For 2023 Important Plan Information - CareSource
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P.O. Box 8738
Dayton, Ohio 45401-8738
Important
Plan Information
for 2023
Complete your You can earn a $30 Walmart® gift card. It’s easy to do!
Health Needs Screening Just call 1-833-230-2011 (TTY: 711) Monday - Friday between 7 a.m. to 6 p.m. Eastern Time
REVIEW YOUR CARESOURCE ID CARD(S)
This ID card identifies you as a CareSource member. Always show your card
to health care providers before you get care.
Questions? Or is your name incorrect on the card? Please call Member Services at
1-844-607-2829 (TTY: 1-800-743-3333 or 711). A representative can be reached
Monday through Friday from 8 a.m. to 8 p.m. Eastern Time.
1
Member Name: Member Name:
Member ID (MID): Member ID (MID):
FPO FPO
RxBIN - 003858 RxBIN - 003858
Member Services: RxPCN - MA
Member Services: RxPCN - MA
1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01 1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01
Member Services Hours: Member Services Hours:
8 a.m. – 8 p.m. Monday – Friday 8 a.m. – 8 p.m. Monday – Friday
Log on to MyCareSource.com to check for eligibility and Log on to MyCareSource.com to check for eligibility and
Primary Medical Provider (PMP). Primary Medical Provider (PMP).
Member Name: Member Name:
Member ID (MID): Member ID (MID):
FPO
RxBIN - 003858 RxBIN - 003858
FPO
Member Services: Member Services: RxPCN - MA
RxPCN - MA
1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01 1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01
Member Services Hours: Member Services Hours:
8 a.m. – 8 p.m. Monday – Friday 8 a.m. – 8 p.m. Monday – Friday
Log on to MyCareSource.com to check for eligibility and Log on to MyCareSource.com to check for eligibility and
Primary Medical Provider (PMP). Primary Medical Provider (PMP).
EMERGENCIES: EMERGENCIES:
FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST
EMERGENCY ROOM (ER) EMERGENCY ROOM (ER)
If your health event is not life-threatening and you are not sure about If your health event is not life-threatening and you are not sure about
going to the ER, call the RNs at CareSource24®, Nurse Advice going to the ER, call the RNs at CareSource24®, Nurse Advice
FPO FPO
Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711). Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711).
BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464 BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464
ESI PHARMACY HELP DESK: 1-800-416-3632 ESI PHARMACY HELP DESK: 1-800-416-3632
PROVIDER SERVICES: 1-844-607-2831 PROVIDER SERVICES: 1-844-607-2831
RR2022-N-MED-M-908313 RR2022-N-MED-M-908313
EMERGENCIES: EMERGENCIES:
FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST
EMERGENCY ROOM (ER) EMERGENCY ROOM (ER)
If your health event is not life-threatening and you are not sure about If your health event is not life-threatening and you are not sure about
going to the ER, call the RNs at CareSource24®, Nurse Advice going to the ER, call the RNs at CareSource24®, Nurse Advice
FPO
Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711).
BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464
FPO
Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711).
BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464
ESI PHARMACY HELP DESK: 1-800-416-3632 ESI PHARMACY HELP DESK: 1-800-416-3632
PROVIDER SERVICES: 1-844-607-2831 PROVIDER SERVICES: 1-844-607-2831
RR2022-N-MED-M-908313 RR2022-N-MED-M-908313
Member Name: Member Name:
Member ID (MID): Member ID (MID):
FPO FPO
RxBIN - 003858 RxBIN - 003858
Member Services: RxPCN - MA
Member Services: RxPCN - MA
1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01 1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01
Member Services Hours: Member Services Hours:
8 a.m. – 8 p.m. Monday – Friday 8 a.m. – 8 p.m. Monday – Friday
Log on to MyCareSource.com to check for eligibility and Log on to MyCareSource.com to check for eligibility and
Primary Medical Provider (PMP). Primary Medical Provider (PMP).
Member Name: Member Name:
Member ID (MID): Member ID (MID):
FPO
RxBIN - 003858 RxBIN - 003858
FPO
Member Services: Member Services: RxPCN - MA
RxPCN - MA
1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01 1-844-607-2829 (TTY 1-800-743-3333 or 711) RxGRP - RXINN01
Member Services Hours: Member Services Hours:
8 a.m. – 8 p.m. Monday – Friday 8 a.m. – 8 p.m. Monday – Friday
Log on to MyCareSource.com to check for eligibility and Log on to MyCareSource.com to check for eligibility and
Primary Medical Provider (PMP). Primary Medical Provider (PMP).
EMERGENCIES: EMERGENCIES:
FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST
EMERGENCY ROOM (ER) EMERGENCY ROOM (ER)
If your health event is not life-threatening and you are not sure about If your health event is not life-threatening and you are not sure about
going to the ER, call the RNs at CareSource24®, Nurse Advice going to the ER, call the RNs at CareSource24®, Nurse Advice
FPO FPO
Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711). Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711).
BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464 BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464
ESI PHARMACY HELP DESK: 1-800-416-3632 ESI PHARMACY HELP DESK: 1-800-416-3632
PROVIDER SERVICES: 1-844-607-2831 PROVIDER SERVICES: 1-844-607-2831
RR2022-N-MED-M-908313 RR2022-N-MED-M-908313
EMERGENCIES: EMERGENCIES:
FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST FOR EMERGENCIES CALL 911 OR GO TO THE NEAREST
EMERGENCY ROOM (ER) EMERGENCY ROOM (ER)
If your health event is not life-threatening and you are not sure about If your health event is not life-threatening and you are not sure about
going to the ER, call the RNs at CareSource24®, Nurse Advice going to the ER, call the RNs at CareSource24®, Nurse Advice
FPO FPO
Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711). Line for help at 1-844-206-5947 (TTY: 1-800-743-3333 or 711).
BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464 BEHAVIORAL HEALTH CRISIS LINE: 1-833-227-3464
ESI PHARMACY HELP DESK: 1-800-416-3632 ESI PHARMACY HELP DESK: 1-800-416-3632
PROVIDER SERVICES: 1-844-607-2831 PROVIDER SERVICES: 1-844-607-2831
RR2022-N-MED-M-908313 RR2022-N-MED-M-908313WELCOME TO CARESOURCE WHAT’S IN YOUR
NEW MEMBER BOOKLET
Review Your CareSource ID Cards
Each CareSource member in your family will have their own ID card.................................................... 1
Member Welcome Letter
Welcome to CareSource!........................................................................................................................ 8
Contact Us
Member Services is here to help............................................................................................................ 9
Quick Start Steps
What steps to take first as a new CareSource member....................................................................... 10
Make the Most of Your Plan
Get the care you need quickly and easily ................................................................................................ 13
Transportation
Get a ride to a doctor, a pharmacy and other places at no cost if you don’t have transportation ...... 15
Choosing or Changing Your Primary Medical Provider (PMP) or Primary Dental Provider
(PDP)/Dental Home
Choose the physician and dental provider you want to see most often.............................................. 17
Where to Go for Care
You have options if you aren’t sure where to go to get care ................................................................ 18
Incentives and Rewards
CareSource rewards you and your family for getting and staying healthy........................................... 19 6Make Sure Your Medical Services Are Covered by CareSource
Understand prior authorization requirements....................................................................................... 20
Early and Periodic Screening, Diagnostic and Treatment (EPSDT)/HealthWatch®
Understand the special services and rewards for babies and children ................................................. 22
CareSource Life Services®
CareSource can help you find a good job, community support and education or training .................. 24
CareSource JobConnect™
Get help finding a rewarding career ......................................................................................................... 24
MyResources
Use our search tool to help you find food, shelter and more............................................................... 25
myStrength SM
Use our online tool to take charge of your mental health ....................................................................... 25
Renewing Your Benefits
Renew your Medicaid benefits each year................................................................................................ 26
Benefits At-a-Glance
A guide that lists the benefits you have as a CareSource member........................................................ 27
Request Member Handbook and Provider Directory
Tear out the request cards to get a printed copy of your member handbook or provider directory.... 31
Notice of Privacy Practices
Understand your privacy rights related to your health information ................................................... insert
Member Consent/HIPAA Authorization Form
7 Consent to share your health information with your health care providers and/or someone else .. insertMember Welcome Letter!
We are glad to have you as a member! We are excited to serve you and other Hoosier Healthwise (HHW)
members. At CareSource, our mission is to make a lasting difference in our members’ lives by improving
their health and well-being. We know life is busy. We are here to make things easier to start your health
journey with us. We believe you deserve more than high quality health care. You deserve health care
with heart. You are now a member of a health care plan, also known as a managed care entity (MCE).
CareSource provides health care services to Indiana residents who are eligible, including children up to
age 19 and some pregnant women.
The HHW program covers children up to age 19 and some pregnant women. There is little or no cost for
members. The plan covers:
• Doctor visits • Prescription medicine • Immunizations and vaccinations
• Mental health care • Dental care • Hospitalizations
• Surgeries • Family planning
CareSource is here to help you. Let us know if you have questions or concerns about your health care.
Please call Member Services toll free at 1-844-607-2829 (TTY: 1-800-743-3333 or 711). We are open
Monday through Friday from 8 a.m. to 8 p.m. Eastern Time.
8Contact Us
HAVE QUESTIONS?
Call Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711) Monday through Friday from
8 a.m. to 8 p.m. Eastern Time. We are ready to help you:
• Get a new ID card • Arrange transportation
• Choose or change your Primary Medical • Get a printed copy of your member handbook
Provider (PMP) or provider directory
• Make appointments with your health • Answer any questions you may have
care providers
Problems Reading or Understanding This Information?
Call Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or
711). We can explain this information in English or in another language.
If you have problems seeing or hearing, we can provide special help
like large print, braille or audio. This is all at no cost to you.
9Quick Start Steps
WHAT SHOULD YOU DO FIRST?
1. Review your ID Card(s) and the ID Cards of your family members. Included in this
booklet is your member ID card. You will show this card anytime you visit a health
care provider.
2. Set up a My CareSource® account. You can use your this account to change
your PMP, ask for a new ID card, view claims and plan details, update your contact
information and choose how you would like to hear from us. It’s easy to do:
• Go to My.CareSource.com • Click Register
• Click Sign Up at the bottom of • Download the CareSource app to
the page access on your mobile phone
• Answer the questions
3. Make sure the health care providers you plan to use are in the CareSource
network. Visit findadoctor.CareSource.com to view the most up-to-date list of
health care providers in the CareSource network. You can also use the Find a Doctor
tool on the CareSource mobile app. Health care providers in the CareSource network
are those who accept your CareSource insurance plan. In most cases, CareSource
does not pay for charges from health care providers that are not part of our network.
Do you have health services scheduled? If you had appointments scheduled before
joining CareSource, tell us right away. We may be able to help you keep your out-of-
network services until you get an in-network health care provider.
104. Make sure your prescriptions are on the CareSource drug list. You can
use the Find My Prescriptions search tool to see what drugs and medical
supplies are covered. You may need prior approval for prescription drug coverage.
We will let you know if you need prior approval for your prescriptions. Just go to
CareSource.com/Indiana, select your plan, click Tools and Resources, and then
click Find My Prescriptions.
5. Would you like a paper copy of the member handbook and/or provider directory?
If you would like printed copies of either document, follow the steps on the enclosed
request postcards. Mail the request postcards for the item or items you would like
to receive. There is no postage necessary. We will mail the materials you ask for
to you. You can also call Member Services and ask for copies at 1-844-607-2829
(TTY: 1-800-743-3333 or 711). We are open Monday through Friday from 8 a.m. to
8 p.m. Eastern Time.
