Complaints
This profile includes complaints for CareSource's headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 63 total complaints in the last 3 years.
- 18 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. 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.
Initial Complaint
Date:10/07/2025
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Their billing - One month they bill for one month then next billing they are charging double. I have contacted CareSource and asked that a statement be generated, was told they can’t provide that. Sent on 9/10/25 an accounting sheet what they have charged and what I have paid. This paper proved that they have over billed. When we looked at their ratings the major complaint was their billing. Upon one phone call they said I hadn’t paid for this past June. I told them my check had been cashed, they needed proof from bank that I paid it even though they had cashed it. So I provided a copy of bank statement and requested my account to be audited, who knows what else is messed up. That is bulk of complaints, their billing.Business Response
Date: 10/23/2025
Thank you for sharing this complaint.
Upon review of the concerns noted in the members complaint and to protect the members PHI, CareSource staff contacted and spoke to the member directly on 10/08/25 to discuss their concerns in detail. We reviewed the payment and invoicing history and confirmed that premium payments are due in advance for the upcoming month. We also sent the member’s billing history via mail with an offer to review the information line by line over the phone. We have made multiple attempts to contacts the member to review the items line by line but have not yet been able to reach the member to do so. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.Initial Complaint
Date:09/24/2025
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Recieved an EoB that they processed my medial claim 11 months after it was submitted by Promedica. How a HEALTHCARE INSURANCE company is operating in this fashion is CRIMINAL.Business Response
Date: 09/29/2025
Upon reviewing the member's previous claims and call history, it was determined that the EOB received was for a claim that had previously processed. The claim initially processed in November of 2024. We contacted the member via phone on 09/25/2025 and advised that claims can reprocess for any number of reasons, however, this claim did not change any cost sharing for the member. The cost share that shows on the most recent EOB reflects the same amount as November of 2024, and is not an additional charge to the member. The member understood and accepted this explanation.Initial Complaint
Date:09/23/2025
Type:Customer Service IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
CareSource offers Healthy Rewards incentives for yearly screening mammograms, issuing a $25 reward once they receive a claim that for a screening mammogram. On September 4, 2025, I had a diagnostic mammogram after noticing a change in my breast.
On September 23, 2025, I called CareSource to confirm whether a diagnostic mammogram would qualify for the $25 Healthy Rewards incentive they offer. The representative informed me that because the claim is billed as a diagnostic mammogram instead of a screening mammogram, I would not receive the incentive. This creates an issue because the diagnostic mammogram serves the same preventive purpose as a screening. Additionally, the medical facility where I had my mammogram explained that after a diagnostic mammogram is performed, no doctor will order, nor will any facility perform, a second screening mammogram back-to-back, since both tests serve the same purpose of detecting breast cancer.
I understand CareSource has up to 60 days after a claim is paid to issue Healthy Incentive Rewards, but I am being proactive to make sure this is addressed. A mammogram is a mammogram, whether diagnostic or screening—the purpose is breast cancer detection. Patients should not be penalized simply because their doctor ordered the more appropriate test.
I am requesting that CareSource recognize my diagnostic mammogram as qualifying for Healthy Incentive Rewards, especially when they replace a screening, and issue my reward.Business Response
Date: 09/23/2025
Thank you for sharing ***** ***** complaint. Upon review of the concerns noted in the members complaint and to protect the members PHI, a Customer Care Specialist contacted and spoke to the member directly on 09/23/2025 to discuss their concerns in detail. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.Customer Answer
Date: 09/23/2025
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
Date:09/22/2025
Type:Service or Repair IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
The Company issued me a charge card for extra healthy food purchases each month as a benefit to being a policy holder. Everytime I go to use the card it is rejected by the store. I have complained numerous times to the Company but nothing changes.Business Response
Date: 09/30/2025
Thank you for sharing **** ********’s complaint. Upon
review of the concerns noted in the members complaint and to protect the
members PHI, a Customer Care Specialist contacted and spoke to the member
directly on 09/30/2025 to discuss their concerns in detail. We appreciate the
inquiry. Please contact us if we can provide any additional information. Thank
you.Customer Answer
Date: 10/01/2025
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
Date:09/03/2025
Type:Customer Service IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
All employees are foreign not the issue English is not first language very hard to communicate. I ask question 1 and when they confirm the reason what they repeat had nothing to do with the i initial question. Spending hours on the phone just to be told the incorrect information. You can call ask a question to 5 different people and get 5 different answers... this has prolonged my prescription refill and caused health issues.Business Response
Date: 09/09/2025
Thank you for sharing this
complaint.
