Benefits and Services
All CareSource plans provide broad benefits that include all essential health benefits recommended under the Affordable Care Act (ACA). Note: Prior Authorization (PA) is needed for certain services.
Preventive Care
Preventive care is coverage for medical services and medicines that focus on preventing disease and evaluating a person’s current state of health. A specific list of preventive care services are covered at no cost to you when you use in-network providers. All our health plans include coverage for these preventive care benefits at no cost share when the services are billed appropriately. We encourage you to use these services to help maintain your health.
Your doctor will know exactly which preventive health screenings you need and are right for you, based on your health history. If you have questions, please contact your Primary Care Provider (PCP). You can also speak to one of our nurses any time by calling our 24-Hour Nurse Advice Line. The number is listed on your ID card.
Prior Authorization
You and your doctor need to get our approval for certain services, equipment or medicines before you receive treatment. This is called Prior Authorization (PA). The process makes sure the planned care is medically necessary.
- To see the list of prescription drugs that require PA, view the formulary.
- For details about medical and behavioral services that require PA, view the Prior Authorization list.
Frequently Asked Questions About PA
Services – We Are Here to Help You!
Member Services
Use the secure online Tell Us form. Or call Member Services.
24-Hour Nurse Advice Line
Call the number on your member ID card 24-hours a day, 7 days a week to speak to a registered nurse about health and medical concerns.
Care Management
Do you or your child have special health care needs? We offer care managers to work with you and your doctor one-on-one to help coordinate your care. Care managers include registered nurses, social workers and outreach workers. Learn more.
CareSource MyLife
Use CareSource MyLife to manage your health plan and get support for everyday care. Access self-help tools, virtual care, community resources and additional benefits included in your plan.