6. Review your member handbook at www.CareSource.com/in/plans/medicaid/
plan-documents/. It has information on:
• Your benefits (including limitations)
• Plan descriptions (and how to keep your benefits)
• Important phone numbers and webpages
• Pharmacy tools like Find My Prescriptions
• Care and services available
• How to get care
• Full list of rewards and incentives
• Care (and disease) management information
11• Additional CareSource programs
• And much more!
7. Earn rewards*† by filling out your Health Needs Screening (HNS). The HNS is a
questionnaire. It asks about your health history and helps us identify health issues
or concerns. CareSource wants you to stay healthy. Using a few questions about
your health and lifestyle, CareSource can help your health care providers coordinate
your care. You can earn a $30 Walmart® gift card when you take the HNS. It only
takes a few minutes.
You can take the HNS in one of these ways:
• Online: Just log into your secure My.CareSource.com account and click on
the Health tab.
• Phone: 1-833-230-2011 (TTY: 711) Monday through Friday from 7 a.m. to
6 p.m. Eastern Time
• At a health kiosk: In your local Walmart pharmacy
• By paper copy: Mailed separately
*You must complete the HNS within your first 90 days with CareSource to get the reward.
†Rewards are subject to change.
HAVE OTHER QUESTIONS?
We look forward to helping you achieve your health and wellness goals.
If you have questions, please call Member Services at 1-844-607-2829
(TTY: 1-800-743-3333 or 711) Monday through Friday from 8 a.m. to
8 p.m. Eastern Time.
12Make the Most of Your Plan
Visit CareSource.com to: Need medical advice?
• Learn about covered services and how to get them. Call CareSource24®, our Nurse Advice Line at
• See the list of covered prescription drugs. 1-844-206-5947 (TTY: 1-800-743-3333 or 711) and speak
to a registered nurse to:
• Use the Find a Doctor tool at
findadoctor.CareSource.com to find an in-network • Get help with how to care for an illness or injury.
health care provider. • Find out about prescriptions or over-the-counter (OTC)
• Learn about your membership rights and medications.
responsibilities. • Decide whether you need self-care, a doctor visit or
• Learn how you can earn rewards. the Emergency Room (ER).
• See an online copy of the member handbook. • Know more about a medical issue, recent doctor’s visit
or a test.
Use the Free CareSource Mobile App to:
• Learn about healthy eating or staying well.
• View and share your digital ID card.
• Know more about a dental issue or concern, and after
• Access your secure My.CareSource.com account.
hour care options.
• Find a doctor, hospital, clinic or urgent care near you.
• View your claims.
• Call and speak with Member Services with a touch.
13Addiction Help • Feeling depressed
Call our Behavioral Health Crisis line at 1-833-227-3464 • Feeling like there is no reason for living
and speak to a licensed mental health professional. • Using or abusing drugs or alcohol
Or call the Addiction Hotline at 1-833-674-6437
• Having dramatic mood changes
(TTY: 1-800-743-3333 or 711).
Are you ready to quit using tobacco?
To learn about addiction or what to expect when calling, visit
www.CareSource.com/members/education/behavioral- CareSource is here to help! Using tobacco in any form can
health/addiction-help/. harm your health. It can even cause diseases that can lead
to death. CareSource helps members stop using tobacco
Knowing you need help takes courage and strength. Please and offers rewards for participating in Quit Now Indiana.
do not do it alone. Treatment is more than focusing on your Just call 1-800-784-8669.
habit. It is your day-to-day challenges. These can be things
like medical needs and mental and social challenges. It can
also be family history.
You can call 24 hours a day, 7 days a week. We are here
to help you when you are going through a mental health
or substance use crisis. We want to make sure you get the
right services as soon as possible.
Give us a call if you are: Through Quit Now Indiana, you will have access to a free
and confidential Quit Coach, online tools and resources, and
• Feeling hopeless
your own quit guide.
• Feeling overwhelmed
• Feeling anxious
• Feeling alone
14Transportation
NEED A RIDE?
HHW Package A Plans include ride benefits and an option for mileage reimbursement. Trips include:
• Unlimited rides to any covered doctor visit or health care visit.
• Unlimited rides to the pharmacy after your visit with the doctor and 5 trips to the pharmacy per
month when without a doctor visit.
• Unlimited rides to the local Women, Infants and Children (WIC) office.
• Unlimited rides to service redetermination appointments with the State.
• Unlimited rides to CareSource events.
• Rides to pick up food from a food pantry or curb-side food pick up from a grocery store.
• Rides to and from a Neonatal Intensive Care Unit (NICU).
HHW Package C members can get an ambulance transport between medical settings. A doctor needs
to ask for this service. It also has a $10 copay.
How do I Set up a Ride?
Please call Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711) to set up a ride. Please
call at least two business days before your visit. When you call, tell the person helping you:
• Your pick-up address - Oxygen
• Your appointment address and name - Wheelchair
• Any special needs you have, such as: - Wheelchair size and weight
- Help getting into or out of the vehicle
15No-Shows
If you are not ready when your driver comes, they
can only wait 10 minutes. You will be deemed a
no-show after 10 minutes.
When Should I Set up my Ride?
You can ask for a ride up to 30 days before a
medical visit. Call Member Services to arrange
a ride at least two business days before your
appointment.
How do I Cancel a Ride?
Please let us know if you cannot keep your
appointment or if it changes. Call Member
Services to cancel as soon as possible if you
cannot keep your appointment.
Can a Friend or Family Member Get Paid to
Take Me?
