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Initial Complaint
07/05/2024
Complaint Type:
Product Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
Paid for the insurance and the first time I tried to use it my medication was not covered. Canceled coverage and only got a partial refund.
Business response
07/18/2024
Upon review of the concerns noted in the members complaint and to protect the members PHI, a Member Services Representative contacted the member via email on 717/2024. The Representative advised the member of the plans findings and what the member will need to do to receive a full refund. We appreciate the inquiry and believe this will resolve the issue. Please contact us if we can provide any additional information. Thank you
Customer response
07/18/2024

Complaint: ********

I am rejecting this response because: They said to call the Marketplace and have them retro the cancellation date. The Marketplace said that they cannot do that. So I've done what I can Caresource needs to refund the full amount and stop ripping people off.

Sincerely,

******* *******
Business response
07/23/2024
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 7/23/2024 to discuss the concerns in detail. The Member Services Representative was not able to reach the member by phone, so on 7/23/2024, a secure followup email was sent to the member advising a refund can not be issued without the Marketplace permission. The member was instructed to contact the Marketplace to cancel enrollment as the plan can not issue a refund with out a file from the Marketplace advising of the enrollment cancellation. Please contact us if we can provide any additional information. Thank you
Customer response
07/23/2024

Complaint: ********

I am rejecting this response because: This is the same response as before. Worded differently.

Sincerely,

******* *******
Initial Complaint
05/02/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
In early April, I contacted CareSource regarding a missing reward for completing a Bone Density Exam, listed on the MyHealthy Rewards website. However, I was informed by a customer service agent that I must be 65 years old to qualify, contrary to the stated eligibility of "adults age 50+" on the CareSource website. (please see attached screenshot). Furthermore, there are discrepancies in the information provided regarding cholesterol and colonoscopy screenings. According to the agent, these screenings are required once every 5 and 10 years respectively, contradicting the information on the website. (please see attached screenshots). I attempted to reconcile this discrepancy by requesting further clarification, but unfortunately, the agent was unable to provide an explanation. Subsequently, I requested written confirmation of eligibility and received a brochure a week later, confirming the exact information displayed on the website. On 4/19, after receiving the brochure, I spoke to a Supervisor who informed me that perhaps I received an old brochure and that she cannot control which brochure I receive, nor can she contact the rewards or brochure department directly. She assured me that she would seek clarification and promised to call me back within 2 days. However, as of May 2nd, I have not received any communication from Joni or any other representative from CareSource. It is very frustrating to encounter so much difficulty in resolving what should be a straightforward matter. To ensure clarity and consistency moving forward, I kindly request official documentation detailing the following: 1. Eligibility criteria for rewards associated with specific health screenings, including but not limited to Bone Density Exams, cholesterol screenings, and colonoscopies. 2. Age requirements for participation in the MyHealthy Rewards program and eligibility for rewards. 3. Frequency and timing of screenings required to qualify for rewards, as outlined by CareSource.
Business response
05/10/2024
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 5/10/2024 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
Customer response
05/10/2024

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
04/30/2024
Complaint Type:
Billing Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I cancelled my healthcare insurance policy with CareSource on or about 12/15/2023 on the HealthCare.Gov internet site as required / directed. My user portal on the HealthCare.Gov internet site immediately posted that my policy with CareSource was cancelled. I contacted CareSource on or about 12/15/2023 to notify them of the cancellation via the HealthCare.Gov internet site. Their rep informed me that they could not update my account until notified by the HealthCare.Gov system. I asked CareSource to note my account regarding the cancellation. When asked why I cancelled, I told them that I was switching to medicare beginning 1/1/2024. CareSource processed an auto bill / payment to my credit card account for about $339. I contacted them to reiterate that my policy was cancelled and asked that they stop processing auto billing and issue a chargeback. They refused. I filed a dispute with my bank and the charge was found to be made in error and my account was adjusted accordingly. In late January 2024, CareSource processed a new auto bill to my credit card for about $678. When contacted, they refused to stop processing auto billing and refused to process a chargeback. I filled a dispute with my bank and the charge was found to have been made in error and my account was adjusted accordingly. Around the same time, I contacted HealthCare.Gov for their assistance in resolving my issue with CareSource. They told me that they had a record of notifying CareSource of my cancelled policy. They also confirmed that my policy was cancelled timely, i.e., no premiums were due after coverage ended 12/31/2023. CareSource auto billed my account in late February ($1,017) and late March ($1,356). Those charges were successfully disputed via my bank. My bank took measures to prevent CareSource from processing any further auto bills. On 4/8/2024 CareSource billed me by USPS mail for about $1,695. CareSource continues to bill me for a cancelled policy.
Business response
05/09/2024
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 05/07/2024 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
04/03/2024
Complaint Type:
Customer Service Issues
Status:
Answered
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
I was giving the wrong member ID number. The one given to me was to my old Medicaid account. I used that number to pay what I thought was my marketplace account. Spent quite awhile on the phone with both Medicaid department and market place department with no success. I was told there is no way to make a payment on a Medicaid account but I did.. I have payment confirmation receipt that will be attached. I need that money either refunded or moved over to the correct account. Payment was paid to member id ***********. It should have been paid to *********.
Business response
04/26/2024
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 four diferent occassions twice on 4/25/2024 and twice on 4/26/2024 to discuss their concerns in detail. The Member Services Representative was not able to reach the member by phone so a voicemail was left advising for a return call to discuss the resolution. Also, an email was sent on 4/26/2024 advising we are trying to reach them to provide the resolution, and to contact member services. We appreciate the inquiry and hope the member will respond to our voicemail to resolve her issue. Please contact us if we can provide any additional information. Thank you
Customer response
04/30/2024

Complaint: ********

I am rejecting this response because: I regret to inform you that I was unavailable during the times of your attempted calls. My working shift conflicts with your business hours. With that being said, I spent nearly an hour on the phone with your representatives previously, and I encountered difficulty in resolving the issue and was given conflicting information. Therefore, I need to properly set up a time for further discussion. My primary objective is to address the matter of refunding the payment made to member ID number ***********. Again the payment confirmation receipts are attached (for the money paid to the account for member ID number ***********) for your reference.
Sincerely,

****** *****
Business response
05/14/2024
Good morning
The CareSource Member Services Representative was only able to reach via email. They advised the member that the payments had been applied to her marketplace account. By the time the Members Services Rep finished we could no longer provide any information through the BBB portal. We go believe after the emails this has resolved the members issue. Please advise if we need to provide any additional information. Thank you
Initial Complaint
03/14/2024
Complaint Type:
Service or Repair Issues
Status:
Resolved
The complainant verified the issue was resolved to their satisfaction.
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
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
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
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
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
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
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
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
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
The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
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

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