) or coverage is limited in some way, such as prior authorization,...

...learn more about CareSource PASSE’s collaboration with BetterDoctor, view the BetterDoctor FAQs. Up-to-date contact information is critical to process your claims and prior authorization requests. In addition, it ensures our...

...and no annual or lifetime dollar limits for essential health benefits. Now, you can get these additional healthy heart benefits too! *Prior authorization or step therapy required. **Limit of one...

...the regular clinic hours, if needed. Is there a specific enrollment process for providers? No, CareSource will identify eligible providers. Does this service require prior authorization? No, there are no...

Common Ground Healthcare is now CareSource! We have a new name, but our commitment is the same. We make health insurance simple to use and easy to understand. Open Enrollment...

...ID card. Get printed copies of any member materials. Find out if a service needs prior approval. File a complaint about CareSource PASSE, a provider, or if you think you...