CareSource MyCare® Ohio (Medicare-Medicaid Plan) Medicaid-Only Member Handbook 2021 CareSource MyCare Ohio | Medicaid-Only Member Handbook Contact Us Member Services Phone: 1-855-475-3163 (TTY: 1-800-750-0750 or 711) Monday - Friday, 8 a.m. to 8 p.m. Mailing Address: 230 N. Main Street Dayton, Ohio, 45402 Online: CareSource.com/MyCare The Member Services phone number and website are listed at the bottom of each page of this handbook. Care Management: 1-855-475-3163 (during business hours shown above) 1-866-206-7861 (after hours) Care Manager: ________________________________ (write your care manager’s phone number here) Behavioral Health Crisis Line: 1-866-206-7861 (TTY: 1-800-750-0750 or 711) CareSource Privacy Officer: 1-937-531-2023 (TTY: 1-800-750-0750 or 711) Reporting Fraud, Waste and Abuse: 1-855-475-3163 (TTY: 1-800-750-0750 or 711) Email: [email protected] ATTENTION: If you speak English, language services, free of charge, are available to you. Call 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. The call is free. ATENCIÓN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingística. Llame al 1-855-475-3163 (TTY: 1-800-750-0750 o 711), el lunes a viernes, 8 a.m. a 8 p.m. La llamada es gratuida. If you have any problem reading or understanding this information or any other CareSource MyCare Ohio information, please contact our Member Services at 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. for help at no cost to you. We can explain this information in English or in your primary language. You can get this document for free in other formats, such as large print, braille, or audio. Call 1-855-475-3163 (TTY: 1-800-750-0750 or 711), Monday – Friday, 8 a.m. – 8 p.m. The call is free. CareSource® MyCare Ohio (Medicare - Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. CareSource may not discriminate on the basis of race, color, religion, gender, gender identity, sexual orientation, age, disability, national origin, military status, ancestry, genetic information, health status, or need for health services in the receipt of health services. I If you have questions, please call Member Services at 1-855-475-3163 (TTY: 1-800-750-0750 or 711) Monday - Friday from 8 a.m. to 8 p.m. For more information, visit CareSource.com/MyCare. CareSource MyCare Ohio | Medicaid-Only Member Handbook Table Of Contents Contact Us...................................................................................................................................................... I Welcome ........................................................................................................................................................... 1 Who is Eligible to Enroll in A MyCare Ohio Plan? ........................................................................................ 2 New Member Information................................................................................................................................ 3 Network Providers ........................................................................................................................................... 4 Identification (ID) Cards .................................................................................................................................. 5 Member Services ............................................................................................................................................. 7 Interpreter Services....................................................................................................................................... 8 CareSource24® Nurse Advice Line................................................................................................................. 9 My CareSource® ............................................................................................................................................. 10 CareSource Mobile App ................................................................................................................................ 10 Care Management.......................................................................................................................................... 11 Primary Care Provider (PCP) ........................................................................................................................ 12 Preventive Care .......................................................................................................................................... 12 Changing Your PCP .................................................................................................................................... 12 Doctor Appointments ................................................................................................................................... 13 Provider Directory ....................................................................................................................................... 13 Healthchek (Well Child Exams) .................................................................................................................... 14 Services Covered by CareSource MyCare Ohio ......................................................................................... 16 Behavioral Health Services ......................................................................................................................... 16 Dental Services ........................................................................................................................................... 17 Vision Services ........................................................................................................................................... 17 Prior Authorization ....................................................................................................................................... 17 Services Not Covered by CareSource MyCare Ohio .................................................................................. 18 Services Not Covered Unless Medically Necessary ................................................................................... 18 Frequency Limitations ................................................................................................................................. 18 Benefits .......................................................................................................................................................... 19 Benefits At-A-Glance ................................................................................................................................... 19 Benefits Guide ............................................................................................................................................ 22 Additional Benefits Or Services ................................................................................................................... 28 Transportation ............................................................................................................................................. 28 If you have questions, please call Member Services at 1-855-475-3163 (TTY: 1-800-750-0750 or 711) II Monday - Friday from 8 a.m. to 8 p.m. For more information, visit CareSource.com/MyCare. CareSource MyCare Ohio | Medicaid-Only Member Handbook myStrengthSM .............................................................................................................................................. 28 Express Banking ......................................................................................................................................... 28 CareSource24® Nurse Advice Line ............................................................................................................. 28 MyHealth ..................................................................................................................................................... 29 Prescription Drugs – Not Covered by Medicare Part D ............................................................................. 30 Medication Therapy Management .............................................................................................................. 30 Medication Disposal .................................................................................................................................... 31 Where To Get Medical Care .......................................................................................................................... 32 Primary Care Provider (PCP) ...................................................................................................................... 32 Telehealth .................................................................................................................................................... 32 Convenience Care Clinics ........................................................................................................................... 33 Urgent Care Centers ................................................................................................................................... 33 Emergency Services ................................................................................................................................... 34 Follow-Up Care (Also Called Post-Stabilization Care) ...............................................................................