Switching Streams: Navigating The Shift From Paramount Advantage To Caresource Insurance Plans

If you're looking to change from Paramount Advantage to CareSource Insurance, there are a few things you should know. Firstly, it's important to understand that you can only switch health plans during open enrollment or under certain special circumstances. Open enrollment is a period when you can sign up for a new health plan, and it may vary by state or region. In Ohio, for example, Medicaid's managed care plans are designed to provide personalized care and allow you to choose your preferred plan. If you're already enrolled in a health plan and want to switch to CareSource, you can do so by calling the Ohio Medicaid hotline, completing a change request within 90 days, and specifically requesting CareSource.

Switching from Paramount Advantage to CareSource Insurance during open enrollment

If you are already enrolled in a health plan, such as Paramount Advantage, you can only switch to CareSource Insurance during the open enrollment period or under certain special circumstances. Open enrollment is a time period when you can sign up for a health plan, and it typically occurs each November. The exact timing may vary by state or region.

To switch from Paramount Advantage to CareSource Insurance during open enrollment, you can follow these steps:

• Contact the Ohio Medicaid Hotline or Visit the Ohio Benefits Portal: Call the Ohio Medicaid Consumer Hotline at 1-800-324-8680 or apply online using the self-service Ohio Benefits Portal. Representatives are available Monday through Friday from 7 am to 8 pm Eastern Time and on Saturday from 8 am to 5 pm ET. They can provide assistance with enrollment and answer any questions you may have about open enrollment.
• Complete a Change Request: Inform them that you are currently enrolled in Paramount Advantage and wish to switch to CareSource Insurance. If you have been on your current plan for more than 90 days, you are eligible to switch during the open enrollment period.
• Choose a Primary Care Physician: When selecting a plan, remember to choose a primary care physician for yourself and each member of your family. If you do not choose a physician, the plan will select one for you.
• Review the Benefits of CareSource Insurance: CareSource is the most popular choice for Ohio Medicaid plans, with over 1.4 million members. They offer a large provider network, reward programs, free rides to healthcare appointments, and more. CareSource also provides access to a personal Life Coach and various lifestyle programs to support your health and well-being.
• Finalise the Switch: Complete the necessary enrollment steps as guided by the Ohio Medicaid Hotline or the Ohio Benefits Portal. Ensure that you do not have a gap in your health coverage during the transition.

By following these steps, you can switch from Paramount Advantage to CareSource Insurance during the open enrollment period. Remember that open enrollment typically occurs annually, so plan your switch accordingly.

Switching outside of open enrollment

If you are already enrolled in a health plan, you can only switch plans during open enrollment or under certain special circumstances. Open enrollment is a time period when you can sign up for a health plan, and it can vary by state or region.

If you are already enrolled in a plan and would like to change to a different one, you must meet one of the following requirements:

• You have been a member of your current plan for three months or less
• You tried to get help from your MCP, but continue to have problems finding the care you need

If you believe you meet one of these requirements, complete the change request. If you do not meet one of the requirements above and still want to change your plan, you may change your plan during open enrollment each November.

In Ohio, Paramount Health is one of five providers that offer a state Medicaid plan. In 2020, Paramount Health announced it would be reducing the area of coverage for its Medicaid plan in Ohio to just two of the three regions that make up the state's Medicaid program. If you are affected by this change, Paramount will assist you in transitioning to a new plan, with no lapse in coverage.

Eligibility for Medicaid in Ohio

Medicaid provides free or low-cost health coverage to eligible individuals in need. To be eligible for Ohio Medicaid, you must be a resident of the state of Ohio, a U.S. national, citizen, permanent resident, or legal alien, in need of health care or insurance assistance, and have a low or very low income. You must also meet one of the following criteria:

• Be responsible for a child aged 18 or younger
• Have a disability or a family member in your household with a disability
• Be 65 years of age or older

Additionally, your annual household income (before taxes) must be below the following amounts:

• For adults with an income-based Medicaid, the maximum income level is $20,783 per year for a single person.
• For children with an income-based Medicaid, the maximum income level is $65,832 per year for a family of four.
• For pregnant women, the maximum income level is $41,902 per year for a single person.

If you are already enrolled in a health plan, you can only switch plans during open enrollment or under certain special circumstances. If you want to switch to CareSource, call the Ohio Medicaid hotline, complete a change request within 90 days, and inform them of your preference. If you have been on your current plan for more than 90 days, you can switch during the next open enrollment period.

Benefits of CareSource Insurance

CareSource is a nonprofit organization that provides quality health care coverage for underserved and low-income communities. It offers both private health insurance plans and government-subsidized plans, including Medicare Advantage and MyCare Ohio plans. With over 1.9 million members across five states, CareSource is one of the largest providers of Medicaid managed care plans in the nation.

Comprehensive Coverage

CareSource plans provide comprehensive coverage for individuals and families, including optional dental and vision coverage for adults. All plans include hearing coverage through the TruHearing provider network and pediatric vision and dental care. Adults can also choose to add on the Dental, Vision, and Fitness plan, which includes access to fitness centers such as LA Fitness, Anytime Fitness, and Planet Fitness.

No Copays and Free Transportation

CareSource members do not have to pay copays for healthcare visits, and transportation to and from appointments is covered if the member must travel 30 miles or more from their home to receive healthcare services. Additionally, CareSource provides free rides to pick up food from food pantries or other food distribution sites.

24/7 Nurse Advice Line

The CareSource24® Nurse Advice Line gives members 24-hour access to registered nurses who can provide advice and answer questions about health and medical concerns. This service is commonly used to help manage conditions such as pregnancy, asthma, and diabetes.

Care Management Services

CareSource offers care management services to children and adults with special healthcare needs. Registered nurses, social workers, and outreach workers are available to work one-on-one with members to help coordinate their care and ensure they receive the support they need.

Life Services Program

The Life Services program assists Medicaid members in addressing their needs and reducing their dependence on governmental services. It provides life coaching, access to resources, and helps members find job opportunities. This program is particularly beneficial for those seeking to improve their overall health and well-being.

Reward Programs

CareSource offers reward programs with values of up to $415 for members who make healthy choices, encouraging and recognizing their efforts to improve their health.

With its wide range of benefits, CareSource is committed to making a lasting difference in the lives of its members by improving their health and wellness.

Contacting CareSource

If you have questions about CareSource, you can contact them at 1-800-488-0134 (TTY: 711). They also have a mailing address available at 505 South High Street Columbus, OH 43215.

If you are already enrolled in a health plan, you can only switch to CareSource during open enrollment or under certain special circumstances. Open enrollment is a time period when you can sign up for a health plan, and it can vary by state or region.

If you are assigned to a health plan other than CareSource and wish to switch, you can do so within 90 days by calling the Ohio Medicaid Consumer Hotline at 1-800-324-8680. Representatives are available Monday through Friday from 7 am to 8 pm Eastern Time and on Saturday from 8 am to 5 pm ET. They can provide interpreters and answer member questions about open enrollment.

If you have been on your current plan for three months or less, or if you have tried to get help from your MCP but continue to have problems finding the care you need, you may be eligible to switch to CareSource. In this case, complete the change request and specify that you want to switch to CareSource.

You can also switch to CareSource during the next open enrollment period, which occurs each November. If you are already enrolled in a plan and would like to change to a different plan, you can do so by enrolling online, by mail, or over the telephone. To enrol online, use the self-service Ohio Benefits Portal. To enrol by mail, download the appropriate enrollment form and mail it to the provided address. Alternatively, you can call and speak to a customer service representative who will help you enrol over the telephone.

Frequently asked questions