Frequently Asked Questions

CareSource is a Medicaid managed health care plan. We serve Ohio Medicaid consumers who receive:

• Covered Families and Children Medicaid.
• Healthy Start and Healthy Families Medicaid.

We work with the Ohio Department of Job and Family Services to provide services.

What are the advantages of being a member of CareSource?

CareSource has all the same services as regular Medicaid. And we have more. Extra benefits include:

• Transportation. We offer free rides to doctor visits and more.
• Our Babies First program. Pregnant members and new moms can earn up to $150 in gift cards to a local store.
• CareSource 24. This is our free, 24-hour nurse hotline.
• A member service center. Our friendly staff is here to help you.
• Case management. We help members manage their conditions such as pregnancy and asthma. We can also help you coordinate your care.
• An expanded selection of eyeglass frames.
• A personalized member ID card.
• Health information. We send you news about ways to stay healthy. You can also call and ask us questions about your health care.

For more information, please see Extra Benefits.

 
How can I become a member of CareSource?

To become a CareSource member, you must be eligible. Your local Department of Job and Family Services can tell you if you qualify. Or you can call 1-800-605-3040. (TTY for the hearing impaired: 1-800-292-3572) to learn more. Then you must choose a doctor who is part of the CareSource network.

 
How can I reach CareSource?

You can call the CareSource service center at 1-800-488-0134. (TTY 1-800-750-0750). Our service center is open from 7 a.m. to 7 p.m., Monday through Friday. We are closed on certain holidays.

For more information, please see Service Center.

 
What if I have a question after hours?

If you have a health or medical question, you can call our nurse hotline at 1-866-206-0554 (TTY 1-800-750-0570). Follow the menu options to speak to a nurse. This hotline is open 24 hours a day, 7 days a week.

For more information, please see CareSource 24.

What services does CareSource cover?

CareSource covers all medically necessary Medicaid-covered services. These services are available at no charge to you. You should not be billed for these services. If you receive a bill, please call us. We also have a lot of extra benefits.

You can get many services without a referral from your primary care provider (PCP). This means that your PCP does not need to arrange or approve these services for you. Just check your provider directory for a list of participating providers who offer these services and schedule an appointment yourself.

Other services require a referral. That means you must get an okay from your PCP before you can receive the service.

A few services require both a referral from your PCP and prior authorization from CareSource. This means that your PCP has to okay the service and get an okay from CareSource, too.
 

For more information, please see Covered Services.

 
What if I get a bill for services?

You do not have to pay for any service that CareSource covers. So you should not get a bill for any of those services. If you do get a bill, please call our service center at    1-800-488-0134 (TTY 1-800-750-0750).

 
I need a new CareSource member ID card.

CareSource will send you an ID card. Please call our service center at 1-800-488-0134 (TTY 1-800-750-0750) if:

• You have not received your card yet.
• Anything on the card is wrong.
• You lose your card.

A new card will automatically be mailed to you when you change your primary care physician (PCP).

 
I need a new CareSource member handbook or provider directory.

CareSource sends a new member kit to all new members. Your kit includes these materials.

To get more copies, please call our service center at 1-800-488-0134 (TTY 1-800-750-0750).

 
What if I or someone in my family speaks Spanish or another language?

Call our service center at 1-800-488-0134 (TTY 1-800-750-0750). We can get someone who can sign or speak your language to help you talk with us or your doctor. And it is free.

We can also give you some printed materials in some other languages. Let us know. We can help.

 
I would like to switch to another PCP.

If you are not happy with your PCP, please call our service center. You can change your PCP to another doctor who participates with CareSource at any time. You can change up to once a month, if needed.

 
What are my rights and responsibilities as a CareSource member?

CareSource members have a lot of rights. You have the right to be treated with respect. You have the right to get health services in a timely manner. You can take part in how your health is treated.

CareSource members also have a few responsibilities. You need to be on time for your appointments. If you have to cancel, you should call 24 hours in advance. You should always carry your CareSource member ID card.

For more information, please see Member Rights.

 
I would like to file a complaint.

We hope you are happy with CareSource. If you are unhappy with anything, call us right away. Call our service center at 1-800-488-0134 (TTY 1-800-750-0750). We want you to let us know so we can help.

For more information about grievances and appeals, please see Complaints.