CareSource Health Insurance Review
CareSource has good private Medicaid services in some states. But its regular health insurance is only a good option for some plan types and areas.
Find Cheap Health Insurance Quotes in Your Area
CareSource is mostly known for its Medicaid programs, but it also sells marketplace health insurance in Indiana, Ohio, Kentucky, Georgia, North Carolina and West Virginia. The company has average rates and low customer satisfaction scores.
CareSource can be a good choice for Medicaid plans. But if you need regular health insurance, you should compare CareSource plans with options from other companies.
Pros and cons
Pros
Good cancer drug coverage
Works with Managed Medicaid plans
Cheap dual-eligible special needs plans
Cons
Poor customer service
Rates for Bronze and Silver are average
Gold plans are expensive
Cost of CareSource health insurance
CareSource has slightly cheaper-than-average rates for Bronze and Silver plans, but its Gold plans are expensive.
A Bronze plan from CareSource is slightly less expensive than the national average by $2 per month, and a CareSource Silver plan costs $17 less per month than average. However, Gold plans cost $80 more per month. CareSource does not sell Catastrophic or Platinum health insurance plans.
Plan tier | CareSource cost | National cost |
|---|---|---|
| Bronze | $460 | $462 |
| Silver | $550 | $567 |
| Gold | $699 | $619 |
Average monthly rates for a 40-year-old.
CareSource is slightly cheaper in Ohio and N.C. In Ohio, a Silver plan with CareSource is $10 cheaper each month than the state average. But in North Carolina, a CareSource Silver plan costs $77 less per month than the state average.
Find Cheap Health Insurance in Your Area
CareSource isn’t usually the cheapest health insurance option, but it’s also not the most expensive. Because rates vary, shopping around and comparing health insurance quotes can help you find the best plan.
CareSource vs. state average costs
State | CareSource | State average |
|---|---|---|
| Indiana | $445 | $436 |
| Ohio | $525 | $535 |
| Kentucky | $516 | $497 |
| Georgia | $526 | $509 |
| North Carolina | $561 | $638 |
| West Virginia | $872 | $877 |
Average monthly rates for a 40-year-old with a Silver plan.
CareSource may be a cheap option for Dual-Eligible Special Needs Plans, which are plans for those who qualify for both Medicare and Medicaid. In all three states where coverage is available, CareSource advertises that the plans have a $0 monthly health insurance premium.
CareSource plan options and types
CareSource offers health plans that fall into three main categories.
The company also partners with some states to offer state-specific programs and coverage options.
Medicaid plans
CareSource offers Medicaid managed care plans in several states. If you are eligible for Medicaid and live in a state that offers managed care plans, CareSource may be an option.
Depending on the state where you live, you may have different CareSource Medicaid options.
In Arkansas, PASSE programs help Medicaid members with complex behavioral, developmental or intellectual health concerns. PASSE stands for “Provider-Led Arkansas Shared Savings Entity.” Each PASSE organizes care services for its members. CareSource is one of four PASSE organizations in Arkansas.
Arkansas Medicaid members may have access to CareSource PASSE if they have complex mental health needs. CareSource PASSE helps you coordinate your health care and gives you access to educational tools to better understand your health and coverage.
CareSource offers two Medicaid programs in Georgia.
- Managed care: CareSource works with the state of Georgia as a “managed care organization,” or MCO. This means that you can choose to get your Medicaid benefits from CareSource rather than from the state. CareSource is one of five Medicaid managed care organizations in the state.
- Georgia Pathways to Coverage: The Georgia Pathways to Coverage program helps people get Medicaid coverage when they wouldn’t otherwise qualify. You have to be between 19 and 64 and not eligible for traditional Medicaid. You also have to meet other requirements, like doing 80 hours of “qualifying activities” each month. These activities can include employment, community service, educational activities and more.
CareSource works with two Medicaid programs in Indiana.
- Healthy Indiana Plan (HIP): Adults between the ages of 19 and 64 may be able to get coverage through the Healthy Indiana Plan if they meet certain income requirements.
- Hoosier Healthwise (HHW): This is Indiana’s Medicaid program for pregnant women and children.
