Caresource: Private Insurance And What It Means For You

CareSource is a health insurance provider that offers a range of plans to meet the needs of individuals and families. Their plans are designed to be simple and affordable, covering pre-existing conditions and essential health benefits such as pediatric dental and vision care. CareSource also provides free or low-cost health insurance for eligible low-income individuals, families, children, pregnant women, elderly adults, and people with disabilities. In addition, they offer individual and family health insurance for those who do not have employer insurance and do not qualify for programs like Medicare or Medicaid. CareSource is committed to making health insurance accessible and affordable for its members, with additional benefits such as prescription drug coverage, preventive care, and telehealth services.

CareSource Dual Advantage™

CareSource is a non-profit public-sector health care company that provides free or low-cost health insurance for eligible low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. They have been in operation for over 30 years and currently have over a million members.

In Ohio, the plan includes a $150 monthly debit card allowance for healthy food and over-the-counter (OTC) items at participating retailers. In Georgia, the plan includes a $500 quarterly debit card allowance for OTC items such as first aid supplies and vitamins.

Additionally, CareSource Dual Advantage™ offers enhanced vision benefits, providing a $350 (GA) or $450 (OH) allowance for frames, lenses, or contacts through EyeMed®. The plan also includes hearing aids and hearing exams through TruHearing®, as well as a dental allowance of $4,000 (GA) or $6,000 (OH) through DentaQuest®.

Members also have access to no-cost memberships at participating fitness centers and select YMCAs, as well as a home fitness kit that may include a wearable device such as a Fitbit or Garmin®. Furthermore, CareSource provides a transportation benefit for health-related trips to provider appointments, pharmacies, gyms, and grocery stores.

The plan also includes a Brain Health & Memory Benefit through BrainHQ®, which provides online exercises to enhance memory, attention, brain speed, people skills, and more. There is also an additional $1,000 (OH) or $1,100 (GA) per year flex allowance for dental, vision, and hearing services and accessories.

Pregnancy, maternity and newborn care

CareSource provides free or low-cost health insurance for eligible low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Their Planning for Healthy Babies® (P4HB®) program offers family planning services at no cost to eligible women in Georgia.

The P4HB® program has three parts: Inter-pregnancy Care (IPC), Resource Mother (Care Management), and Family Planning. To be eligible for the Family Planning aspect of the program, you must be a U.S. citizen, a woman between 18 and 44, a Georgia resident, and have a family income of no more than 211% of the federal poverty level (FPL). Additionally, you must not be eligible for any other Medicaid or managed care program. If you meet these requirements and have delivered a very low birth rate (VLBW) baby (less than 3.3 lbs) on or after January 1, 2011, you will be eligible for the IPC part of the program. If you receive Medicaid and delivered a VLBW baby on or after January 1, 2011, you can be part of the Resource Mother services.

The IPC program offers primary care services, limited dental services, management and treatment of chronic diseases, substance abuse treatment, and prescription drugs for conditions that may increase the risk of VLBW delivery. The Resource Mother program provides case management and help with personal, social, and social services.

In addition to the P4HB® program, CareSource offers a range of health insurance plans that include coverage for pregnancy, maternity, and newborn care. These plans provide benefits such as pediatric dental and vision coverage, optional adult dental, vision, and fitness benefits, prescription drug coverage, and preventive care coverage. Their Marketplace plans are designed to save members money on health insurance, with four out of five customers able to obtain a plan for under $10 a month with financial assistance.

Medicaid health care coverage

CareSource is a health insurance provider that offers free or low-cost health insurance for eligible low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Their plans are simple and affordable, covering pre-existing conditions and offering pediatric dental and vision benefits or coverage.

Medicaid is a government-funded health insurance program that provides free health insurance for eligible individuals. It is jointly funded by states and the federal government and administered by states according to federal requirements. Medicaid provides comprehensive health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults, and people with disabilities.

Medicaid offers a wide range of services depending on age, financial circumstances, family situation, or living arrangements. These services are provided through a large network of healthcare providers that can be accessed directly using a Medicaid card or through a managed care plan. Some services may have small co-payments, which can be waived if the individual cannot afford them.

Medicaid coverage can be obtained in several ways, including contacting the local department of social services or the state's Human Resources Administration. Pregnant individuals and children can apply at many clinics, hospitals, and provider offices. It is important to note that eligibility requirements, such as income thresholds, vary based on factors like age, household size, and citizenship or immigration status.

Both CareSource and Medicaid aim to provide accessible and affordable health insurance options for individuals and families, particularly those with low incomes or specific health needs. By offering coverage for a range of services, they help ensure that people can access the healthcare they need without incurring significant financial burdens.

MyCare Ohio

The MyCare Ohio plan provides all the same benefits as Medicare and Medicaid, including long-term care services and behavioural health. MyCare Ohio plans may also include additional services for their members.

There are two options for receiving MyCare Ohio benefits:

Dual-Benefits

The MyCare Ohio plan provides both Medicare and Medicaid benefits for members. Members are eligible to receive added benefits such as $0 copayments for prescription drugs covered by Medicare, and additional transportation services.

Medicaid-Only Benefits

A MyCare Ohio plan only covers Medicaid-covered services. Members will continue to receive prescription drugs through their Part D plans and any associated co-payments. Medicare benefits will be provided through traditional Medicare or through a private insurance company, commonly referred to as a “Part C” plan.

The primary benefit of MyCare Ohio is the coordination of all services, both medical and behavioural, and long-term care. The current Medicare and Medicaid services can be confusing and difficult to navigate, with no single entity accountable for the whole person. MyCare Ohio dual-benefits members only need to carry one medical coverage card and have one point of contact.

Switching plans

CareSource offers a range of health insurance plans to suit different needs and budgets. Their plans are simple and affordable, covering pre-existing conditions and offering pediatric dental and vision benefits as standard.

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

If you are in Ohio, you can switch to CareSource MyCare Ohio if you are eligible for Medicare Parts A & B and Medicaid and live in one of the following counties: Columbiana, Cuyahoga, Geauga, Lake, Lorain, Medina, Mahoning, Trumbull, Portage, Stark, Summit, or Wayne. To enrol, call the Ohio Medicaid Consumer Hotline or visit their website and select MyCare Ohio.

If you are on another managed care 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 specifying that you want to switch to CareSource. If you have been on your current plan for more than 90 days, you will have to wait until the next open enrollment period to switch.

CareSource offers a range of plan options, including Silver and Bronze plans, to suit different budgets and healthcare needs. Silver plans are a good option if you expect to have a lot of doctor appointments or need many prescription drugs, as they offer lower out-of-pocket costs. Bronze plans have the lowest premiums but higher deductibles and other out-of-pocket costs.

Frequently asked questions