ComplaintsforCareSource

• Initial Complaint

  03/14/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Resolved

  More info

  On December 10 of 2023 I was approved for a rolling shower due to the inability to walk I have multiple sclerosis. It was awarded to Assistive Solutions Doug Lane contractor by Care source in the amount of $10,000 since this time I have not yet got this shower, I keep getting different excuses and paying out-of-pocket for things done in which I have all receipts for. I would like a resolution to this immediately this hinders me from having my basic needs met.

  Customer response

  03/14/2024

  Please close complaint it’s been resolved 

• Initial Complaint

  03/11/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I have breast cancer and was planning surgery with my provider, an excellent surgeon, *** ****** *******. Got a letter from Caresource, Ohio, Bronze, Marketplace, on 2/28/24 (attached) saying she "will no longer be contracted with Care Source after 4/26/2024." There was no explanation as to why. I contacted my Doctor's office that is part of a large hospital network that is contracted with Caresource and they said that was in error because they were contracted with Caresource and so is she. When I first recieved the letter I was very emotionally distraught worrying that suddently I could no continue with my cancer doctor who I trust. I called Caresource and they could not give me any cohernt information. They would not investigate the problem, just said she wasn't in the network. All of their represenatives are in Asia (e.g., the Phillipines) and could not give me any information and were very rude.

  Business response

  03/21/2024

  Upon review of the concerns noted in the members complaint and to protect the members PHI, a Member Services Representative contacted the member directly on 3/18/2024 to discuss their concerns in detail. The Member Services Representative was not able to reach the member by phone so they tried to leave a voicemail but it was full and unable to leave a message.  The Member Services Rresentative sent a trying to reach you letter on 3/18/2024.  To date no return call has been received.  We appreciate the inquiry.  Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  03/05/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  They shut off my insurance after I paid and called them up last week. I go to check this week to find out I can't get my script filled because they ended my service LAST YEAR!! But I had insurance last week. Worst insurance ever.

  Business response

  03/14/2024

  Upon review of the concerns noted in the members complaint and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly on 3/8/2024 to discuss their concerns in detail. As a result of the discussion with the member, we were able to fully resolve the issue and the member expressed no additional questions or concerns at that time. We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  02/29/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Answered

  More info

  CareSource is not following their policy of disenrollment which is listed online. It states that you can leave CareSource for the following reasons: When you have a reason to change, such as: You want to be on the same plan as a family member You need care or providers that are not offered in the CareSource network You got poor quality care I am unable to find a psychotherapist. They also cannot provide me with the provider that is recommended by my psychiatrist. I’ve also received poor service in dealing with pre authorizations with caresource. They call me constantly, and I am honestly tired of dealing with them. Suffering from PTSD and Major Depression, the last thing I need is to be fighting with a company over getting the care I need to better myself. They only want the state of Georgia to keep paying them, and they could care less about the needs of the patient. They are not honoring their policy l, they are instead trying to find loopholes to get me to stay and this has been the most stressful process I’ve been through in a while. Most providers hate dealing with CareSource, because of their rigid policies. My complaint is valid. They need to allow me to go to a managed care plan that is offering the services I need…they can’t provide them.

