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CareSource

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3.9

Overall Score

Author: Kaitlyn Short

LAST UPDATED: July 16th, 2024

CareSource provides managed health care plans for people who have difficulty accessing health insurance and health care. CareSource offers Medicaid, children's health care programs, Marketplace plans, and Medicare Advantage plans.

CareSource provides excellent additional services to its members, including rewards programs for healthy living, access to a registered nurse via CareSource24 ®.

It also stands out for the support programs offered with its plans. These include programs to help with job hunting and support for maternal and children's health.

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The Good

  • Good Medicaid Plans
  • Children’s Health Care Programs
  • Marketplace Plans
  • Medicare Advantage
  • Additional Programs
  • Member Services

Good Medicaid Plans

CareSource's Medicaid plans cover all the medically necessary services and prescriptions covered by Medicaid. Emergency services are covered at any hospital and urgent care.

With CareSource Medicaid plans in Ohio, there are no copays for health care visits or for some prescriptions.

Plan options in Indiana are Healthy Indiana (HIP) and Hoosier Healthwise (HHW) plans. The specific plan options include the following:

  • HIP Plus
  • HIP Basic
  • HHW Standard Plan

In Kentucky, CareSource offers a Medicaid plan in partnership with Humana: Humana-CareSource (Managed Care Plan).

CareSource also offers Medicaid in Georgia. Some special features of CareSource's Medicaid plans include the following:

  • Transportation assistance to and from appointments
  • Vision and dental
  • Life Services Program provides help with resume writing and job searching

Children’s Health Care Programs

With most of its Medicaid plans, CareSource offers a Babies First rewards program. Women who have signed up can earn points for rewards by attending doctor appointments while pregnant, receiving post-birth care, and attending well-child visits after the baby is born.

In Georgia, CareSource also offers a Planning for Healthy Babies (P4HB) program for qualifying mothers. Eligible mothers are notified in writing by the Department of Community Health.

The P4HB program offers family planning services and inter-pregnancy care or access to a Resource Mother for care management.

In Indiana, CareSource offers the government’s Children’s Health Insurance Program (CHIP).

In Georgia, CareSource offers Peach Care for Kids ®, which provides health insurance for children less than 19 years old who are not eligible for other insurance programs and meet certain income requirements.In Indiana, CareSource offers the government's Children's Health Insurance Program (CHIP).

In Georgia, this insurer offers Peach Care for Kids ®, which provides health coverage for children less than 19 years old who are not eligible for other insurance programs and meet certain income requirements.

Marketplace Plans

CareSource offers Marketplace plans in Indiana, Ohio, Kentucky, and West Virginia. If you choose Marketplace coverage, you can benefit from a subsidy on the monthly premium if your income qualifies.

Some of these plans are health savings account (HSA) compatible and include the following benefits:

  • Essential benefit coverage
  • Prescription drug coverage
  • Optional dental and vision package
  • TruHearing ® hearing coverage
  • Active&Fit ® program (access to gyms or two home fitness kits)
  • Pediatric dental coverage
  • Emergency dental coverage

Medicare Advantage

CareSource offers a Medicare Advantage plan in Ohio.

Medicare Advantage plans combine hospital insurance, medical insurance, and prescription drug coverage.

Each plan also includes discounts on hearing aids, vision benefits, preventive dental coverage, and access to gyms or two home fitness kits through the Silver&Fit ® program.

These additional features are common for insurance companies offering Medicare Advantage plans.

Member Services

CareSource also offers its members great services and tools. Some features may not be available with every plan.

Members have access to a registered nurse via phone through CareSource24 ®. CareSource also offers disease management programs for asthma and diabetes and other care management resources.

These members services are common among health insurers.

Like other insurance providers, CareSource has mobile apps. The myStrength app is designed to assist with mental health. The myHealth app provides users with healthy living tips.

CareSource also provides:

  • Caregiver resources
  • Fraud, waste, abuse reporting tools
  • Ways to submit grievances or appeals

Additional Programs

CareSource offers three additional programs in Ohio:

  • MyCare Ohio
  • Community Transition Program
  • Ohio Home Care Waiver Program

MyCare Ohio combines Medicare and Medicaid coverage for qualifying individuals. People with this plan work with a Care Manager who acts as their advocate within health care system and point of contact when taking the team approach to health care. CareSource works with local agencies to coordinate care needs. These plans include transportation assistance.

The Community Transition Program (CTP) helps people resume normal life as they transition from mental health and addictive service facilities.

The Ohio Home Care Waiver Program is designed for people who are Medicaid-eligible and under 60. There are additional program eligibility requirements. Services include the following:

  • Meal delivery
  • Adaptive/assistive devices
  • Home modification
  • Personal care
  • Non-medical transportation
  • Emergency response systems

These additional services offer valuable support that meets specific needs. These plans can be beneficial for people seeking more support than usually offered with a health insurance plan.

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The Bad

  • Limited Customer Insight
  • Plans Vary by State
  • Only Pays for Covered Services

Limited Customer Insight

CareSource does not have very many customer reviews on Best Company. Unfortunately, most of these reviews show negative customer experiences. Reviewers mention difficulty with claims, covered services, and provider networks.

Keep these reviews in mind as you consider working with CareSource. However, limited conclusions can be made about this insurance carrier because of its low number of reviews.

Plans Vary By State

Not all of CareSource's plans and benefits are available in every state it services. Additionally, the health plan specifics also vary. The health insurance company's offerings may only available in some counties of these states.

Medicaid is available in Ohio, Kentucky, Georgia, and Indiana. The Life Skills support is not available in Kentucky. Transportation assistance to and from doctor appointments varies by state.

Most of the Medicaid plans come with programs to support mothers during and after pregnancy. Georgia has a unique program that offers more support for qualifying mothers with family planning, pregnancy care, and provides access to a care manager in some cases.

Medicare Advantage plans are only available in Ohio, as are the MyCare Ohio plans, Community Transition Program, and Home Care Waiver programs.

Marketplace plans are available in Ohio, Indiana, Kentucky, and West Virginia.

Specially designed health insurance programs for qualifying children are offered by CareSource through CHIP in Indiana and Peach Care for Kids ® in Georgia.

Only Pays for Covered Services

CareSource health insurance only covers the health care services that are medically necessary and covered under the plan's rules.

A list of covered services is available in CareSource's member handbook on its website. It also lists some of the services that are not covered under its plans.

For more information about covered services, interested consumers can view CareSource's website or contact CareSource directly.

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The Bottom Line

While CareSource’s plans do not cover everything and vary state to state, CareSource is worth considering for individuals that qualify for its insurance coverage.

CareSource has good Medicaid plans. The Life Services program that comes with most of its Medicaid plans provides assistance with job searching.

CareSource also has several programs specially designed to improve maternal and infant health care, like its Babies First and Planning for Healthy Babies programs. It also offers CHIP in Indiana and Peach Care for Kids ® in Georgia.

Its additional programs in Ohio that combine Medicaid and Medicare, provide support for those recovering from addiction, and in-home support for Medicaid-eligible individuals under 60 are also great services.

In some states, you can also purchase a Marketplace plan from CareSource.

The support programs that accompany CareSource insurance plans makes it stand out from other health insurers.

A full recommendation based on the CareSource member experience requires more reviews on Best Company. However, the insurance provider offers helpful programs and administers government health plans. 

If CareSource is available in your area and you qualify for its health care coverage, the insurance company is worth investigating further.

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1.3

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51 Reviews

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Norm Risoya Columbus, OH

Company does okay with paying clAims but is difficult too reach n the phone

4 years ago