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CareSource

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32 User Reviews

3.9

Overall Score

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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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Star Rating

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32 Reviews

Review Breakdown

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4 grade

6%

3 grade

3%

2 grade

0%

1 grade

91%

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Heather Hetrick Perrysburg, OH

I don't even want to give a 1 star. Caresource was my only option through marketplace insurance when I turned 26. We pay over $600 a month after tax break for a plan that stated what they paid for through healthcare.gov. Most of what was stated online is completely wrong. For instance, any fertility or related care, I have infertility from hashimotos, PCOS, etc and I was denied appointments at all fertility clinics in both Michigan and ohio (I live in ohio) because they said caresource literally will pay for nothing even if its coded correctly. I used to take synthroid for my thyroid, for years it didn't work and no dr could figure out why. Well the second I switched to caresource and went to go pickup my synthroid, caresource refused to fill that and instead had kroger fill it with a different generic without telling me or asking about allergies. I am allergic to gluten, many fillers/dyes, etc. This was during a horrible snow/ice storm here and I had a horrific allergic reaction to the medication. My dr noted on my chart that I was clearly allergic and its why the previous ones didn't work, well caresource decided that being allergic wasn't a good enough reason for them to cover Tirosint which is the only "Synthroid" with no fillers and is completely gluten free. On their formulary for 2021 it shows it as covered and all other thyroid meds without a PA. I was told I needed a PA and they wouldn't pay. My dr and I spent months calling, faxing, mailing, etc them MORE than what they asked for. I have no income/assistance so I cannot pay out of pocket for it. I filed a grievance and requested both internal & external reviews and for them to cover it while they did these which is noted in ACA. They said they never got my mailed (certified mail) forms, then said they were wrong, then said they never got any of my PAs or any of my review requests online even though I have proof of them going through. It took me going on twitter and publicly saying what they did for someone to contact me and get my med approved. I will have to redo this every month because they only fill a month at a time. After this, my neurologist ordered a brain mri, lumbar and cervical mris. I had failed back surgery in 2018 and have over 10 chronic debilitating pain conditions and bladder incontinence from this. It is the reason I was fired in 2019. They approved the brain mri no problem but the letters I received for lumbar/cervical state that a pediatrician denied my mris (why does she work for caresource and why is a pediatrician allowed to make decisions on adult care). They said the codes were wrong, and memory issues wouldn't need back mris, they are not for my memory issues but for all my other conditions. I called them and then they said because I hadn't attempted PT in the past 6 months (I've had caresource since January) they wouldn't approve it. I lived in another state when I had my surgery and did PT for many months after it but had to stop because it made me worse. I have DDD, impinged nerves, bladder incontinence, multiple bulging discs, reherniation and scar tissue from my surgery, have had serious falls in the past weeks due to my nerve related leg weakness which came out of nowhere. But those arent good enough for CS to pay for an mri. I haven't had an mri since right after my failed surgery in 2018 even though I've had very good reasons to get another one. I haven't been able to because I had no insurance and then I had caresource who pays for nothing. DO NOT get this insurance. they literally make having chronic conditions 2 full time jobs to deal with them. I already have extreme stress/trauma and they make my life 1000% harder. Even if this is your only choice, don't get it. I regret it because I now cannot get financial assistance anywhere since have insurance even though they pay nothing. They break laws, like not giving info about the reviews and reasoning and give wrong numbers and emails when you attempt to have your dr contact them. They alienated my PCP because they made her redo stuff so much and kept giving wrong numbers. When someone like myself who has over 30 chronic conditions, needs an MRI you do it, you don't deny it. Ill be reporting them everywhere I can because they bait and switch you.

1 week ago

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Glenda Evansville, IN

I'm only giving it a 1 because they will not allow a 0. This insurance is a scam. I call and ask which provider I should go to for dental. They gave me a name and number x 3. All three were out of business so I call back. They not only do they give me a name but they set up the appointment. Now they are refusing to pay the bill. This is the third time something like this has happened. I know you think it will be different if you cover all your bases but it won't. They will refuse to pay and you will be powerless to do anything. I'm going on the Better Business Bureau next but I doubt it will do any good.

2 months ago

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Regenia Thomas Statesboro, GA

Just left the dentist office, I was told that my dentist does not accept this insurance, now I’m reading all the bad reviews about this company, this must be some kind of scam to make money off of innocent people.