  Business response

  03/08/2024

  Upon review of the concerns noted in the non members complaint and to protect the members PHI, a Member Services Representative contacted the member directly on 3/8/024 to discuss their concerns in detail. The member had contacted the plan in the past regarding the issue.  The Member Services Rep offered to locate an in network but member declined. The Member Services Representative was not able to reach the member by phone so a secure email was sent with the plan’s findings in detail on 3/8/2024.  We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  02/16/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I am writing this to because CareSource denied coverage for my newborn daughter, ****** ***. As per KY state law (and as was written in the policy), my infant is covered for the first 31 days of her life. I was told by the insurance sales rep and by an employee in India with Member Services that all I needed to do was use my insurance card for my newborn and that she would automatically be covered. However, my newborn’s hospital bill during our stay in the maternity ward at Baptist Health has been denied, as have her first two pediatrician visits with Metro Pediatrics. I canceled my insurance policy on December 31, 2023 because I moved out of state. Her doctor visits (and birth) occurred BEFORE the policy was canceled. Therefore, CareSource is required to cover her medical bills. I have more than paid my out-of-pocket max ($9,100) so my balance should equal $0. I will be filing a complaint to the Kentucky Attorney General and the Kentucky Dept. of Insurance. Denial of my daughter’s coverage under my plan is immoral, egregious, and overtly illegal. No insured person should have to file an appeal with their insurer over something like this. “The Kentucky Office of Insurance takes the position that KRS 304.17A-139(3) advises that… the implication is that payment of a specific premium or fee and the application of a separate deductible shall not be applicable to coverage of a newly born child during the first thirty-one (31) days after the date of birth. Rather, payment of a specific premium or fee may only be charged for coverage that begins after the first thirty-one (31) days from the date of birth have passed.” Baptist Health, Louisville, KY, Dates Of Service: 11/20/2023 - 11/22/2023 for the amount $6,302.09 Metro Pediatrics, 11/20/2023 and 11/27/2023 for the amount of $967.00

  Business response

  04/05/2024

  Upon review of the concerns noted in the members complaint and rebuttal and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly on 4/5/2024 to discuss their concerns in detail. As a result of the discussion with the member, we were able to resolve the issue. We appreciate the inquiry, please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  02/01/2024

  Complaint Type:

  Service or Repair Issues

  Status:

  Answered

  More info

  I signed up for health insurance through the marketplace. I paid on time, and my insurance was canceled, and more money taking out. I have talked to different agents and get different answers. I was told different due dates, and paid on time and still canceled. The agents is spoke with had no idea was was going on, and I don't know how anyone can run a legitimate business in this manner. This conflicting information and uninformed company cost me health insurance enrollment and my husband has cancer and diabetes.

  Business response

  02/09/2024

  Upon review of the concerns noted in the members complaint and to protect the members PHI, a Member Services Representative contacted the member directly on 2/8/2024 to discuss their concerns in detail. The Member Services Representative was not able to reach the member by phone so a secure email was sent with the plan’s findings in detail on 2/8/2024.  We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

  Customer response

  02/09/2024

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  ***** *****

  Customer response

  03/20/2024

  Consumer’s Duplicate Complaint:
  I filed a complaint over a month ago for paying for insurance and not having it, and or one unauthorized payment coming out of my bank account. I have NOT received the refund and when I call I get the run around by customer service. I need my money refunded. I have a limited income and this is unacceptable.

  Consumer’s Desired Resolution:
  Refund

  Business response

  04/05/2024

  Upon review of the concerns noted in the members rebuttal and to protect the members PHI, a Member Services Representative contacted the member directly on04/04/2024 to discuss their concerns in detail. The Member Services Representative was not able to reach the member by phone so a secure email was sent with the plan’s findings in detail on 04/04/2024.  We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  01/29/2024

  Complaint Type:

  Customer Service Issues

  Status:

  Resolved

  More info

  Had Caresource Bronze insurance 2 years prior to turning 65. Medicare started for me 11/01/2023. Reported to both Caresource and the Marketplace switch to Medicare and to cancel caresource health insurance. In November started receiving mail about caresource continuing. Week of Thanksgivkng called again to cancel , spoke to both Caresource and a rep from the Marketplace, told by both insurance was canceled. Then in Dember received more malings. Called again to check on cancelation. Both parties said insurance canceled. Now in January Caresource is billing t he Marketplace for insurance I don't have and do not want because I am very happy and pleased with my Medicare insurance wi th Devoted Health. Just want the malings, emails to stop but really want them to stop billing the Marketplace in my name for an insurance product I don't want or need.

  Business response

  02/08/2024

  The member was contacted on 2/08/2024 to advise that this issue has been resolved in their favor. 

