Where To Get Care
You have options when you need to get care. CareSource works with certain doctors and providers to get you care. We call these in-network providers. To have your health care services covered by your CareSource plan, you must go to an in-network provider.
Use our Find A Doctor/Provider tool to see if your provider is in our network. Click on Get Started and fill out location information. Under the Choose Plans page, scroll to your state and filter the results under Medicare by selecting Dual Special Needs from the list.
Here are options for where you can get care.
Primary Care Provider | Usually open during regular business hours. Appointment needed. Used for routine care, common illnesses and advice. You will get most of your preventive care from your PCP. See your PCP the most often! |
Telehealth | Convenient access to a provider via a phone or computer from where you are. Use telehealth for common illnesses such as coughs, sinus problems, rashes, mental health concerns and more. Learn more about Telehealth. |
Convenience Care Clinic | Typically, open 7 days a week with additional evening and weekend hours. They are found in many local drug and grocery stores. Use when your provider is not available. Used for common illnesses like coughs, colds, sore throats and to get immunizations. |
Urgent Care | Usually, open 7 days a week with additional evening and weekend hours. When your provider is not available. Common illnesses, x-rays, deep cuts, etc. Used to treat a condition or injury that can’t wait for a PCP visit and is not life threatening. |
Hospital Emergency Room | Open 24 Hours a day, 365 days a year. When your provider is not available. Use for life-threatening situations such as chest pain, head injury or emergencies. Call 911 or go to the nearest ER. |
If you aren’t sure where to go for care or have questions about your health, call
our CareSource24® Nurse Advice Line. The number is on the back of your CareSource member ID Card. We’re here for you 24 hours a day, 7 days a week, 365 days a year.
Network Exceptions
View Chapter 3 Using the plan for your medical and other covered services in your Evidence of Coverage (EOC) on the Plan Documents page for full information on in-network and out-of-network copayments, as well as applicable conditions and limitations.
Help Us Improve Our Provider Network
CareSource wants you to be happy with your provider and the network of providers we offer. If you have suggestions that would improve our network, we want to hear from you. Share your ideas with us on the Access Opportunity Form.
The Access Opportunity Form gives you a chance to suggest a provider for our network, tell us about things like if it is easy to schedule appointments, and more.
When You Are Outside of Our Service Area
If you get sick or hurt while traveling outside of our service area, you can get medically necessary covered services from a provider not in our network. You should get urgent care from the nearest and most appropriate health care provider. Emergency care is covered both in and out of our service area.
Prior to seeking urgent care, we encourage you to call your PCP or talk with a provider via Teladoc® for guidance, but this is not required. You can find the phone number of your PCP on your CareSource member ID card.
If you receive emergency care from an out of network provider or urgent care services outside the service area, submit the bill you receive to CareSource with a claim form found on our Forms page. You can also get a claim form by calling Member Services at 1-833-230-2020 (TTY: 1-833-711-4711 or 711). We are open 8 a.m. to 8 p.m. Monday through Friday, and from October 1 through March 31 we are open the same hours, seven days a week.
Please call Member Services or see your Evidence of Coverage for more information.