3 weeks ago

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Kathryn Streletzky Mount Hope, WV

I moved to WV from CA in November. I chose CareSource on the Healthcare.gov marketplace because it was less expensive than Highmark. Bad idea! They refused to pay for an expensive prescription that my CA neurologist had prescribed, and my CA Bronze plan had no qualms about covering. CareSource refused to pay, so I filed a grievance and an ER Doc and Nurse said I could not have it because I did not have a certain diagnosis. I spoke to my neurologist in WV and she said she'd help me appeal, but since open enrollment was still in effect, I decided to just switch companies. Highmark covered the prescription without any issues and my copay was just $52.48. DO NOT SIGN UP WITH CARESOURCE!

3 months ago

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Anne Dayton, OH

This company has improved by leaps and bounds in the past few years and find there are sometimes hiccups that arise but by calling their customer service, they are great to explain and tell the process that needs followed to correct any issues..

4 months ago

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Nothing but the Truth Atlanta, GA

DO NOT GET THIS INSURANCE!!!! THERE IS A REASON IT BARELY HAS 1 STAR, TRUST THE REVIEWS, THEY ARE NO LYING TO YOU!!! I WILL BE GETTING OTHER COVERATE AS SOON AS POSSIBLE. I would give them a ZERO if it was an option!! This insurance is SOOOOO bad no doctors want to take it! Furthermore, getting CareSource to actually PAY A CLAIM is nearly impossible (so far, it has been COMPLETELY impossible. I had 2 covid tests in January and December, which are supposed to be fully covered under my plan. I called CareSoure to confirm coverage before getting the testing done. Afterwards, I sent the claims in using Care Source's required Claim Form, along with the billing and other supporting information (with CPT codes) which I had received from the Urgent Care facility. It has now been 3 times that I have submitted these claims, and every time they HAVE BEEN DENIED, with some completely bogus response saying they didn't get the procedure codes and diagnosis codes!!!!!

5 months ago

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Danhead ,

Trash trash , corruption and trash . First off NO kentucky primary care doctors , or dentist take this ! I called customer service and a dental quest extension 5 days and every time was given names that didn’t take plan . All they do is file a grievance with their own company and say give them 30 days to resolve . Guess what no resolution happens : Do not buy this insurance and avoid them at all costs ! Kentucky should Investigate them quickly !

4 months ago

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Sean Mclenithan Savannah, GA

Terrible coverage. I’ve had Caresouce for 2 months... I’m very unhappy with them. Basically no one takes the insurance and if they do then CareSource simply denies the charges and has the provided bill you dir3ctly. They did not pay for my annual blood work: $300. They did not pay for a routine hearing test: $270. They did not pay for my 3 COVID 19 tests at $160 each. You’re almost better off with no insurance at all.

4 months ago

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Jean Becker Evansville, IN

Whatever you do, don't get Cruel Source Insurance. I needed emergency orthopedic surgery and could not find one orthopedic doctor who would take Cruel Source insurance. They have terrible problems with network adequacy. The A.D.A. mandated that insurance companies offer sufficient numbers of providers (doctors) that are within the plans network. In my case, three different orthopedic groups refused to take patients with Cruel Source Insurance. Cruel Source told me they would give me the name of an In-Network orthopedic doctor in one to two business days after I initially called them. It took them nine days to give me the names of two In-network orthopedic doctors. The first doctor on the list moved out of state and the second doctor was not in network. Cruel Source kept telling me prior to the surgery that a local orthopedic group would take Cruel Source Insurance. I repeated told Cruel Source that I called the group that they mentioned and was informed on two different occasions they do not take patients with Cruel Source insurance. This company is a pathetic joke. They are like a shell company. I would encourage readers to make a formal complaint to your state's insurance board. I have done this. I would also advise writing a complaint letter to your state's Attorney General. If you have Cruel Source Marketplace insurance, I would suggest you write to the Attorney General of the United States and let him know how Cruel Source is treating customers with Marketplace insurance. Let the US Attorney General know how Cruel Source is using the money it receives from the Department of Treasury in the form of subsidies. My state board of insurance could not find that Cruel Source had broken any laws by failing to provide me with the name of one orthopedic doctor. Makes me wonder why I paid $336 every month for my premiums. I would have been better off to use that $336 for toilet paper. Cruel Source is not worth the paper it's printed on. The only thing I can think that might get some traction with Cruel Source is a class action lawsuit. Unfortunately I really don't believe the Federal or state governments are interested in protecting the consumer from unscrupulous companies like Cruel Source.