   

  Thank you,

   

  CareSource

  Customer response

  02/08/2024

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********, and find that this resolution is satisfactory to me.
  
  Sincerely,
  
  **** *******

• Initial Complaint

  01/26/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  CareSource bills would come too late to pay by mail in order for the bill to get there on time. So like an idiot I signed up for their auto pay through my credit card. I have canceled this insurance through the marketplace December 2023. I tried to cancel the auto pay using the phone number that was given. But this phone number no longer works. I also tried to cancel auto pay through signing up through the account online. But it will not let me sign in so I could cancel. I called them and finally got a human to talk with. When trying to reset the password the page they send me to is an old timed out page. I called my credit card company and could not get a human or an option to talk about stop paying said bill. So I wrote them a letter. I have been charged twice now on my credit card. I don’t know what to do. If their system work or the phone number they keep giving me is the wrong number and it won’t work. so if they would give me a real number instead of bogus number, I would’ve canceled it already. Thanks for any help that you can give me.

  Business response

  01/31/2024

  Upon review of the concerns noted in the members complaint and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly on 1/30/2024 to discuss their concerns in detail. As a result of the discussion with the member, we were able to fully resolve the issue and the member expressed no additional questions or concerns at that time. We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  01/08/2024

  Complaint Type:

  Billing Issues

  Status:

  Answered

  More info

  I received a letter from CareSource dated early December 2023 telling us that our primary care doctor was not on their list of covered providers and thus they were denying a claim from her office. I called CareSource on the only number they provide on their website and was on the phone the first time for 1 hour 30 minutes with a customer service representative that could not resolve the issue. The next day CareSource again and spoke with another customer service representative and this person was able to find our family doctor, *** ****** ******, was in fact listed as one of their network providers. He told me he would put this information into their customer computer records system to ensure it was corrected. In between these calls I had filed a grievance appeal on CareSource's website. A few days later I did receive another letter in the mail from CareSource that they had received my grievance appeal and would get back with me in a couple days. Today is January 5, 2024 and I have not gotten a response in the mail. However, on December 29, 2023 I did get voicemail from a Fred from CareSource stating he was following up on my grievance appeal. He did not leave a callback number. I did not answer the call because I didn’t recognize the phone number. He did call me back on January 2, 2024 and I explained to him my grievance appeal. I had him look up my two doctors, who I had already verified through HealthCare.gov as accepted providers on CareSource’s site in December 2023. I did this before signing up with CareSource for 2024 coverage. The two doctors are *** ****** ******l and *** ****** ******** both associated with Cleveland Clinic. Initially Fred said they were not listed as CareSource providers and then he asked me if both doctors were associated with Cleveland Clinic which I responded, yes, they are. He then said he needed to look into something and would get back with me. The next day he called back and left me another voice mail stating he tried to get some answers from Cleveland Clinic but could not get any information from them and thus he stated that both doctors were not in CareSource’s list of providers and he would be following up with a letter being sent to us denying our grievance appeal. These responses from CareSource are unacceptable. I have been getting different answers from each customer service rep, one acknowledging that my doctors are in their network and he will add the information into the system and the other two saying otherwise? I have screenshots from the CareSource website showing *** ****** ****** as one of their providers dated December 11, 2023. I have never experienced such frustration or incompetence in 50 years of dealing with hundreds of businesses and services. I cannot understand how their customer website and customer representatives can be so unhelpful and incompetent and the fact that they do not give you a number to call back is also ridiculous. I expect this to be resolved appropriately and apparently it is going to take an outside agency to hopefully get it resolved. I really have to question the leadership team of this organization and really would like to hear what they think of this type of customer experience, overall I estimate I have spent 8 hours of my time dealing with this issue on phone calls and researching how to get this fixed.

