CareSource
Healthcare with heart
Teresa’s Story
CareSource 24 Hour Nurse Advice Line
Talk to a registered nurse anytime
With the 24-Hour Nurse Line, you can speak to a registered nurse about a variety of health issues —
whenever you need to. Plus:
It’s toll-free
You can call as many times as
you need — at no extra cost
Your covered family members
can use it too
Call 678-214-7500
Since CareSource is a non-profit organization, their main goal is to keep members healthy. The partnership under Georgia Families, by the Georgia Department of Community Health (DCH) and CareSource, is organized to provide healthcare services for Medicaid and PeachCare for Kids eligible members who are uninsured and belong to lower income families.
What Do CareSource Plans Offer?
Care Coordination
Transportation Benefits
Programs for Pregnant Women & Children
Rewards Program
Dental & Vision Coverage
Healthcare Referrals With CareSource
One of the great added benefits with CareSource is that members do not need referrals from their PCP to see a specialist within the CareSource network of providers. However, in some cases, a specialist may require a prior authorization, in which case this provider will direct the request to CareSource and once the request is approved, the specialist will provide the member with an appointment. For any services that are not detailed on the CareSource website or which are listed as “coming soon,” the member needs to call the toll-free number and confirm if the service is covert.
Most members covered by Medicaid and PeachCare for Kids are required to make copayments. Depending on the service the copayments are either fixed or as a percentage of the cost of the service. For families where a member is also covered by additional insurance plans, Member Services will help plan members to coordinate pay claims as well as benefits.
Additional CareSource Benefits
There are many additional benefits covered by CareSource with specific levels of service for family planning and maternity. These are meant to ensure that mothers and future mothers are at their healthiest prior to pregnancy, during pregnancy, and following the birth of a child. Members do not need prior approval from CareSource and these providers are not required to be within the network.
Additional benefits include dental and vision care as well as the rewards for wellness program. A transportation service provides rides to and from healthcare appointments for Georgia Medicaid plan members. Complete up-to-date information, as well as plan member documents, are available on the CareSource website at www.caresource.com or by calling their toll-free line.
Frequently Asked Questions
Features of Caresource Bronze Health Plans, Including the High Deductible Health Plan (HDHP)
Bronze Health Plan Overview
Bronze health plans are designed with higher deductibles and copayments to help keep monthly premiums more affordable. These plans are ideal for individuals who prefer lower premiums but are prepared to pay more out-of-pocket when accessing healthcare services. Here are the key features:
- Higher Deductibles and Copayments: Expect to pay more upfront when you need medical care, but benefit from reduced monthly premiums.
- Affordable Premiums: Lower premiums make these plans a budget-friendly option for those who do not frequently access healthcare services.
High Deductible Health Plan (HDHP)
The High Deductible Health Plan (HDHP) comes with a unique advantage when paired with a Health Savings Account (HSA). Here’s what you can expect:
- Compatibility with HSA: This plan allows you to open an HSA, a tax-free account to save money for future medical expenses.
- Tax-Free Savings: Contributions to your HSA are tax-free, and funds can be used to pay for qualified medical expenses without tax penalties.
- High Deductibles: Like the standard Bronze plan, the HDHP features higher deductibles, meaning you’ll need to pay more out-of-pocket before the insurance kicks in.
Taking advantage of the tax savings and future planning capabilities provided by the HSA makes the HDHP particularly appealing for long-term financial health.
What are the Different Caresource Silver Health Plan Designs and Their Benefits?
When selecting a Silver health plan, you generally have three main designs to choose from:
- Silver Standard Plan
- Silver Low Premium Plan
- Silver Low Deductible Plan
Each of these plans comes with a unique set of benefits tailored to different healthcare needs and financial priorities.
Silver Standard Plan
- Comprehensive Coverage: This plan provides standard coverage for a range of healthcare services.
- Primary Care & Specialist Copayments: You’ll pay fixed copayments for visits to primary care doctors and specialists.
- Urgent Care and Prescription Coverage: Copayments for urgent care and prescription drugs are included, and you do not need to meet the deductible first.
Silver Low Premium Plan
- Lower Monthly Premiums: This plan offers lower monthly payments, making it a budget-friendly option.
- Primary and Specialist Care: Like the standard plan, it includes copayments for primary and specialist visits.
- Urgent Care and Prescriptions: Fixed copayments are available for urgent care and medications without requiring you to meet the deductible initially.
Silver Low Deductible Plan
- Reduced Deductibles: This plan features lower deductibles, providing quicker access to full coverage benefits.
- Copayments for Visits: You get the same copayment benefits for primary and specialist care as the other Silver plans.
- Immediate Urgent Care and Rx Benefits: Enjoy the advantage of receiving urgent care and prescription coverage without having to meet your deductible first.
Summary of Benefits
Each Silver health plan design aims to balance out-of-pocket costs and coverage. They all include:
- Primary Care Copayments
- Specialist Copayments
- Urgent Care Coverage
- Prescription Drug Copayments
By understanding these options, you can better match a plan to your healthcare needs and financial situation.
What Types of Health Insurance plans are offered in Georgia by Caresource?
CareSource is a non-profit organization, their main goal is to keep members healthy. The partnership under Georgia Families, by the Georgia Department of Community Health (DCH) and CareSource, is organized to provide healthcare services for Medicaid and PeachCare for Kids eligible members who are uninsured and belong to lower income families. CareSource is one of the nation’s most extensive Medicaid-managed care plans. The company has built a legacy of providing quality healthcare coverage for Medicaid consumers. In addition to Medicaid coverage, CareSource has a diverse offering of insurance plans on the Health Insurance Marketplace. The company also offers Medicare Advantage plans that help consumers close the gap in coverage as they age.
Health Insurance Plans Offered in Georgia
CareSource offers a variety of health insurance plans in Georgia to meet the diverse needs of its members. These plans are organized into three metal tiers: Gold, Silver, and Bronze.
Gold Plan
The Gold CareSource health plan features a $2,000 member deductible and affordable copayments for office visits. Primary Care visits have a copayment of $10, while Specialist visits are $45. Prescription copayments also apply without needing to meet the deductible first, making it easier to manage healthcare costs.
Silver Plans
CareSource provides three Silver plan designs:
- Silver Standard
- Silver Low Premium
- Silver Low Deductible
All Silver plans include copayments for Primary Care, Specialist visits, urgent care, and prescriptions without having to meet the deductible first. These plans offer a balanced approach to healthcare costs and benefits.
Bronze Plans
The Bronze plans include a copay health plan with higher deductibles and copayments to keep premiums more affordable. Additionally, there is an HSA high deductible health plan option. Pairing this plan with a tax-free Health Savings Account allows members to pay for qualified medical expenses with tax-free money.
CareSource’s diverse range of plans ensures that members can find a plan that fits their healthcare needs and budget, providing peace of mind and access to essential health services.