Where To Get Care

Used for common sickness like coughs, colds, sore throats, and to get shots. They are found in many local drug and grocery stores
Primary Care Provider

Used for common sicknesses and tips. You will get most of your preventive care from your PCP. You should see your PCP the most often.

Dental Home

Go to the dentist routinely for exams, x-rays and teeth cleanings. This will help with your overall health.

Community Behavioral Health Centers (CBHCs)

CBHCs give health and social services for mental health and/or substance use problems. CBHCs are often the first place people go to get help for behavioral health (BH) issues.

Telehealth

Visit with a PCP by phone or computer. Ask them if they offer telehealth.

If your PCP is not available or does not offer telehealth, call Teladoc® at 1-800-TELADOC (835-2362) or visit www.Teladoc.com/CareSource

Convenience Care Clinics

Used for common sickness like coughs, colds, sore throats, and to get shots. They are found in many local drug and grocery stores.

Urgent Care

Used to treat non-life threatening issues. When You can not visit your PCP, and your health issue cannot wait.

Hospital Emergency Room

Used for life-threatening issues or emergencies. Call 911 or go to the nearest ER.

Not sure where to go? Call CareSource24 Nurse Advice Line. We’re here for you 24 hours a day, 7 days a week. Call 1-844-206-5944 (TTY: 711) to talk to a CareSource24 nurse.

CareSource offers a focused network of providers. To have covered health care services covered, you must get them from  an in-network provider. The only exceptions are:

  • In cases of emergency.
  • If you need urgent care services when traveling out of our service area.
  • When authorized by CareSource.

Use the Find a Doctor/Provider

tool to find a provider near you.

CareSource wants you to be happy with your providers. If you have suggestions, tell us on the Access Opportunity Form. It gives you a chance to suggest a doctor and tell us about them.

Your Primary Care Provider (PCP)

Each CareSource member has a primary care provider (PCP). PCPs can be:

  • General or family doctors
  • Pediatricians
  • Internists
  • OB/GYNs
  • Physician assistants (PA)
  • Nurse practitioners (NP or CNP)

Your PCP will:

  • Work with you to direct your health care
  • Treat you for most of your health needs
  • Send you to a specialist, if needed
  • Admit you to the hospital

Your PCP get to know you and your needs. You will see them most often. The more your PCP gets to know you, the better they will be able to treat you.

If you don’t have a PCP, we will choose one for you. We will send you a letter about this within 10 days. We made this choice based on:

  • Where you live
  • If a PCP you have visited before is close to your home
  • The PCP is taking new patients
  • Your language choice

Appointments

Set up visits with your provider as far ahead as you can. You need to keep your visits. Call offices at least 24 hours before if you need to change or cancel a visit. If you miss too many visits, they may ask that you choose another provider.

Preventive Care

See your PCP even if you are healthy. This helps them find and treat problems early and before they get worse.

This covers:

  • Yearly well-adult and well-child exams
  • Mammograms and cervical cancer exams for women
  • Prostate cancer exams for men
  •  Preventive dental exams and cleanings
  •  Routine exams
  • Early and Periodic Screening, Diagnostic and Treatment (EPSDT). This is for children under the age of 21.

Family Planning Providers

You do not need a referral to see a family planning provider. If you need help finding a family planning provider, you will find a list of network family planning providers in the Find a Doctor/Provider tool. If you need help choosing a family planning provider, call Member Services at 1-855-202-0729 (TTY: 1-800-255-0056 or 711). 

You may see a network family planning provider or a qualified out-of-network family planning provider for your care. CareSource will cover in-network and qualified out-of-network family planning provider services.

Low-Cost Primary Care Services

The Georgia Association for Primary Health Care helps people with no insurance or not enough insurance to get primary care. This will help Planning for Healthy Babies® enrollees find affordable primary care services they might not have access to under their family planning health plan.

Visit the website to learn more.

Where to Get Care After Hours

We want you to get the right care from the right health care provider when you need it. If your doctor’s office is closed or if you are very sick or hurt, you have options.

CareSource24® Nurse Advice Line

CareSource24 gives around-the-clock access to a caring and experienced staff of registered nurses.

Our nurses can help you:

  • Decide when self-care, a doctor visit or the emergency room is needed
  • Understand a medical condition or recent diagnosis
  • Find out more about prescriptions or over-the-counter medicines

CareSource24 Nurse Advice Line is open 24/7, 365 days a year, along with observed holidays. The phone number is on the back of your ID card.

Telehealth

Telehealth uses a phone, computer or tablet to meet with them. You can use telehealth for many common issues. These can be sinus infections, allergies, rashes and more. It can also give you quick medical advice. There is no cost to use telehealth.

Check with your PCP to see if they offer telehealth. If they do not offer telehealth or has limited hours, you have options. CareSource offers two types of telehealth services: Georgia Partnership for Telehealth (GPT) and Teladoc®. Learn more about the options CareSource offers for telehealth visits.

Convenience Care Clinics

Can’t see your PCP? A retail visit is quicker and cheaper than the urgent care  or an ER. You can go to clinics inside CVS® and Walgreens® for basic care. You can:

  • Get a flu shot
  • Get health tests and physicals

Get care for aches and pains, sicknesses and minor wounds. Most clinics  are open in the evening, seven days a week. Visits can be scheduled for the same day. Walk-ins are often welcome. Note: children’s shots are not covered here.

Urgent Care

Urgent Care is for non-emergencies when you can’t see your PCP. They help with wounds, sickness, or mental health issues. You can find one in your Provider Directory or at findadoctor.CareSource.com. Always check in with your PCP after you go to an urgent care. If you need to visit an urgent care out of state, call your PCP or CareSource24 Nurse Advice Line at 1-844-206-5944 (TTY: 711).

Emergency Services

If you have an emergency now, call 911 or go to the emergency room (ER). Emergency Services are for severe health issues that must be treated right away. CareSource covers them both in and out of the county where you live. They can be:

  • Black out
  • Chest pain
  • Hard to breathe
  • Major burns
  • Miscarriage/pregnancy with vaginal bleeding
  • Seizures

Emergency care is covered in and out of our service area in the United States. You do not have to contact CareSource before you get emergency services. If you are not sure if it is an emergency, call your PCP first. Or call CareSource24 our Nurse Advice Line at 1-844-206-5944 (TTY: 711).

When You Are Outside of Our Service Area

If the emergency care is out of network, you will need to send the bill with a claim form to CareSource. You will also need to do this if you visit urgent care outside your service area.

Member Services: 1-855-202-0729 (TTY: 1-800-255-0056 or 711), Monday – Friday 7 a.m. – 7 p.m.

Family Planning Providers

You do not need a referral to see a family planning provider. If you need help finding a family planning provider, you will find a list of network family planning providers in the Find a Doctor/Provider tool. If you need help choosing a family planning provider, call Member Services at 1-855-202-0729 (TTY: 1-800-255-0056 or 711). 

You may see a network family planning provider or a qualified out-of-network family planning provider for your care. CareSource will cover in-network and qualified out-of-network family planning provider services.

Low-Cost Primary Care Services

The Georgia Association for Primary Health Care helps people with no insurance or not enough insurance to get primary care. This will help Planning for Healthy Babies® enrollees find affordable primary care services they might not have access to under their family planning health plan.

Visit the website to learn more.