Member Reimbursement Form Ohio Caresource (2024)

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Member Reimbursement Form Ohio Caresource (1)

Ach all prescription receipt(s) to the back of this form. 3. All receipts must contain all of the following information or they will not be accepted: RX number, date lled, Pharmacy NPI#, drug name with NDC number, strength, quantity, days supply, and amount paid. 4. If you have any questions, please call Member Services: 1-800-708-8729 (TTY/TDD 1-800-750-0750) or 711. 5. The form should be signed by the member and mailed to: CVS Caremark Med D Claims P.O. Box 52066 Phoenix, AZ 85072-2066 Re.

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Buckeye Health Plan Rated Best Medicaid Health Plan for Quality Performance. The Ohio Department of Medicaid (ODM) awarded Buckeye Health Plan the highest quality rating among all Ohio managed care plans with 20 stars across the five categories on its 2018 Managed Care Plans Report Card published today.

Medicaid health care coverage is available for eligible Ohioans with low income, pregnant women, infants and children, older adults and individuals with disabilities. CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

The following individuals may qualify for Medicaid coverage in Ohio: Be a United States citizen or meet Medicaid non-citizen requirements. Individuals with low-income. Pregnant women, infants, and children.

The Ohio Department of Medicaid (ODM) provides health care coverage to more than 3 million Ohioans through a network of more than 165,000 providers.

CareSource® MyCare Ohio is a Medicare-Medicaid plan that delivers extra benefits and the coordinated care needed by both patients and caregivers, giving patients more coverage and caregivers more options.

Providers may file a written claim dispute no later than 12 months from the date of service or 60 calendar days after the payment, denial or partial denial of a timely claim submission, which is later. Submitted complaints should include: The member's name, CareSource member ID number and date of birth.

CareSource Attn: Claims Department P.O. Box 8730 Dayton, OH 45401-8730 Timely Filing: 365 calendar days from the date of service or discharge CareSource encourages providers to submit claims electronically for the most efficient processing.

EDI Clearinghouses Please provide the clearinghouse with the CareSource payer ID number: 38325.

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Member Reimbursement Form Ohio Caresource (2024)

FAQs

What does CareSource not cover in Ohio? ›

Routine dental services, basic dental care, major dental care and orthodontia are not covered for adults age 19 and older under the basic CareSource plans. Accidental dental (treatment for dental emergencies) is covered for all ages. See Enhanced Plan Benefits below.

What is the timely filing limit for CareSource of Ohio? ›

What are the timely filing guidelines for Coordination of Benefits? 365 days from the date of service or 90 days from the primary carrier's Explanation of Benefits date, whichever is greater.

Is Ohio Medicaid the same as CareSource? ›

Medicaid health care coverage is available for eligible Ohioans with low income, pregnant women, infants and children, older adults and individuals with disabilities. CareSource Medicaid is available across the state of Ohio. When you apply for Ohio Medicaid, you can choose CareSource as your managed care plan.

How do you qualify for CareSource in Ohio? ›

To be eligible for coverage, you must:
  1. Be a United States citizen or meet Medicaid citizenship requirements. Your local county Job and Family Services office can help to explain these requirements and can help get you enrolled.
  2. Have or get a Social Security number.
  3. Be an Ohio resident.
  4. Meet financial requirements.

Does Ohio CareSource cover dental? ›

Dental Care

CareSource covers care like exams, cleanings, and fillings at no cost to you. Your dental provider will work with you to make sure you get the care you need. Your dental benefits are provided by Dentaquest.

Which Medicaid plan is best in Ohio? ›

Buckeye Health Plan Rated Best Medicaid Health Plan for Quality Performance. The Ohio Department of Medicaid (ODM) awarded Buckeye Health Plan the highest quality rating among all Ohio managed care plans with 20 stars across the five categories on its 2018 Managed Care Plans Report Card published today.

What are the income limits for CareSource Ohio 2024? ›

Family Size Monthly Income* 1 $1,883 2 $2,555 3 $3,228 4 $3,900 5 $4,573 6 $5,245 7 $5,918 8 $6,590 9 $7,263 10 $7,935 Families with monthly incomes higher than the amount in the first column, but lower than the amount in the second column MUST apply if they do not have private health insurance.

