Business Profile

HMOs

CareSource

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.
17 complaints closed in the last 12 months.

If you've experienced an issue

Submit a Complaint

The 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:02/18/2025
Type:Customer Service Issues
Status:
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 received many calls from CareSource and informed them I do not have CareSource coverage (I have Medicare Advantage through United Healthcare, and I told them this). After at least the second call to them last week, I was assured I would not be called again. I have since received at least two more calls from them. I cannot simply block their calls as they use various, and apparently rotating, phone numbers. It is at this point, I feel, harassment. I just want the calls to stop.
Business Response
Date: 02/19/2025
Thank you for sharing **** ******** complaint. Upon review of the concerns noted in the members complaint and to protect the members PHI, an IRE Specialist contacted and spoke to the member directly on 02/19/25 to discuss their concerns in detail. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.
Initial Complaint
Date:01/06/2025
Type:Service or Repair Issues
Status:
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 called CareSource Insurance/Marketplace several times trying to resolve a fairly easy fix. I felt I was discriminated against. The person on the phone would not help me resolve my issue, they kept putting me on hold ( I could hear them speaking to co-workers and laughing.) I needed to update my current insurance so that I could see my doctor. I need to see my doctor and they want my current insurance card. I cannot afford to pay out of pocket for my healthcare needs. I have a screenshot of my wait time being over 1 hour, half of which time no one ever let me know what they were doing to help me. All I need is an updated insurance card and my account updated. I do not know what else to do. I have called several times and still no one will help me. This is affecting my medical / health needs. This is totally unacceptable.
Business Response
Date: 01/12/2025
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
01/07/24 to discuss her concerns in detail. We answered her questions about her
policy and apologized for the unacceptable experience that she had with Member
Services. We have reviewed the call with Member Services leadership and
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:01/02/2025
Type:Customer Service Issues
Status:
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.
#1 We were at ********* ****** Hospital, and I called CareSource Transportation, and they would not answer the phone period for me and my wife. And ****** Hospital has given us a blanket because it was cold outside. And I had to catch a ride fortunately for my cousin. We need our $30 back.
#2 Occasion it was at the (***** ********** **** *********). We called the CareSource Cab Company, and they hung up the phone, and then the Law Officer ****** called them, and they hung up the phone on him. And my wife is not very well BBB.
Business Response
Date: 01/08/2025
Thank you for sharing Mrs. ******* (*****) ***** complaint.
Upon review of the concerns noted in the members complaint and to protect the
members PHI, an IRE Specialist contacted the member directly on 01/03/25, 01/06/25,
and 01/07/25 to discuss their concerns in detail. The IRE Specialist was not
able to reach the member by phone so a letter was sent on 01/08/25. We
appreciate the inquiry. Please contact us if we can provide any additional
information. Thank you.
Customer Answer
Date: 02/11/2025
Mrs. ******** **
Caresource didn't send send me a letter on the 6,7,8 last month January Month. Please ask them to honer there business.
******* ***** ********* and
******* *****
Business Response
Date: 02/13/2025
Thank you for sharing ******* ***** complaint. Upon review of the concerns noted in the members complaint and to protect the members PHI, an IRE Specialist contacted the member directly on 02/11/2025, 02/15/2025, and 02/13/2025 to discuss their concerns in detail. The IRE Specialist was not able to reach the member by phone so a letter was sent on 02/13/2025. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.
Initial Complaint
Date:12/02/2024
Type:Billing Issues
Status:
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.
CareSource is refusing to pay for my hospital stay. They say "The request does not MCG criteria." I can't afford to pay this bill.
Business Response
Date: 12/11/2024
Thank you for sharing Joel Brown's complaint with CareSource.

Upon review of the concern noted in the member’s complaint and
to protect the member's PHI, a Customer Care Specialist contacted Mr. Brown
directly on December 9th to discuss the matter in detail.

Unfortunately, the Customer Care Specialist was unable to reach
Mr. Brown by phone; therefore, a secure email was sent on December 11th with
the resolution of his complaint.

We appreciate your inquiry and are committed to addressing our
members' concerns. Please do not hesitate to contact us if we can provide any
additional information or assistance.

