What services does CareSource MyCare Ohio cover?
If you have both Medicare and Medicaid through CareSource MyCare Ohio you get all medically necessary Medicaid and Medicare-covered services. This includes preventive, physical and behavioral health services.
What does CareSource Medicare Advantage cover?
CareSource Medicare Advantage plans provide coverage* for: With CareSource Advantage ® (HMO), get a $25 quarterly allowance for over-the-counter pharmacy items like allergy medication, antacids, pain relievers, skin care products and more. Our Medicare Advantage plans offer coverage for one pair of glasses or contacts with $0 copay.
What can you buy over the counter with CareSource advantage?
Over-the-Counter (OTC) Items. With CareSource Advantage ® (HMO), get a $25 quarterly allowance for over-the-counter pharmacy items like allergy medication, antacids, pain relievers, skin care products and more. Glasses or Contacts.
What forms of claims does CareSource accept?
CareSource accepts claims in a variety of formats, including online and paper claims. Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims and any necessary attachments, track claim payments and more. CareSource offers this service at no cost.
Is CareSource Ohio Medicaid or Medicare?
Medicare-MedicaidCareSource® MyCare Ohio is a Medicare-Medicaid plan that delivers extra benefits and the coordinated care needed by both patients and caregivers, giving patients more coverage and caregivers more options. QUESTIONS?
Is Ohio Medicaid the same as CareSource?
CareSource is the number one plan of choice for Medicaid in Ohio. QUESTIONS ABOUT CARESOURCE? WE'RE HERE TO HELP!
Is Humana the same as CareSource?
CareSource.com At Humana – CareSource, we call healthcare providers our health partners. A “health partner” is any healthcare provider who participates in Humana – CareSource's provider network. You may find “health partner” and healthcare provider used interchangeably in our manual, agreements and website.
Is CareSource the same as Wellcare?
In January 2020, Wellcare was acquired by Centene Corporation. In 1989, CareSource was founded on the premise of providing quality health care coverage for Medicaid consumers. Today it offers one of the nation's largest Medicaid managed care plans.
Can you have Medicare and Medicaid in Ohio?
Dual-Benefits: A MyCare Ohio plan provides both the Medicare and Medicaid benefits for members. Members are eligible to receive added benefits of the plan, such as $0 copayments for prescription drugs covered by Medicare, additional transportation services, etc.
What does CareSource cover in Ohio?
CareSource MyCare Ohio Medicaid-only members receive all medically necessary Medicaid-covered services. This includes preventive, medical and behavioral health services. It also includes long-term services and supports, durable medical equipment, and limited pharmacy (prescriptions not covered by Part D Medicare).
Can you have Medicare and Medicaid?
Medicaid is a state and federal program that provides health coverage if you have a very low income. If you are eligible for both Medicare and Medicaid (dually eligible), you can have both. They will work together to provide you with health coverage and lower your costs.
How do I qualify for dual Medicare and Medicaid?
Persons who are eligible for both Medicare and Medicaid are called “dual eligibles”, or sometimes, Medicare-Medicaid enrollees. To be considered dually eligible, persons must be enrolled in Medicare Part A (hospital insurance), and / or Medicare Part B (medical insurance).
Is CareSource not for profit?
CareSource is a nonprofit, nationally recognized managed care organization with over 2 million members.
Which Medicaid insurance is best?
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. attained the highest overall rating among Medicaid plans for HPR 2021. The plan demonstrated high-quality preventive care, with five stars for nearly every prevention measure for which it provided data.
What is the difference between Medicare and Medicaid?
The difference between Medicaid and Medicare is that Medicaid is managed by states and is based on income. Medicare is managed by the federal government and is mainly based on age. But there are special circumstances, like certain disabilities, that may allow younger people to get Medicare.
What is not covered by Medicaid?
Medicaid is not required to provide coverage for private nursing or for caregiving services provided by a household member. Things like bandages, adult diapers and other disposables are also not usually covered, and neither is cosmetic surgery or other elective procedures.
Dental
Good dental care is important to your health. As we age we experience oral changes. Your oral health can impact your overall health. Attention to your mouth can prevent and control many diseases and conditions. Your dental benefit includes a dental exam and cleaning visit every six months.
Vision
At CareSource MyCare Ohio, we want to make sure you can see clearly. We cover an extra pair of eyeglasses, including lenses and/or frames, every two years, in addition to your other vision services. See your member handbook on our Plan Documents page for more information.
Transportation
Do you need a ride to the doctor? CareSource MyCare Ohio can help. We provide transportation at no cost to you for up to 60 one-way trips to your health appointments. See Additional Services for more information about getting a ride from CareSource.
Medicare Advantage (HMO) Plans
CareSource offers Medicare Advantage (HMO) plans that include prescription drug coverage. These plans are for those who qualify for Medicare parts A & B and want low (or no) monthly payments.
Are You a Member?
Get quick access to prescription coverage, find a doctor or provider, use health and educational tools, and discover what you can do with your My CareSource ® account.
Submit Claims Online
Providers have the option to submit claims through our secure, online Provider Portal. You can submit claims and any necessary attachments, track claim payments and more. CareSource offers this service at no cost.
Traditional Providers, Community Partners and Delegates and Health Homes
CareSource’s traditional providers, community partners and delegates and health homes all may submit claims through the CareSource Provider Portal using online forms. Three types of claims may be submitted:
Waiver Services Providers
MyCare waiver services providers can also submit claims through the Provider Portal, but they do not use the same process as traditional providers, community partners and delegates and health homes. All claims for waiver services reimbursement or appeals for claim denials should be submitted electronically through our Provider Portal.
Get Paid Electronically
CareSource has partnered with ECHO Health, Inc. to deliver provider payments. ECHO offers three payment options:
Paper Claims
For the most efficient processing of your claims, CareSource recommends you submit all claims electronically. Paper claim forms are encouraged only for services that require clinical documentation or other forms to process. Refer to the provider manual for instructions to submit paper claims.
Claim Overpayment Recovery Requests and Resources
Navigate Overpayment Recovery Form – Submit this form to offset overpaid claims against a future payment.
Payment Review
Navigate Payment Review Tool – Use this tool to reference CareSource’s pre- and post-payment review processes and appropriate contacts.