Upon review of the concerns
noted in the members complaint and to protect the members PHI,
CareSource staff contacted and spoke to the member directly on 09/04/25 to
discuss the concerns in detail. We reviewed the account and assisted with the
pharmacy issue by contacting the provider to have them submit an authorization
request. The member has now filled the medication. We apologized for the experience
that she had with Member Services. We reviewed the calls and identified that
there was an error with an override that was placed for a medication which
prevented the member from being able to fill her prescription. We have
addressed the issue with the representative in question as well as reviewing
our processes that may have led to the experience. We appreciate the inquiry.
Please contact us if we can provide any additional information. Thank you.Initial Complaint
Date:08/25/2025
Type:Product IssuesStatus:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I paid Care Source $1321.92 on 12/6/24. Please see attached bank statement for proof of payment. This was my health insurance premium for the full year of 2025. 12 months at a rate of $110.16 per month. In July, I cancelled my health insurance coverage because I moved from Ohio to New Hampshire as required by the Affordable Care Act. CareSource cancelled my coverage on 7/31/25. Please see attached screenshot from my account that proves my coverage was cancelled before August. I would like CareSource to send me a refund of $550.80 for 5 months of coverage at $110.16 per month.
I spoke with Janine from Care Source on 8/5/25 and she said my refund of $550.80 would be send to my Park National Checking account within 7 business days. I sent CareSource an email via their portal a later to follow up.
To date, CareSource has not sent me a refund.Business Response
Date: 08/28/2025
Thank you for sharing this complaint.
Upon review of the concerns noted in the
members complaint and to protect the members PHI, CareSource staff
contacted and spoke to the member directly on 08/26/25 to discuss their
concerns in detail. We reviewed the payment and invoicing history and confirmed
that the member received a partial refund of $330.48. We apologized for the
inconvenience and advised that the remaining $220.32 will be refunded. We
contacted the member again on 8/28/25 to advise the remaining $220.32 has been
refunded electronically. We appreciate the inquiry. Please contact us if we can
provide any additional information. Thank you.Customer Answer
Date: 09/02/2025
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
Date:08/15/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I currently have a lawyer at ******** Law Firm handling surrogation at Caresource. They have a lein with my personal injury case. My car accident occurred in Jan 22,2023. The status of limitation is two years. The lein should be lifted and Caresource state how much they are paying for fees with my personal injury caseBusiness Response
Date: 08/18/2025
Thank you for sharing this complaint. After reviewing the concerns outlined in the member's complaint and to ensure the protection of their PHI, a Customer Care Specialist reached out and spoke with the member directly on August 18, 2025, to discuss their concerns in detail. We appreciate your inquiry. Please feel free to contact us if you need any further information. Thank you.Initial Complaint
Date:06/16/2025
Type:Customer Service IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I NEED WRIST SURGERY. I HAVE DONE EVERYTHING THAT DR. ******** HAS ASKED OF ME, MY HAND /WRIST HAS NOT GOTTEN BETTER. WE SUBMITTED MY INFORMATION TO CARESOURCE IN ORDER FOR ME TO HAVE SURGERY. A DR ******** WHO HAS NEVER SEEN OR TREATED ME MADE A DECISION THAT I DON’T NEED SURGERY. I CAN BARELY HOLD THINGS IN MY RIGHT HAND ( I AM RIGHT HANDED ). I AM LOSING MOBILITY AND I AM OVER MEDICATING ON MY HEART MEDICATION. I AM IN A LOT OF PAIN, TYLENOL, EXCEDRIN, AND ANY OTHER OVER THE COUNTER MEDICINE I HAVE TRIED IS NOT WORKING. I AM ALLERGIC TO NSAIDS SO I CANNOT TAKE THEM. I ALSO AM LACKING SLEEP FOR BEING IN PAIN.. I NEED THIS SURGERY TO HELP MY HAND/ WRIST. THE SURGERY I WAS TO HAVE IS PROXIMAL ROW CARPECTOMY. THE SURGEON IS DR. ******* ********. DR ******** DOES NOT KNOW A THING ABOUT ME OR MY SITUATION. CARESOURCE IS VERY WRONG FOR THIS DENIAL..Business Response