We reimburse friends and family when
they take you to non-emergency medical
appointments. They need to fill out and send in
a gas reimbursement form. Find the form and
application process at
www.in.gov/medicaid/members/540.htm.
16Choosing Or Changing Your Primary
Medical Provider (PMP) or Primary Dental
Provider (PDP)/Dental Home
Choose your PMP/PDP as soon as possible. It find a health care provider to meet your needs.
will speed up making appointments when you or The CareSource mobile app can make it even
your family members are sick and need to see easier for you to choose your PMP/PDP. It is
them. It helps you and your family get care from a free! You can download it for both iPhone® and
PMP/PDP who knows you and sees you and your Android® phones through the Apple App Store® or
family regularly. It also ensures that you have a through Google Play®.
PMP/PDP you trust who can direct your care with
specialists or other medical professionals. My CareSource® will allow you to create your
personal online account.
If you do not choose a PMP/PDP, CareSource will Visit My.CareSource.com to:
choose one for you. We will choose a PMP/PDP • Register/login to change your health care
for you based on where you live and if the PMP/ provider
PDP is taking new patients.
• Ask for a new ID card
Change or choose a new PMP/PDP by logging
• See claims and plan detail
into your My.CareSource.com account and
choosing one from the health care providers in • Update your contact information
the CareSource network. Remember, once you have a My CareSource
What if I can’t find a health care provider? account you can also get a free digital picture of
Call Member Services at 1-844-607-2829 (TTY: your ID card.
1-800-743-3333 or 711). We are here to help you
17Where to Go for Care
You can call our CareSource24 Nurse Advice Line 24 hours a day 365 days a year. Talk to a nurse for advice on how to treat
your symptoms, illness, or injury. Our nurses can let you know where to get care when your doctor’s office is closed. This
could be telehealth, a clinic, a doctor’s visit or the ER. The CareSource24 telephone number is 1-844-206-5947. It is also on
the back of your ID card.
Call the Behavioral Health Crisis line at 1-833-227-3464 and speak to a licensed behavioral health (mental health)
professional. You can call 24 hours a day, 7 days a week. We are here to help you when you are going through a mental
health or substance use crisis. We want to make sure you get the right services as soon as possible.
Telehealth is a great choice for things that might get worse without quick attention. Talk with your provider about
telehealth options.
Walk-in convenience clinics are great for quick care. Their doctors can see you when your PMP office is closed. They
can also help when your PMP can’t see you soon enough. You can often find these clinics in your local pharmacy or
grocery store. They are usually open evenings and weekends. You do not need an appointment.
Urgent care clinics are for injuries or illnesses and non-traumatic dental concerns. You can get shots or x-rays if needed.
They can handle many of the reasons people go to an ER. These are things like help with minor broken bones and wound
care. Urgent care clinics are normally open evenings and weekends.
Emergency Rooms are for true emergencies like heart attacks, strokes, trouble breathing and serious injuries.
The CareSource mobile app can help you find the nearest in-network health care provider. You can download the CareSource
mobile app from the Apple or Android app stores.
You can get quick care when you need it if you choose the best place for it.
18Incentives and Rewards* MAKE LIFE MORE REWARDING
One of your benefits is our rewards programs. Go to CareSource.com/in/plans/medicaid/benefits-services/rewards/ for
a complete list of rewards and to register. You can also register by calling Member Services.
BABIES FIRST® REWARDS
Going to the doctor is healthy for you and your baby. The Babies First program helps you earn up to $200
in rewards. Earn rewards for seeing your doctor while pregnant. Earn them also when you complete visits
with your baby after they are born. You must register for Babies First to earn the rewards.
KIDS FIRST REWARDS
CareSource wants to make sure kids have what they need to be healthy. The Kids First program helps your
child earn rewards. You earn rewards by going to yearly checkups, dental visits, flu shots and more. Kids
aged 16 months through 17 years can earn rewards up to $50 in the program. You must register each of
your children in Kids First to earn rewards.
MYHEALTH REWARDS
We automatically enroll adults 18 and over in the MyHealth rewards program. You may be earning rewards
right now! You can earn up to $300 in rewards for getting:
• Regular physical exams • Dental exams • Other preventive screenings
You also earn rewards for taking part in smoking cessation and other wellness programs. You can redeem
rewards at a variety of retailers.
PLEASE NOTE: If you are no longer a CareSource member, the Rewards Portal will be deactivated and any unused rewards
may be no longer available.
*Rewards subject to change. Rewards for Babies First, Kids First and MyHealth may vary by age, gender and health needs.
Log in to your My.CareSource.com account to sign up for the reward programs. Learn more about the benefits CareSource
offers. Call Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711) or visit CareSource.com.
19Make Sure Your Medical Services are
Covered by CareSource
WHAT IS PRIOR AUTHORIZATION?
Prior authorization is permission you need for your health care provider to provide a service. Some
services will not be paid for by CareSource if your health care provider does not ask for a prior
authorization first. CareSource will decide prior authorization requests based on medical necessity,
medical appropriateness and your benefit limit.
Prior authorization requirements for our covered services can be found online in the member
handbook at www.CareSource.com/in/plans/medicaid/plan-documents/. You may also ask for a
paper copy by calling Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711).
Examples of preventive care that DO NOT need a prior authorization:
• Annual physical exam
• Early Periodic Screening, Diagnostic and Treatment (EPSDT) for ages up to 21
• Dental and eye exams
• Breast, cervical or colon cancer screenings (dependent upon age)
• Cholesterol and diabetes (A1c) screenings
• Vaccines
20Examples of benefits that MAY need a prior authorization:
• Certain prescription medications
• Dental care (in hospitals and ambulatory surgery centers)
• Inpatient hospital care
• Some medical supplies and equipment
• Inpatient services (mental health and addiction
services)
• Rehabilitation services
The examples above are not complete lists of covered services for prior authorization.