Ohio Medicaid members have access to two CareSource programs.
- Managed care: Medicaid members in Ohio can choose to get their benefits through CareSource. You’ll have to use the CareSource network of doctors to have coverage. CareSource is one of five Medicaid managed care organizations in Ohio.
- OhioRISE: This Ohio Medicaid program is focused on behavioral health issues, like an eating disorder or substance use disorder. To qualify, you have to be enrolled in Ohio Medicaid, be age 20 or younger, have been hospitalized for a behavioral health issue, and have a referral from the Child and Adolescent Needs and Strengths (CANS) program.
Marketplace health insurance plans
CareSource sells regular health insurance on state health marketplaces and HealthCare.gov.
CareSource health insurance has good benefits, but it’s not the best choice for most people.
That’s because CareSource only has average rates and below-average customer satisfaction. All CareSource health insurance plans are HMOs. That means you can only see in-network doctors if you want coverage. You’ll also have to get a referral to see a specialist, which can delay treatment.
CareSource is one of the best health insurance companies for cancer patients, though. The company covers at least eight of the most commonly prescribed cancer drugs, making it a good choice if you need cancer medication coverage.
CareSource has a rewards program with its marketplace plans. You earn points for completing health exams, like annual physicals and cancer screenings. You can then redeem your points for gift cards.
If you buy a CareSource marketplace plan, you might also want to consider the company’s extra coverage options.
- CareSource Dental, Vision and Fitness Plan: This gives you a $1,000 benefit for dental services and $250 for glasses or contacts. You also can join the Active&Fit program. The program gives you free access to certain gyms, as well as virtual workout support. You might even get a free wearable device with some plans.
- MyHealth for Adults: MyHealth for Adults offers health assessments, wellness tools and tracking for exercise goals. It is free for anyone over 18 who has CareSource health insurance.
- myStrength: This wellness app can help you manage stress, boost your mood, get better sleep, improve your relationships and more.
- MyResources: MyResources can help you find support for issues like social pressures and food insecurity.
- KidsHealth: This offers videos, articles, tools and doctor-reviewed health advice for children.
- TruHearing Choice Program: TruHearing covers an annual hearing exam and pays for new hearing aids once every three years.
If you choose a Bronze plan that is eligible for a health savings account (HSA), you could set it up through CareSource’s partnership with HSA Bank. You don’t have to choose HSA Bank for your account, but the partnership with CareSource might make it easier to set up and manage.
Dual-Eligible Special Needs Plans (D-SNPs)
If you are eligible for both Medicare and Medicaid, you could consider buying a Dual-Eligible Special Needs Plan from CareSource.
Special Needs Plans, or SNPs, are Medicare Advantage plans that offer coverage for groups with specialized health care needs. Dual-Eligible SNPs, or D-SNPs, help you coordinate your care between Medicare and Medicaid.
This plan’s benefits include coverage for dental, vision and hearing services, a fitness program, and access to BrainHQ’s puzzles and games for cognitive health.
Many plans don’t require out-of-pocket payments, called copays, for a variety of services including annual physicals, some generic prescription drugs, urgent and emergency care, lab services, and routine vision, dental and hearing exams. CareSource D-SNPs are HMOs, which means you have to stay within a network of doctors and get referrals from your primary care doctor.
CareSource D-SNPs also include transportation coverage. You’ll have coverage for up to 60 one-way trips to health-related activities, like doctor appointments, treatment appointments and trips to the pharmacy.
Other CareSource coverage options
CareSource offers a handful of other health insurance coverage options, depending on your state.
- Planning for Healthy Babies (Georgia): This program is aimed at lowering the number of babies who are born at an unhealthy low weight. To qualify, you must be a Georgia resident between 18 and 44. You can’t be eligible for any other Medicaid program.
- PeachCare for Kids (Georgia): You may qualify for this program if you’re under 19 and don’t qualify for Medicaid or any other health insurance options.
- MyCare Ohio: You have to be dual-eligible for Medicare and Medicaid for MyCare Ohio. If you enroll, all your coverage comes from one plan. This is a Medicare-Medicaid Plan (MMP), which is similar to a Special Needs Plan.