Date: 06/23/2025
Thank you for sharing the member's complaint. We have reviewed the concerns and, to protect their Protected Health Information (PHI), a Customer Care Specialist spoke directly with the member on 6/20/2025 to address their issues. We appreciate your inquiry. Thank you.Initial Complaint
Date:05/20/2025
Type:Service or Repair IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have insurance through CareSource and I have type 2 diabetes. I have tried to get my medication for nearly 3 weeks and I have had no success. CareSource demanded a prior authorization to fill my medication, however, when I had my former primary caregiver from a different state, send a prior authorization, the insurance company would not accept it. it has been thrown out multiple times. After waiting three weeks to get my medication filled I finally had to pay out-of-pocket. What is the use of having insurance if I have to pay out-of-pocket anyway?Business Response
Date: 05/30/2025
Upon review of the concerns noted in the members complaint, and to protect the members PHI, CareSource staff contacted and spoke to the
member directly on 05/22/25 to discuss their concerns in detail. We reviewed the
member’s pharmacy concerns, and offered to call back once a Prior Authorization
was on file for the member’s medication. We contacted the provider office to
obtain that authorization. A Prior Authorization was received on 05/29/25. We
spoke with the member and advised that it was received and pending. As soon as
the authorization processes, we will proceed with attempting a refund of the
money paid out of pocket. We appreciate
the inquiry. Please contact us if we can provide any additional information.
Thank youCustomer Answer
Date: 06/20/2025
Hi,They partially solved the problem. They did finally get a Prior Authorization form and approved the medication. But, they haven’t refunded the money I had to pay out of pocket yet.Thank you,
******* ****Business Response
Date: 06/27/2025
Upon review of the concerns noted in the members complaint, and to protect the members PHI, CareSource staff attempted to contact the member by phone on 6/23 and 6/27but were unable to reach her. We followed up via email on 6/23 providing the member with the form and instructions to request reimbursement from Express Scripts. As previously discussed with the member while facilitating the submission of the prior authorization needed for the medication, she filled the prescription at an out of network pharmacy and was advised we cannot guarantee reimbursement. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you!Initial Complaint
Date:05/01/2025
Type:Billing IssuesStatus:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- 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.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I terminated the policy with caresource before it was used because I didn't sign up for it. A provider made sure it was terminated before they would see me. So I know it was terminated. Now they are billing me for 5 grand or more. This is crazy. I called at least 3 times to cancel this policy as well. Now I'm stuck with bills from other providers as wellBusiness Response
Date: 05/09/2025
Thank you for sharing this
complaint.
Upon review of the concerns
noted in the members complaint and to protect the member’s PHI, CareSource
staff tried to contact Mr. ******* several times to discuss their concerns but
were unable to reach them. We followed up via email on 05/08/2025 to advise
CareSource isn’t able to terminate the coverage unless directed to do so by the
Federally Facilitated Marketplace (FFM). We have submitted a request to the
Marketplace for permission to do so. If we don’t receive permission, Mr.
******* will need to contact the Federally Facilitated Marketplace (FFM) to
request the coverage be terminated. Mr. ******* can reach out to them directly
to make this request, we are also happy to contact the Marketplace with Mr. Mangrum
to help get this request submitted. We
appreciate the inquiry. Please contact us if we can provide any additional
information. Thank you.
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