CareSource should give you permission with a prior authorization before you get a medical
service. CareSource will not pay claims for services in which you needed a prior authorization but did
not get one through your medical provider first.
REMINDER: It is important for you or your health care provider to contact CareSource to make
sure that any prescription or services you have already scheduled will be covered by CareSource.
CareSource can also help you choose different options if your prescription or service is not covered.
Your PMP or specialist has tools to help them ask for a prior authorization. They can also check
online or through a written request to see if we approved your prior authorization. CareSource has
Provider Services representatives ready to help your health care provider’s office through this process.
Do emergency services need a prior authorization? No. Emergency services do not need this. An
emergency is a medical condition that may cause serious harm to a person’s health.
21EPSDT/HealthWatch®
EPSDT stands for: Babies and children need to have regular doctor visits and well-
child exams. Be sure to ask for an EPSDT exam when calling
E = EARLY your doctor.
so problems are treated soon
Members under the age of 21 can get care management services
P = PERIODIC as part of HealthWatch. The program is for those who have special
to set up regular visits health care needs or any member who wants more support.
Getting screenings and shots can help your child/teen stay
S = SCREENING
well. Use the chart below to know when to make appointments.
to check for a health problem
What’s Who’s When to Have Cost
D = DIAGNOSTIC Covered? Covered? First Exam
to find a health problem
Visits to the HHW under 21 Within the first $0
T = TREATMENT doctor and any members that 90 days of being
to care for a problem shots and lead meet eligibility a CareSource
testing needed requirements. member, if needed.
at that time.
22When to have a well-child or EPSDT/HealthWatch Exam
Baby Children/Teen/Young Adults
At birth 12 months old
3-5 days old 15 months
By 1 month old 18 months
2 months old 24 months
4 months old 30 months
6 months old Each year from age 3 to 21
9 months old
Your child can earn rewards for completing some
EPSDT activities!
Learn more at CareSource.com/in/plans/medicaid/benefits-services/
additional-services/rewards/. Enroll in our Babies First or Kids
First programs.
23CareSource Life Services®
Good health requires more than just quality health care. Having a good job, community support, and
access to education or training impacts your overall health and well-being. That’s why CareSource
Life Services is here for you. We can help remove barriers that stand in the way of reaching your goals.
CareSource Life Services can help pave the way from where you are to where you want to be. You
can be part of CareSource Life Services if you are a CareSource member or parent or guardian of a
CareSource member and at least 14 years old. We can link you to services and support for:
• Transportation • Housing
• Access to food • Childcare
• Budgeting and financial assistance • Employment opportunities
• Legal assistance (CareSource JobConnect™)
CareSource JobConnect
CareSource JobConnect helps you get new skills, links you with local services, and helps you find
a job. We will pair you with a Life Coach who can help set you up for success. Life Coaches provide
one-on-one coaching for up to 24 months. CareSource JobConnect partners with employers to
help you in your job search. There is no cost to you for this service. Please fill out our online form at
https://secureforms.CareSource.com/en/LSRInfo/IN to learn more. You can also call us at
1-844-607-2832 or email LifeServicesIndiana@CareSource.com.
24MyResources
Sometimes you just need a little extra help. We have a search tool
called MyResources that helps you find free or low-cost programs and
support for:
• Food • Work
• Shelter • Financial support
• School • And more!
We have programs across the U.S. from small towns to large cities. Log
in to your My.CareSource.com account to access the tool. You can also
call Member Services to find support near you.
myStrength
SM
Take charge of your mental health. Try our online wellness tool called
myStrength. This online learning platform has:
• Self-help tools • Inspirational reading
• Wellness help
This is a safe tool designed to help with your mind, body and spirit.
Go to bh.mystrength.com/caresource to sign up, create a profile,
and learn more. You can also find myStrength on our member portal at
My.CareSource.com. Or download the free app on your mobile device.
You can get the myStrength app for Apple and Android devices at
mystrength.com/mobile. Sign in using your login email and password.
25Renewing Your Benefits
When it’s time to renew your benefits, you will get a renewal form from the state. The form will tell
you what action is required. If you are unsure, visit the Indiana Family & Social Services Benefits
Administration Portal at: www.fssabenefits.in.gov or call 1-800-403-0864 and select option 1.
You can renew your benefits:
• By Mail. Fill out the renewal form.
• In Person. Visit your local Division of Family Resources (DFR). Find the office nearest you at
www.in.gov/fssa/dfr/ebt-hoosier-works-card/find-my-local-dfr-office/.
Please note that CareSource cannot renew your benefits. You must do it through Indiana’s DFR by one
of the ways listed above. Have questions? Call DFR at 1-800-403-0864.
Remember, we will give you a ride to your redetermination appointment.
We provide trips to any non-emergency health care, WIC or redetermination visits.
You can also schedule a ride to CareSource events. Please call 1-844-607-2829
(TTY: 1-800-743-3333 or 711) to arrange a ride at least two business days before
your appointment.
Be sure to be at your pick-up location on time. If you have to cancel, please call at
least two hours before the pick-up time.
If you have questions, call Member Services at 1-844-607-2829 (TTY: 1-800-743-3333 or 711). We are
open Monday through Friday from 8 a.m. to 8 p.m. Eastern Time.