  Business response

  01/18/2024

  On 12/11/2023, the member filed a Grievance regarding this issue. On 1/3/2024 a member of the Grievance team contacted and spoke with the member to advise of their findings. The Specialist offered to assist in locating a new provider, but the member declined.  On 1/8/2024 the member filed a complaint with the Ohio Department of Insurance as well as the Better Business Bureau. The issue was researched and on 1/17/2024 a Issue Resolution Specialist contacted the member and provided the plan’s findings. The member expressed understanding of the resolution and requested a letter with the information be mailed to him for his files.   We appreciate the inquiry and believe the members issue is resolved. Please contact us if we can provide any additional information.

  Customer response

  02/04/2024

  No it is not resolved. 
  
  
  I spoke with a representative from Care”Source in mid January, a ******* *. explained that they had determined there was a computer programming error with regards to Tax Identification numbers (TIN) within their Find-A-Doc tool on their website that had caused my problem. They said this was a problem on their part and they were correcting it. I requested a formal letter explaining what had occurred and the fix they were putting in place to ensure I didn’t run into this in the future and had record of their negligence on my part. She assured me that a letter would be sent to me explaining the problem that had occurred and the fixes they were putting in place. It is now February and I have not received a letter from CareSource as I requested. So from my perspective this complaint is not resolved. Thank you for your assistance on this matter. 

  Also, CareSource sent conflicting information to the Ohio Department for Insurance saying nothing about the computer glitch on their part with regards to the Tax Identification Numbers (TIN), but rather putting the responsibility on the doctors to enter the information correctly. I am still quite frustrated with this whole situation with CareSource. 

  
  Sincerely, ***** *********

  Business response

  02/22/2024

  Upon review of the concerns noted in the members rebuttal and to protect the members PHI, a Member Services Representative contacted the member directly on 02/21/2024 to discuss their concerns in detail. The Member Services Representative was not able to reach the member by phone so a secure email was sent with the plan’s findings in detail on 02/21/2024.  We appreciate the inquiry and we believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you

• Initial Complaint

  12/05/2023

  Complaint Type:

  Billing Issues

  Status:

  Resolved

  More info

  I had an issue with caresource about 2 claims almost a year. I called over 7 times and they always give me a different answer and tell me it can take almost up to 60 days. I was supposed to start a job January but I had surgery and started in March. My job accidentally started my benefits on January 30th and ended it at 12am on 31th because the system caught the mistake. I have a letter from that insurance that they sent over and I have saved where it states the dates and caresource still says I had a primary insurance for my Jan 31st appointment which I didnt! They tell me I cant talk to a manager and one of the claims went to collections. I call and they cant find the letter or tell me something different. The process is very disorganize and I don’t want my second bill to go to collections too. I been in calls between both insurances and caresource says they cant call them. This is an issue that can be solve in 10minutes if they would get in contact with each other or kept my letter where it says the end date of the mistake the other insurance did in my file. Caresource even told me I have to get a bill sent to Anthem , have them deny it and then get it sent to them for approval but Anthem said that they cant accept the bill because i was NOT active with them on the 31st!! As soon as 12am on the 31st started I no longer had insurance. Every time I call is someone new, they cant find my old information and tell me they cant do much beside me filing a claim again. I already have 1/2 bills in collections because no one wants to help me. One time they even said they tried to reach me through my phone and letters home. I didn’t receive anything. I always have my phone beside me because of work!

  Business response

  12/07/2023

  Upon review of the concerns noted in the member's complaint and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly on 12/07/2023 to discuss their concerns in detail. As a result of the discussion with the member, CareSource was able to fully resolve the issue and the member expressed no additional questions or concerns at that time. We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information.  Thank you.

  Customer response

  12/08/2023

  
  Better Business Bureau:
  
  I have reviewed the response made by the business in reference to complaint ID ********* and find that this resolution is satisfactory to me.  Caresource indicated that they paid the bills yesterday (December 7th, 2023). I called the companies but they said it can take 4-8 weeks for the payment to show up so I will follow up with them then to make sure that its paid. 
  
  Sincerely,
  
  ******** ******* ******

*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