- Home Care Waiver (Ohio): If you are eligible for Medicaid, this program allows you to get care in your home instead of a nursing home, rehab facility or hospital.
Where is CareSource available?
CareSource offers coverage in eight states. The CareSource options available to you will depend on where you live.
Arkansas
- CareSource PASSE
Georgia
- Dual-Eligible Special Needs Plan
- Marketplace health insurance
- Medicaid managed care
- Pathways to Coverage
- PeachCare for Kids
- Planning for Healthy Babies
Indiana
- Dual-Eligible Special Needs Plan
- Healthy Indiana Plan (HIP)
- Hoosier Healthwise (HHW)
- Marketplace health insurance
Kentucky
- Marketplace health insurance
Michigan
- Medicaid
- MI Health Link
North Carolina
- Marketplace health insurance
Ohio
- Dual-Eligible Special Needs Plan
- Home Care Waiver
- Marketplace health insurance
- Medicaid managed care
- MyCare Ohio
- OhioRISE
West Virginia
- Marketplace health insurance
Availability varies even within each state. You may only be able to buy CareSource insurance in certain counties.
CareSource resources and features
The biggest company benefit CareSource offers is CareSource Life Services. Life Services helps CareSource members get access to services that help improve their quality of life. The program is free for qualifying CareSource members.
The program is available in Georgia, Indiana and Ohio for CareSource members with Medicaid or marketplace health insurance plans. Georgia residents in the Planning for Healthy Babies program are also eligible.
The CareSource website makes it easy to find information about the company’s plans, availability and even what medications it covers.
The company has a mobile app that is available on both Google Play and the Apple App Store. The app lets you access your ID card, find in-network doctors, check on the status of claims, make payments and review your benefits. Although the reviews are generally positive, some users complain about glitches.
CareSource also partners with Fifth Third Bank to offer “Express Banking.” The account has no monthly fees, minimum balances or overdraft charges. Mobile deposit is available, and you can get a debit card with the account.
Customer reviews and complaints
CareSource has poor customer satisfaction and more complaints than average.
CareSource gets more than twice as many complaints as an average company its size, according to the National Association of Insurance Commissioners (NAIC). In some states, CareSource has an even higher level of complaints. For example, CareSource West Virginia has over six times more complaints than normal.
Not all of CareSource’s reviews are poor. The National Committee for Quality Assurance (NCQA) rates CareSource Medicaid managed care plans as having moderate quality and a decent member experience.
CareSource’s D-SNPs have a 4.0 star rating from the Centers for Medicare & Medicaid Services. The rating reflects the quality of coverage and customer experience. The highest rating is 5 stars.
Frequently asked questions
What is CareSource?
CareSource is a health insurance company. Its plans are available in eight states, but not all types of coverage are available in every state. CareSource sells marketplace health insurance, Medicaid managed care plans and Dual-Eligible Special Needs Plans for those enrolled in Medicaid and Medicare.
Is CareSource good insurance?
CareSource offers above-average Medicaid managed care plans. However, its marketplace health insurance policies aren’
How much does CareSource cost?
A Silver plan from CareSource costs an average of $550 per month for a 40-year-old. The national average cost of health insurance is $567 per month for the same plan. The company’
Methodology and sources
Average rates for marketplace insurance plans are for a 40-year-old individual with a Silver plan, unless otherwise noted. Average costs are based on aggregated Centers for Medicare & Medicaid Services (CMS) data for health insurance plans sold on HealthCare.gov. States that use state marketplace sites, rather than HeathCare.gov, were not included in the analysis. Star rating information is also from CMS.
Other sources include the Apple App Store, the Arkansas Department of Human Services, Better Business Bureau (BBB), CareSource, Disability Rights Arkansas, Georgia Pathways to Coverage, Google Play, HealthCare.gov, the Indiana Family and Social Services Administration, Indiana Medicaid, the National Association of Insurance Commissioners (NAIC), the National Committee for Quality Assurance (NCQA) and Ohio Medicaid Managed Care.
Editorial note: The content of this article is based on the author’s opinions and recommendations alone. It has not been previewed, commissioned or otherwise endorsed by any of our network partners.