26Health Care Visits
• Chiropractor†
• Community Mental Health Center (CMHC)
• Convenience Care Clinics inside of stores like CVS®,
Kroger® and Walmart®
• Emergency Room (ER)
• Federally Qualified Health Center (FQHC) and Rural
Health Clinic (RHC)
• Free-Standing Birth Centers
• Hospital (Inpatient* and Outpatient)
• Primary Medical Providers (PMPs) like doctors, OB/
GYNs, Physician Assistants and Nurse Practitioners
Benefits At-a-Glance • Specialists (e.g., Podiatrist, Neurologist and Oncologist)
At CareSource, we care about you. We know that there is • Telehealth (contact your PMP for more information)
more to health and well-being than just great health care. • Urgent Care
That’s why CareSource offers benefits and services that go
Preventive and Early Detection Care/Screenings
beyond basic care. This guide lists the benefits you have as
a CareSource member. Use it to put your benefits to work • Annual Well Visit
for you! • Autism Spectrum Disorder Screening
Please refer to your member handbook online at • Blood Pressure Screening
CareSource.com or call Member Services to learn more • Bone Mass Measurements
about how to use your benefits. We’re here to help. • Cholesterol Screening
• Colorectal Cancer Screening†
• Diabetes Tests
27• Disease Tests and Treatments, • Health Education Heart
e.g., Hepatitis, human • Hearing Tests • Abdominal Aortic Aneurysm Tests
immunodeficiency virus (HIV) and
• Immunizations (Shots) • Cardiac Rehabilitation Services*
sexually transmitted infection/
sexually transmitted disease • Lab Tests • Heart Disease Risk Reduction
(STI/STD) • Lead Screenings (blood test) Visit* (Therapy for Heart
• Immunizations (Shots) • Nutritional Assessment Disease)†
• Lung Cancer Screening • Vision Exams • Heart Disease Testing
• Breast Cancer Screening Health Condition Management • Electrocardiogram (ECG/EKG)
(Mammogram) Behavioral Health
• Chemotherapy and Radiation
• Nutritional Assessment • Diabetes Screening • All Inpatient Services*
• Obesity/body mass index (BMI) • Diabetes Self-Management • Partial Hospitalization Program
Screening and Dietary Counseling Training (PHP) Services*
• Cervical and Vaginal Cancer Test • Diabetic Services and Supplies • Psychiatric Diagnostic Evaluation*
(Pap smear) • Psychological Testing
• Dialysis
• Physical Exams • Intensive Outpatient Program/
• Kidney Disease Services and
• Prostate Cancer Screening Supplies* Treatment (IOP/IOT) Services*
HealthWatch®/EPSDT Program (Early • Pulmonary Rehabilitation • Transcranial Magnetic
and Periodic Screening, Diagnostic Services* Stimulation (TMS)*
and Treatment) (Under age 21) • Individual Psychotherapy*
Diagnostics
• Comprehensive Health and • Family Psychotherapy*
Developmental Exam • Blood Work/Lab Testing*
• Group Psychotherapy*
• Dental Screening • Scans (e.g., CT, MRI and PET)*
• Substance Use Disorder (SUD)
• Developmental/Behavioral Test • X-Rays Residential*
28• Electroconvulsive Therapy (ECT)* Family Planning and • Physical, Occupational and
• Medication Assisted Treatment Maternity Services Speech Therapy*
(MAT) • Birth Control Vision/Eye Care†
• Pharmacological Management • Breast Pumps • Contacts*
• Opioid Treatment Program (OTP) • Family Planning Exams • Glasses
Services* • Nurse Midwife Services • Eye Exams
Pharmacy and Medications† • Parent Education Dental†
• Brand and Generic Drugs • Prenatal and Postnatal Doctor • Exams and Cleanings
• Mail Order Drugs and Home Visits • X-Rays
• Over-the-Counter (OTC) Items • Sexually Transmitted Disease/ • Dentures/Partials*†
(Prescription from your doctor Sexually Transmitted Infection
is required) (STD/STI) Screenings and • Fluoride Treatments (For ages
Treatment 0-20)
Medical Supplies
• Sterilization Surgery (Male and • Orthodontics† (Covers medically
• Cochlear Implants necessary orthodontic care only,
Female)*
• Diabetic Supplies ages 0-20.)
• Well-Baby Check-Ups
• Durable Medical Equipment • Surgeries and Procedures (e.g.,
(DME) and Related Supplies* Home Health Care* Extractions and Restorations)
(e.g., Oxygen Tank, Wheelchair/ • Durable Medical Equipment (DME Transportation Services
Walker, Wound Care and CPAP – see Medical Supplies)
Machine) • Emergency (Ambulance, Air
• Home Infusion Therapy Flights*)
• Incontinence Supplies • Home Nursing Services • Non-Emergency (Scheduled Ride,
• Nutritional Supplies (e.g., Skilled Nursing, Private Bus Passes, Wheelchair Access)†
• Prosthetic Devices and Related Duty, Certified Nurse Aid and
Social Worker) • Transportation to and from
Supplies Neonatal Intensive Care Unit (NICU)
29Other Care Additional Programs, Services ҂ Available only for certain HHW plans.
• Anesthesia and Rewards † Available only for certain HHW plans.
• Adaptive Behavior Treatment* • Babies First (Rewards Program) Prior authorization may be required.
• Allergy Testing and Treatment • Kids First (Rewards Program) * Prior authorization may be required as
• Lung Cancer Screening† • Text4Baby (Pregnancy Education medically necessary for services that are
• Counseling/Interventions to Texts) not routine. This means that CareSource
Quit Smoking/Using Tobacco • Care Management must approve the service before you
(Smoking Cessation) • CareSource24 – 24-Hour Nurse receive it. Your PMP will request the
Advice Line approval from CareSource. We do this
• Hearing (Audiology) (e.g., Exams,
Hearing Aids* and Cochlear to make sure it is best for you and it
• Behavioral Health Crisis Line
Implant Therapy) is covered.