8 months ago

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Dominique Cleveland, OH

I've had them for 6 almost 7 years since moving to ohio. Never had an issue. I learned about the babies first program in 2016 and its a Great incentive plan for something you'd normally do like go to the Dr or well child visists. They pay you for it. They reimburse you for gas to go to appointments and even have nurses that'll come to your house. Love this insurance company!

1 year ago

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S Manning Lexington, KY

Other than the fact that the people, the so called doctors and I use that term very loosely, making my health care decisions for me are complete IDIOTS they’re swell.

2 months ago

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Chris France TX

Stay away if possible. We pay good money for this ACA plan, but they have been terrible when we needed assistance with various concerns.

2 months ago

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Michael Chikders Louisville, KY

Terrible health insurance company. You’re basically paying to be uninsured. After canceling they continue to bill you even though you have purchased other insurance. Stay away folks run!!!

4 months ago

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Deborah Townley Stallard Newnan, GA

Would not pay for oxygen even though I have COPD. I had to wAit a month for prescription approvals. They did not add anything to my deductibles including doctor visits and prescription s. Basically no insurance even though they were paid 2000.00 in marketplace payments. Truly a rip-off.

7 months ago

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Ashley Myers Littleton, CO

I would give no stars....This insurance sucks big balls....im on vacation and have a serious infection and ended up in the hospital and I'm also pregnant. I tried to get my prescription filled and they are denying to cover it...saying its out of the area...BUT they covered my mothers prescription no problems...i guess me and my baby can die...from a kidney and bladder infection because they want to discriminate against a pregnant person but fill a non pregnant persons pills first no problem...wth is wrong with that picture????

11 months ago

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Frestylescooter Color fell Dawsonville, GA

If I could do 0 stars I would!! It stinks! All the drs that supposedly took it before we bought it, conveniently stopped taking it right after we bought it. Also, when we first got it, it was a family plan but we had a family out of pocket max and an individual out of pocket max. As soon as I met my individual out of pocket max, I got a few things covered at 100% and then it changed and now there’s only a family out of pocket max. You can’t have a individual oop max. The plan keeps changing. It stinks! If I wouldn’t get charged for having no insurance, I’d cancel it. But if I cancel it, I can’t get any different insurance and then I have to pay a stiff penalty. So they have you cornered. Would NOT recommend this policy!!!

1 year ago

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Jo Roswell, GA

This is a new company servicing GA. Avoid like a plague if you can. In order to get a simple Endoscopy, I was told that the only places I can get this simple test is to go to one of the in-network hospitals since they do not have any affiliations with independent facilities. Well, the difference in price is $5000 vs $1000. The doctor (not his fault) was dumbfounded by this suggestion since there is a huge price difference AND normally, they do these procedures/tests at their facilities rather than a hospital. I am now stuck with a $4000 hospital bill due to the higher deductible. Their excuse is simply stated by the fact I am now closer to meeting my deductible. I rather have a $1000 bill than a $4000 bill. Ridiculous! Also their negotiated rates are below the norm.

1 year ago

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C Lambeth Guyton, GA

Racist. Told me I could not access my sons health info because my name didn’t match what is in their system. There is no other parent. I was asked to sign a piece of paper that would take 10 days to process to prove I was my sons mother. I recited his social, date of birth, medical history and doctors name. Nope. I got married over the summer so yes my name is different. Still doesn’t mean I’m not my child’s mom. I was calling about a medical device. Is it or is it not covered? That question has nothing to do with HIPPA. I am asking if a product is covered, my child didn’t even need to be discussed. It was a general question. Lady called my pharmacy to confirm my identity then said she still couldn’t answer my question but left the answer with my pharmacy. What? Well then you know I’m his momma! If I was black I would have been helped 100%.

1 year ago

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John O Lewis Center, OH

I have had a very difficult time finding Doctors that will accept the insurance.. Allot of the Doctors have said they have a hard time getting payment from Caremark and as such have simply stopped accepting it at their practice. Furthermore, the online directory is outdated and worthless. Just today, I searched for a primary care doctor who is " accepting patients" and "accepting caremark". I have already nearly exhausted the list to find that 1) they are not accepting new paitents and have not for many months 2) they dont accept Caresource Marketplace 3) In some cases, the office has "never heard of the doctor". I have been trying to find a PCP for over a year; just recently placed an appointment with a doctor 5 months out only to have them cancel because of the insurance a couple of weeks out. It has been very frustrating especially since I bought my insurance through the marketplace & CareSource totally misrepresented their service and available physicians during the application process. I am Not happy! I have also found that you get different answers depending on who answers the phone in customer service.