Can you sue CareSource for data breach? ›

A data breach that targeted an Ohio-based insurance company has prompted multiple lawsuits including a class action lawsuit filed by victims who lost sensitive personal information following the data breach.

How much does Ohio Medicaid independent provider pay per hour? ›

As of Aug 26, 2024, the average hourly pay for a Medicaid Waiver Provider in Ohio is $24.29 an hour. While ZipRecruiter is seeing salaries as high as $40.22 and as low as $15.08, the majority of Medicaid Waiver Provider salaries currently range between $16.44 (25th percentile) to $31.06 (75th percentile) in Ohio.

What is the monthly income limit for Medicaid in Ohio? ›

Income & Asset Limits for Eligibility
2024 Ohio Medicaid Long-Term Care Eligibility for Seniors
Type of MedicaidSingle
Institutional / Nursing Home Medicaid$2,829 / month*$2,000
Medicaid Waivers / Home and Community Based Services$2,829 / month†$2,000
Regular Medicaid / Aged Blind and Disabled$943 / month$2,000
1 more row
May 31, 2024

Can I use my Ohio CareSource in another state? ›

Emergency care is covered both in and out of our service area, within the United States. You do not have to contact CareSource for an OK before you get emergency services. If you have an emergency, call 911 or go to the nearest emergency room (ER) or other appropriate setting.

Does Ohio CareSource have OTC benefits? ›

Each quarter, as an Ohio MyCare Medicare-Medicaid member, you have an $100 OTC allowance.

What is the highest income to qualify for Medicaid? ›

Who is eligible for California Medicaid?
Household Size*Maximum Income Level (Per Year)
1$20,030
2$27,186
3$34,341
4$41,496
4 more rows

What assets are exempt from Medicaid in Ohio? ›

Exempt Assets
  • Primary residence (with an equity value of up to $688,000)
  • One automobile.
  • Household goods and personal effects.
  • Prepaid funeral arrangements (with certain restrictions)
  • Life insurance policies with a combined face value of $1,500 or less.
  • Term life insurance with no cash value.

What is the monthly income limit for Medicare in Ohio? ›

Qualified Medicare Beneficiary (QMB) Program
Your situation:Monthly income limit:*Resource limit: What counts in resource limits?
Individual$1,275$9,430
Married couple$1,724$14,130

Medicaid | Ohio – Medicaid | CareSourceCareSourcehttps://www.caresource.com ›

Ohio Medicaid. CareSource is the number one plan of choice for Medicaid in Ohio. There is a reason more Ohioans choose CareSource for their Medicaid plan than a...
Reimbursement Policies. Select a Plan. Select your plan below to view more information! CareSource PASSE (AR); Dual Special Needs(Medicare + Medicaid). Georgia ...
Overpayment Recovery. REIMBURSEMENT POLICY STATEMENTMarketplace Policy Name & Number Date Effective Overpayment Recovery-MP-PY-1393 05/01/2024 Policy Type R...

What does Ohio not cover? ›

Things not covered by OHIP:

vision care, such as glasses, contact lenses, and eye surgery. hearing care. certain drugs administered outside of hospital, such as certain costly cancer drugs. ambulance transportation services that are not deemed medically necessary.

What does Ohio Medicaid cover for adults? ›

Medicaid provides primary and acute care services through a fee-for-service system or managed care plans. Both delivery systems provide all medically necessary primary care, specialty and emergency care and preventive services.

Does CareSource cover chiropractic in Ohio? ›

Discover Comprehensive Chiropractic Care Covered by CareSource Insurance. At Centre Chiropractic, we are pleased to offer chiropractic care services covered by CareSource insurance. Our goal is to provide you with comprehensive and effective chiropractic treatment that supports your overall well-being in Dublin, OH.

Does CareSource cover ambulance rides in Ohio? ›

In addition to this transportation benefit, CareSource members may utilize ambulance/ambulette services with a Certification of Medical Necessity approved by the member's ordering physician.

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