• CareSource Mobile App
• Hospice (Facility and Home) • Disease Management
• Inhalation Therapy • Fifth Third Express Banking®
• Medical Nutrition Therapy • Health and Wellness Education
• Nutritional Counseling Programs
• Occupational Therapy • CareSource JobConnect
• Pain Management* • Medication Therapy Management
• Physical Therapy • MyHealth Online Tool
• Podiatry (Foot) Services • myStrength Online Mental Health
• Speech Therapy Tool
• Surgeries (e.g., General, Bariatric, • be me HEALTH (ages 13 up to 19)
Reconstructive and Transplant) • Rewards for Wellness
• TMJ treatment (Jaw pain or
problems with jaw movement)
30Request a Member Handbook or
Provider Directory
You’ve got options! It’s easy!
1. Online: For the member handbook, visit
www.CareSource.com/in/plans/medicaid/plan-documents/
and click on the member handbook link. For the provider
directory, visit findadoctor.CareSource.com.
2. Phone: Call Member Services at 1-844-607-2829
(TTY: 1-800-743-3333 or 711) Monday through Friday from
8 a.m. to 8 p.m. Eastern Time. We are happy to answer your
questions or send you materials.
3. Scan the code below to see the member handbook:
FPO
4. Print: Tear off the card(s) and drop in the mail. You do not
need to address or add postage. We will mail you a member
handbook or a provider directory.
31PLEASE TEAR OFF THIS CARD AND DROP IN THE MAIL
FOR A PRINTED MEMBER HANDBOOK.
Thank you for your request.
FOR CARESOURCE
USE ONLYNO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES
BUSINESS REPLY MAIL
FIRST-CLASS MAIL PERMIT NO.91 PLANO TX
POSTAGE WILL BE PAID BY ADDRESSEE
CARE SOURCE
PO BOX 940569
PLANO TX 75094-9818PLEASE TEAR OFF THIS CARD AND DROP IN THE MAIL
FOR A PRINTED PROVIDER DIRECTORY.
Thank you for your request.
FOR CARESOURCE
USE ONLYNO POSTAGE
NECESSARY
IF MAILED
IN THE
UNITED STATES
BUSINESS REPLY MAIL
FIRST-CLASS MAIL PERMIT NO.91 PLANO TX
POSTAGE WILL BE PAID BY ADDRESSEE
CARE SOURCE
PO BOX 940569
PLANO TX 75094-9818If you, or someone you’re helping, have questions about CareSource, you have the right to get help and information in your
language at no cost. Please call the member services number on your member ID card.
ARABIC DUTCH
أية استفسارات بخصوص، أو لدى أي شخص تساعده،إذا كان لديك Als u, of iemand die u helpt, vragen heeft over CareSource,
فيحق لك الحصول على مساعدة ومعلومات مجانًا وباللغة،CareSource hebt u het recht om kosteloos hulp en informatie te
ُرجى االتصال على، للتحدث إلى أحد المترجمين الفوريين.التي تتحدث بها ontvangen in uw taal. Als u wilt spreken met een tolk. Bel
.رقم خدمة األعضاء الموجود على بطاقة تعريف العضو الخاصة بك naar het nummer voor ledendiensten op uw lidkaart
AMHARIC FRENCH (CANADA)
እርስዎ፣ ወይም እርስዎ የሚያግዙት ግለሰብ፣ ስለ CareSource ጥያቄ ካላችሁ፣ ያለ Des questions au sujet de CareSource? Vous ou la personne
ምንም ክፍያ በቋንቋዎ እርዳታና መረጃ የማግኘት መብት አላችሁ። ከአስተርጓሚ ጋር que vous aidez avez le droit d’obtenir gratuitement du
እባክዎን በመታወቂያ ካርዱ ላይ ባለው የአገልግሎቶች ቁጥር ይደውሉ፡፡ soutien et de l’information dans votre langue. Pour parler à
un interprète. Veuillez communiquer avec les services aux
BURMESE membres au numéro indiqué sur votre carte de membre.
CareSource အေၾကာင္း သင္ သို႔မဟုတ္ သင္အကူအညီေပးေနသူ တစ္
စံုတစ္ေယာက္က ေမးျမန္းလာပါက သင္ေျပာဆိုေသာ ဘာသာစကားျဖင့္ GERMAN
Wenn Sie, oder jemand dem Sie helfen, eine Frage zu
အကူအညီႏွင့္ အခ်က္အလက္မ်ားအား အခမဲ့ ရယူႏိင္ရန္ အခြင့္အေရး႐ွိ CareSource haben, haben Sie das Recht, kostenfrei in Ihrer
ပါသည္။ ဘာသာျပန္တစ္ဦးအား ေၾခ်းဇ်ကဳ ပဳၿပ် သျက္၏ အသျက္် ျက္ၾ eigenen Sprache Hilfe und Information zu bekommen. Um
ကက္ေဳေပၚရွိ အသျက္် ျက္ ဝက္ေ ငျက္င္မႈဝက္်ဝ္ဳနံက္သွိႈသို႔ ောေ ွိႈဳနါ။ mit einem Dolmetscher zu sprechen, Bitte rufen Sie die
Mitglieder-Servicenummer auf Ihrer Mitglieder-ID-Karte an
CHINESE
如果您或者您在帮助的人对 CareSource 存有疑问，您有权免 GUJARATI જો તમે અથવા તમે કોઇને મદદ કરી રહાાં ્ તેમ ાંથી કોઇને
费获得以您的语言提供的帮助和信息。 如果您需要与一位翻译 CareSource વવશે પ્રશ્નો હોર્ તો તમને મદદ અને મ હહતી મેવિવ નો અવવક ર
交谈，请拨打您的会员 ID 卡上的会员服务电话号码。 છે . તે ખર્્ય વવન તમ રી ભ ષ મ ાં પ્ર પ્ત કરી શક ર્ છ.ે દ ભ વષર્ો વ ત કરર મ ટે,કૃપા
કરીને તમારા સભ્ર્ આઈડી કાડ્ય પર સભ્ર્ સેવા માટે ના નંબર પર ફોન કરો.