1 year ago

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andy bullet Lithonia, GA

Please stay away from this Insurance. They are not even worth the 1 star given. In have been trying to get a knee xray and none of the clinics listed on their site is accepting the insurance. I also got a list of places from a customer service representative, and it's the same sad story. What a waste. I repeat, please stay away.

9 months ago

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Cori Hiawassee, GA

You're essentially paying to be uninsured because NO ONE takes them. I paid extra for dental and vision, of which no one accepts, and they hardly cover anything for my normal doctor visits. Customer service also has no idea what they're talking about and you get a totally different answer depending on who you speak with. They just want you off their line. Don't waste your time and money.

1 year ago

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Lisa Neal Hamtramck, MI

Worst company on the face of the planet! Condescending lazy workers . Asked for catalog 1/2 dozen times over a span of 6 mths appalling rude irresponsible call center including a supervisor that only made bad excuses for prior lack of follow through JB on returned calls and appts. Was in extreme pain for 17 days while they docked me around sending me here there and people weren’t even doctors . I’m suing for them now for the torture and li ack of urgently and lack of treatment my civil rights have been violate to receive equal care!!!!

1 year ago

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Slim Cheaks Valparaiso, IN

I've been with CS Marketplace for 2.5 months now and all I have is issues. Hardly any offices take it or they have issues with it. I have been mislead by customer service saying I can go to Planned Parenthood to get a free test. At arrival to PP they said they didn't take CS. I was also told by a nurse who had difficulty pulling up my info, that CS went bankrupt in the past and has always had problems. I DO NOT recommend this insurance AT ALL

1 year ago

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Z. Decatur, GA

AWFUL Insurance! Not widely known, or accepted. Also, THEY ARE LITERALLY CLOSED ON THE WEEKENDS AND EVENINGS!!!! So if you have a question about your coverage or why they are denying your prescriptions (which is what I was calling about) you will have to call back between 9am-5pm M-F. You know...because no one ever has any medical issues/concerns/questions after 5pm and of weekends! Also, once you do call, you'll be on hold for a loooong time. Then you'll talk to a moron who will say they aren't "a medically trained professional" and read off a script. NEVER had insurance this bad.

1 year ago

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Tammy Baker

We have had a very difficult time finding Doctors that will accept the insurance especially dentist & we have a dental plan. Alot of Doctors have told us they have a hard time getting payment from the insurance co. It has been very frustrating especially since we buy our insurance through the marketplace & Caresource was our ONLY option. Not happy! Alot of time you get different answers depending on who answers the phone in customer service.

2 years ago

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Ginger Struble Valparaiso, IN

Horrible.do not go w them.my daughter was covered under caresource at time of service.bill is in collection now ! Caresource refused to pay for it over $1000 dollar bill .caresource refused to pay it she was100 percent covered.do not trust this company this is how they will treat their customers !

1 year ago

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kevon tucker McDonough, GA

Iv had caresource for a year now and they SUCK!!!!I had to change my dentist ,once it took me a while to find one, because the insurance wasn't wanting to pay the claim..so I'm guessing is also happened to Walgreens because I got a letter in the mail saying that CareSource is not welcome at Walgreens.

1 year ago

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M Jackson Newport, KY

The customer service here is THE WORST!! All they care about and the only system they have in place is how to bill you and receive your payment. You will be on hold forever and they have no empathy or care about your time or question. They only have a scripted answers to any and all questions. THE WORST!!!!

2 years ago

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SH Granger, IN

Terrible experience. Got seriouse financial issues relying on their Market Place. Be careful having their service.

4 months ago

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Dumb&Dumber &Dumbest Canon, GA

Horrible insurance in state of Ga. Basically you have no insurance because everyone refuses to accept this insurance from the market place. Would recommend avoiding if possible. Coverage is super limited!

1 year ago

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CriticismCripple Hamilton, OH

Constantly changing its policies and who supports it. So many problems have been because of this, so called, insurance. Many plans have been ruined and even our time was wasted because of late news.

1 year ago

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Norm Risoya Columbus, OH

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

11 months ago

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