CareSource Medicare Insurance Review & Complaints: Health Insurance (2023)

Ohio-based CareSource was created to provide affordable health insurance options to residents of the area, particularly those qualifying for Medicare and Medicaid. The company now serves five states with a range of individual and government-sponsored plans.

This CareSource Medicare review will cover the plans, coverage, and rates. We’ll explain how to get CareSource Medicare quotes, and look at company ratings.

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About CareSource

Originally named Dayton Area Health Plan (DAHP), CareSource was founded as a not-for-profit health insurance company in 1989 in Dayton, Ohio. A $500,000 state grant launched DAHP to provide health insurance plans for underserved populations in the area, particularly low-income families and individuals and those eligible for Medicare and Medicaid.

Expansion beginning in 1996 through acquisitions of other health companies took the company statewide. In 2000 the name change to CareSource re-branded all of those companies under a single name. CareSource continued expansion into four other states: Kentucky, West Virginia, Indiana, and Georgia.

CareSource today is one of the largest HMOs in the nation and the second-largest company headquartered in Dayton. They continue to offer affordable health care options including individual plans via the health care marketplace and Medicare Advantage plans as well.

CareSource Medicare Advantage

Plan options from this company vary by state, so for the purpose of this review, we looked at the options for Ohio. CareSource Medicare and Medicaid plans are offered in a select list of counties in Ohio, Georgia, Kentucky, and Indiana.

CareSource Dual Advantage HMO-SNP is a zero-premium plan with no cost above and beyond your regular Medicare premiums. There is no medical deductible, but a $250 pharmacy deductible applies. Primary care visits have a copay of $9, while specialists are $50. Basic dental, hearing, and vision coverage are all included in this plan. Prescriptions start at $0 for Tier 1 when purchased by mail order pharmacy.

CareSource Advantage is the other plan, with no deductibles either for medical or for pharmacy. There is no copay for primary care visits, and a $49 copay for specialist visits. This plan includes comprehensive dental coverage as well as increased hearing coverage; vision is also included. Prescriptions start at a $4 copay.

CareSource Medicare Rates

The rates for CareSource Medicare plans are clearly displayed with the plan overviews and start with the zero-premium Dual Advantage plan. As with all Medicare Advantage plans, you will still need to pay your regular Part A and Part B premiums.

The mid-range Advantage plan has a monthly rate of $46.00.

While these are Ohio rates and not comparable outside the state, they are very affordable for the level of coverage provided based on our experience. HMO plans are usually priced lower than PPO plans, but even so, these are on the lower side.

Streamlining the CareSource Medicare Claims Process

Ease of Filing a Claim

CareSource Medicare insurance offers a straightforward and user-friendly process for filing claims. Policyholders have the convenience of filing claims online, over the phone, or through mobile apps, providing them with flexibility and ease of access to the claims submission process.

Average Claim Processing Time

While the exact claim processing time may vary depending on the specific nature of the claim, CareSource Medicare strives to ensure that claims are processed efficiently. Policyholders can generally expect reasonable turnaround times for their claims to be reviewed and settled. This commitment to timely claims processing contributes to overall customer satisfaction.

Customer Feedback on Claim Resolutions and Payouts

Customer feedback plays a vital role in evaluating an insurance provider’s claims handling performance. CareSource Medicare values customer input and aims to provide fair and satisfactory claim resolutions and payouts.

The company’s dedication to continuously improving its claims process is informed by policyholders’ experiences and opinions, ensuring they receive the support and compensation they deserve.

Navigating the CareSource Medicare Digital and Technological Features

Mobile App Features and Functionality

CareSource Medicare insurance offers a user-friendly mobile app designed to enhance policyholders’ overall experience. The app provides convenient access to insurance information, claim submission, and account management. With the mobile app’s features and functionality, customers can stay connected with their insurance provider anytime, anywhere.

Online Account Management Capabilities

CareSource Medicare’s online account management platform empowers policyholders with robust tools for efficiently managing their insurance policies.

Through the secure online portal, customers can review coverage details, update personal information, make premium payments, and track claim statuses. This digital convenience enhances the overall customer experience and ensures easy access to essential information.

Digital Tools and Resources

In addition to its mobile app and online account management platform, CareSource Medicare offers a range of digital tools and resources to support policyholders in making informed decisions about their healthcare coverage.

These resources may include educational materials, cost calculators, and wellness programs. CareSource Medicare’s commitment to leveraging technology enhances customers’ access to valuable information and services, fostering a well-rounded healthcare journey.

CareSource Medicare Ratings and Consumer Reviews

CareSource has an A+ rating with the Better Business Bureau (BBB), with a total of 192 complaints on file. That is not an especially high volume for such a large company. The 39 customer reviews are mainly negative, with a mixture of various issues including claims being denied and billing problems.

The National Committee for Quality Assurance has not rated CareSource due to a lack of information. Medicare itself has given their Advantage plans a 2.5-star out of 5 rating, which is one of the lower ratings we have seen from Medicare and is considered to be below average.

We were unable to find much else in the way of reviews or ratings of this company, which is a bit unusual given its size.

CareSource Medicare: The Bottom Line

CareSource has good rates for their Medicare plans, but they have a lot of work to do in order to bring their Medicare ratings up to a level that inspires confidence. There is not really enough information on this company’s reputation to form a solid opinion on them, but what is available does raise some concern. Those seeking good Advantage coverage may want to look around at companies that rank higher.

Affordable CareSource Medicare insurance may be a good choice for you, but make sure you’ve compared it to other options. Enter your ZIP code for free quotes now.