CUSHITE – OROMO
Isin yookan namni biraa isin deeggartan CareSource irratti HINDI
gaaffii yo qabaattan, kaffaltii irraa bilisa haala ta’een afaan यदि आपक,े या आप जिसकी मिि कर रहे हैं उसके CareSource के बारे में
keessaniin odeeffannoo argachuu fi deeggarsa argachuuf कोई सवाल हैं तो आपके पास बगैर दकसी लागत के अपनी भाषा में सहायता
mirga ni qabdu. Nama isiniif ibsu argachuuf, Maaloo और िानकारी प्ाप्त करने का अजिकार ह।ै एक िभाजषए
ु से बात करने के
lakkoofsa bilbilaa isa waraqaa eenyummaa keessan irra जलए कॉल कर,ें कृ पया अपने सिस्य आईडी काड्ड पर दिये सिस्य सेवा नंबर
jiruun tajaajila miseensaatiif bilbilaa. पर कॉल कर।ें
36ITALIAN языке. Для разговора с переводчиком. Пожалуйста,
Se Lei, o qualcuno che Lei sta aiutando, ha domande su позвоните по телефону отдела обслуживания клиентов,
CareSource, ha il diritto di avere supporto e informazioni указанному на вашей идентификационной карточке
nella propria lingua senza alcun costo. Per parlare con un клиента.
interprete. Chiamare il numero dei servizi ai soci riportato
sulla tessera di iscrizione. SPANISH
Si usted o alguien a quien ayuda tienen preguntas sobre
JAPANESE CareSource, tiene derecho a recibir esta información y ayuda
ご本人様、または身の回りの方で、CareSource に関するご en su propio idioma sin costo. Para hablar con un intérprete.
質問がございましたら、ご希望の言語でサポートを受けた Por favor, llame al número de Servicios para Afiliados que
り、情報を入手したりすることができます（無償）。 通訳を figura en su tarjeta de identificación.
ご利用の場合は、お持ちの会員IDカードにある、会員サービ
スの電話番号までお問い合わせ下さい。 UKRAINIAN
Якщо у вас, чи в особи, котрій ви допомагаєте, виникнуть
KOREAN запитання щодо CareSource, ви маєте право безкоштовно
귀하 본인이나 귀하께서 돕고 계신 분이 CareSource에 대해 отримати допомогу та інформацію вашою мовою. Щоб
궁금한 점이 있으시면, 원하는 언어로 별도 비용 없이 도움을 замовити перекладача, Зателефонуйте за номером
받으실 수 있습니다. 통역사가 필요하시면 다음 번호로 обслуговування учасників, який вказано на вашому
전화해 귀하의 회원 ID 카드에 적힌 회원 서비스 팀 번호로 посвідченні учасника
전화하십시오.
VIETNAMESE
PENNSYLVANIA DUTCH Nếu bạn hoặc ai đó bạn đang giúp đỡ, có thắc mắc về
Wann du hoscht en Froog, odder ebber, wu du helfscht, hot CareSource, bạn có quyền được nhận trợ giúp và thông tin
en Froog baut CareSource, hoscht du es Recht fer Hilf un bằng ngôn ngữ của mình miễn phí. Để nói chuyện với một
Information in deinre eegne Schprooch griege, un die Hilf thông dịch viên. Vui lòng gọi số dịch vụ thành viên trên thẻ ID
koschtet nix. Wann du mit me Interpreter schwetze witt, Bel thành viên của bạn.
alstublieft met het Ledenservice nummer op uw lid ID -kaart.
RUSSIAN
Если у Вас или у кого-то, кому Вы помогаете, есть
вопросы относительно CareSource, Вы имеете право
бесплатно получить помощь и информацию на Вашем
37Notice of Non-Discrimination
CareSource complies with applicable state and federal civil CareSource
rights laws and does not discriminate on the basis of age, Attn: Civil Rights Coordinator
gender, gender identity, color, race, disability, national origin, P.O. Box 1947, Dayton, Ohio 45401
marital status, sexual preference, religious affiliation, health 1-844-539-1732, TTY: 711
status, or public assistance status. CareSource does not Fax: 1-844-417-6254
exclude people or treat them differently because of age, CivilRightsCoordinator@CareSource.com
gender, gender identity, color, race, disability, national origin,
marital status, sexual preference, religious affiliation, health You can file a grievance by mail, fax, or email. If you need help
status, or public assistance status. filing a grievance, the Civil Rights Coordinator is available to
help you.
CareSource provides free aids and services to people with
disabilities to communicate effectively with us, such as: (1) You may also file a civil rights complaint with the U.S.
qualified sign language interpreters, and (2) written information Department of Health and Human Services, Office for Civil
in other formats (large print, audio, accessible electronic Rights, electronically through the Office of Civil Rights
formats, other formats). In addition, CareSource provides free Complaint Portal, available at https://ocrportal.hhs.gov/ocr/
language services to people whose primary language is not portal/lobby.jsf, or by mail or phone at:
English, such as: (1) qualified interpreters, and (2) information U.S. Department of Health and Human Services
written in other languages. If you need these services, please 200 Independence Avenue, SW Room 509F
call the member services number on your member ID card. HHH Building Washington, D.C. 20201
If you believe that CareSource has failed to provide the above 1-800-368-1019, 800-537-7697 (TDD)
mentioned services to you or discriminated in another way on Complaint forms are available at
the basis of age, gender, gender identity, color, race, disability,
http://www.hhs.gov/ocr/office/file/index.html.
national origin, marital status, sexual preference, religious
affiliation, health status, or public assistance status, you may
file a grievance, with:
38CareSource.com RR2022-IN-MED-M-1346534; FIRST USE: 9/12/2022 | OMPP APPROVED: 9/12/2022 | ©2023 CARESOURCE. ALL RIGHTS RESERVED. JANUARY 2023
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