Thank you,
Issue Resolution Expert Team

**** *** ***** ******* ** **********
Phone: **************
TTY Line: ************
******************
Initial Complaint
Date:11/25/2024
Type:Billing Issues
Status:
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.
Caresource denied deep cleaning gum and tooth on upper right and upper right quadrants. Picture shows bone loss on my upper teeth especially the front tooth. They approved deep cleaning on my lower teeth which there is less bone loss and it appears they have mixed the bottom and lower teeth up. In the picture you can see the one tooth has bone loss and they can either approve for this to be done or reimburse me after I have it done.
Business Response
Date: 12/05/2024
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 12/03/2024 to discuss their concerns in detail. We advised that we were unable to approve your requested service because the information submitted with the request did not meet the clinical criteria. We reviewed the authorization request and appeal with the member and advised her of her right to request an external review. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.
Customer Answer
Date: 12/11/2024

Complaint: ********

I am rejecting this response because: My dentist will not clean my teeth they insist on the deep gum and root cleaning with will leave me with a $600.00 bill. I've added a picture of my upper tooth which shows bone loss. I believe the dentist who initially reviewed this should have noticed the obvious bone loss on my upper teeth. I will not close this case, even if the approved this at this point I would not get to the dentist in time and have chosen a different insurance for next year.

Sincerely,

**** *********
Initial Complaint
Date:09/04/2024
Type:Service or Repair Issues
Status:
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.
8/30/24

CARESOURCE NEEDS TO PAY CLAIMS 2/27/24 $50 AND 3/7/24 $15 THAT FRANSCICAN SUBMITTED TO THEM. UNFORTUNATELY, If needed my next step is to file with a the Attorney General’s office and CFPB, AND INSURANCE COMMISSION against CARESOIRCE for legal purposes. AND CARESOURCE CAN'T TRY & PUT FALSE INFORMATION ON MY CREDIT.
Business Response
Date: 09/10/2024
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
09/04/2024 to discuss their concerns in detail. We educated the member on the
cost sharing responsibility for covered services under her policy. We
appreciate the inquiry. Please contact us if we can provide any additional
information. Thank you.
Customer Answer
Date: 09/10/2024

Complaint: ********

I am rejecting this response because:

Sincerely,

****** ******

Again, CARESOURCE NEEDS TO PAY CLAIMS 2/27/24 $50
AND 3/7/24 $15 THAT FRANSCICAN SUBMITTED TO THEM RECENTLY. UNFORTUNATELY, My next step is to file with the Attorney General's office AND INSURANCE COMMISSION against CARE SOURCE AS THE INSURANCE CARRIER FOR THE ABOVE. CARE SOURCE ALSO SHOULDN'T TRY AND PUT FALSE INFORMATION ON MY CREDIT which will be disputed.

***, B.A.
************
Business Response
Date: 09/13/2024
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 09/12/2024 to discuss their concerns in detail. The member indicated that Franciscan Health waived the copay, and she no longer has a balance. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.
Customer Answer
Date: 09/19/2024

Complaint: ********

I am rejecting this response because:

Sincerely,

****** ******
CARESOURCE AS THE HEALTH INSURANCE COMPANY SHOULD HAVE BUT FAILED TO NITIALLY PAID ANY AND ALL MEDICAL BILLS RELATED TO FRANCISCAN/HARRIS AND WITHOUT AND CREDIT BUREAU REPORTING. CARESOURCE REPRESENTAIVE JOY & MELANIE ARE THE BLAME AND DID NOY PROPERLY SERVICE THE INSURANCE ACCOUNT. AND AS LONG AS HARRIS/ANTHONY FRANCISCAN CEASE ANY AND ALL FRAUDULENT COLLECTIONS EFFORTS AND DO NOT TRY AND REPORT ANY FALSE AND FRAUDULENT INFORMATION TO THE CREDIT BUREAU.I ALSO JUST SPOKE TO HARRIS PHONE REP' ANGELO 866-309-5424 AND HE SAID THE HARRIS/ANTHONY FRANCISCAN ACCOUNT IS CLOSED.

*** CUSTOMER

Business Response
Date: 09/23/2024
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 09/04/24 to discuss their concerns in detail. We advised that the claims processed correctly with copays applied and educated the member on the cost sharing responsibility for covered services under her policy. An email was sent on 9/09/24 as follow up with a link to plan documents outlining the cost sharing responsibilities for the policy and the member’s right to file a formal complaint. We reached the member again on 09/12/24 and the member indicated that Franciscan Health waived the copay and she no longer has a balance. This issue is resolved and her rebuttal feedback has been received. We appreciate the inquiry. Please contact us if we can provide any additional information. Thank you.
Customer Answer
Date: 09/25/2024

9/25/24

Complaint: ********

I am rejecting this response because:

Sincerely,

****** ******

THANKS BBB, AS LONG AS CARESOURCE/HARRIS/ANTHONY FRANCISCAN CEASE ANY AND ALL FRAUDULENT COLLECTIONS EFFORTS AND DO NOT TRY AND REPORT ANY FALSE AND FRAUDULENT INFORMATION TO THE CREDIT BUREAU. I ALSO JUST SPOKE TO HARRIS PHONE REP' ANGELO 866-309-5424 AND HE SAID THE HARRIS/ANTHONY FRANCISCAN/CARESOURCE ACCOUNT IS CLOSED. CARESOURCE SHOULD OF NEVER GAVE FALSE BILLING INFORMATION TO HARRIS/FRANCISCAN. NEXT STEP, COMPLAINTS TO OIG/INSURANCE COMMISSION AGAINST CARESOURCE...
Initial Complaint
Date:07/29/2024
Type:Service or Repair Issues
Status:
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 confirmed torn labrum since 2017-18

I had surgery schedule to fix it on Monday 7/29/24 cause I am finally going through process to fix it.

Caresource denied my surgery when I can’t even left my arm, I can’t work, I can’t take care of my family.

They do not care about their clients or customers only about the financial aspect they can drag out making people not get the medical procedures they needed.
Business Response
Date: 08/06/2024
Upon review of the concerns noted in the
members complaint and to protect the members PHI, a Grievance Specialist contacted the member directly on 8/6/2024 to discuss their
concerns in detail. The Specialist was not able to reach
the member so a voicemail was left for a return call. On 8/6/2024, the Specialist sent a letter to the member advising of the plans findings and to please contact the plan if additional assistnce is needed. Please contact us if we can
provide any additional information. Thank you
Initial Complaint
Date:07/22/2024
Type:Customer Service Issues
Status:
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.
on going phone conversations over a period of several days, a contradiction of information concerning out of pocket and deductibles being met, resulting in problems getting prescriptions and provider care without a bill, we are told by caresource on one occasion that all our obligations have been met, then the opposite the next day and our Dr, and pharmacy are still trying to charge us a copay, issue number two, the pharmacy says that we dont need a preauth for a certain script, caresourse says that we do.
Business Response
Date: 08/15/2024
Upon review of the concerns noted in the
members complaint and to protect the members PHI, a Member Services
Representative sent a secure email to the member directly on 8/14/2024 containing the plan's findings in detail. The member has been advised if they are still having issues at the providers office to please contact Customer Service for assistance. As well if issues persist with pharmacy to please contact Customer Service for assistaance. Thank you for the inquiry and we believe this issue resolved. Please contact us if we can
provide any additional information. Thank you
Initial Complaint
Date:07/15/2024
Type:Billing Issues
Status:
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.
They charged me a huge amount of money for updated insurance I was never notified about in advance during the open enrollment period in 2023. They had never contacted me, by law, about the changes. No email (after I filed a complaint they admitted to having the wrong email), no phone call, text or snail mail. They first said they would refund my money but then rescinded and passed it to the Insurance Marketplace where I had to deal with them for 7 months including hearings. I was told to contact CareSource for the refund. I spoke to Bryan there who told me he would issue the refund based on the Insurance Marketplace decision but then I was told I have to go back to Insurance Marketplace. I was then on the phone with their hearing dept and received a letter stating I have to go to medicaid to get a letter stating they can tell me I qualify for medicaid from the time where they messed up from last year. I spoke to medicaid and they said it was not their problem, that they should not have even been mentioned. The Insurance Marketplace and CareSource just used this excuse to deflect from their mistake to screw me out of my refund. This is not acceptable. All of this was CareSource's and the Insurance Marketplace's fault and they need to be sued, held accountable and shut down. They both are some of the worst companies I've ever dealt with. They screw the customers, don't rectify their errors or accept their mistakes. They are being reported to the attorney generals office, better business bureau, the media and SEC. Stay away from them at all costs.
Business Response
Date: 07/24/2024
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 on 7/22/2024 to discuss
their concerns in detail. But once the Representative made the introduction the member disconnected the call . A letter detailing all information regarding the issue was sent to the member on 7/23/2024. Please contact us if we can provide any additional
information. Thank you
Initial Complaint
Date:07/05/2024
Type:Product Issues
Status:
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.
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
Date: 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 Answer
Date: 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
Date: 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 Answer
Date: 07/23/2024

Complaint: ********

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

Sincerely,

******* *******

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