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

60 total complaints in the last 3 years.
15 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:05/22/2023
Type:Customer Service Issues
Status:
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.
Unsolicited and harassing phone calls, immediately asking for my private information without any explanation as to why.
Business Response
Date: 05/30/2023
Upon
review of the concerns noted in the complaint, a Member Services Representative contacted the conplaintant directly
on 5/26/2023 and 5/30/2023 to discuss their concerns in detail. The Member Services
Representative was not able to reach the complaintant by phone so a secure email was
sent. The Complaitnat was advised we were not able to locate them anywhere in the system and information was requested to assist with stopping the unwanted contact. To date the complaintant has not responded to the voicemails or emails. We appreciate the inquiry but without the complaintant contacting the plan we will not be able to research and assist. Please contact us if we can provide any additional
information. Thank you
Customer Answer
Date: 05/30/2023

Complaint: ********

I am rejecting this response because:

Sincerely,

**** *******
Customer Answer
Date: 05/31/2023
They just kept calling me after I asked them not to. The whole complaint was the constant calling, so what do they do, just keep calling me. Send me a letter if you need to talk to me, don't call me, and ask me to identify myself with no reason. Thank you
Business Response
Date: 05/31/2023
In response to the complaintants rebuttal. A letter can not be sent as there was no address provided in the original complaint as well as we do not have this person in our system. An email address was provided which the Member Rep did send an email but it went unanswered. Please contact us if we can provide anything further. Thank you
Customer Answer
Date: 05/31/2023

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.

Sincerely,

**** *******
Initial Complaint
Date:04/14/2023
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 bought a marketplace caresource plan in October 2022 to cover my sons ABA services because my employee based insurance does not cover ABA. Once my sons ABA started on December 27th, 2022, my bill claims started getting denied, stating the claims needed to be ran through his primary insurance first. When I questioned the member line about what insurance they had on file as primary, I found out they had entered the incorrect information of an Indiana Health Network plan, which we do not have. I explained we had SIHO and Caresource and that was it. I called the member line 3/3/23, 3/6/23, 3/21/23, 3/29/23. Every time I ended up needing to speak to a supervisor because no one could fix the issues of simply updating the proper information of Siho being primary, and caresource being secondary. We now have $65, 000 in medical bills not being accepted because of Caresources mistake. Now that the bills are being refiled since the information is now correct in Caresources file, bills are still being denied due to the claims, "not being filed in a timely manner," even though it was Caresources fault for making the mistake.
Business Response
Date: 04/25/2023
Belongs to Caresource Insurance.
Business Response
Date: 05/01/2023
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 4/28/2023 to discuss the 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
Date:04/11/2023
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.
Since January of this year I have been getting calls intermittenly from Care Source from one of there representatives asking for ***** so she can discuss his account. I don't know anyone by that name. And Im not sure how they got my cell phone number. I have contacted them numerous times stating that I am not *****, No one lives with me named *****, and that the phone number they have doesn't belong to this *****. Everytime one of the other representatives I speak with tells me they have made a notation on the account that it is the wrong number. Only to have the same representative call me the very next day asking for ***** once again. I am to my witts end with them. My number is registered on the No Call List. I want my number removed from this acount with this so called *****. And for them to stop calling and harassing me.
Business Response
Date: 04/19/2023
Upon review of the concerns noted in the
complaint a Member Services Representative researched the systems but was not able to locate a member
with the name referenced in the complaint. The Member Services Representative
tried to reach the complainant by secure email and phone several times to gain more
information, but to date no response from the calls or emails has been
received. Per the complainants request in the complaint, the Representative did complete a Do Not Call Form for the phone
number referenced.

We appreciate the inquiry and believe this issue resolved. Please contact us if
we can provide any additional information.
Thank you
Initial Complaint
Date:03/31/2023
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.
Not receiving $234.00 back on my bank card. I oldy received $96.00 back on 1-20-23. I've called serveral times, each person I called said 30 days I would receive my $234.00 to review the problem after the 30 days. I called they said that they were not giving it back to me because they were going to but $234.00 on my October payment. They told me 10-01-2022 that I didn't owe anything I had no Insurance from 10-2022 to Jan 2023.
see Attached document
Business Response
Date: 04/25/2023
Upon
review of the concern noted in the non-members complaint, and to protect
the members PHI, a Member Services Representative contacted and spoke to the
member directly on 4/24/2023 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 understood and had no additional questions or concerns. We
appreciate the inquiry and believe this resolves the issue. Please contact us
if we can provide any additional information. Thank you
Initial Complaint
Date:03/21/2023
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 keep getting mail from CareSource about important plan information when I am not with CareSource at all as I dropped CareSource a long time ago they should not be sending me important plan information when they do not have myself as a member.
Business Response
Date: 03/24/2023
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 3/24/2023 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 on 3/24/023. The Representative also mailed a letter to the address found in this complaint with the plan's findings. We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information. Thank you

Customer Answer
Date: 03/24/2023

Complaint: ********

I am rejecting this response because: The letter will be returned to sender and a simple WE WILL NOT SEND ANY MAILINGS again will suffice case not resolved

Sincerely,

**** ******
Business Response
Date: 03/30/2023
No additional outreach will be made to this member from CareSource. Thank you.
Initial Complaint
Date:03/14/2023
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.
I have had Caresource Marketplace insurance for years; however, I was offered insurance through an employer for part of 2022 and took that plan when it was available. That insurance ended 10/1/22, when I went back to Caresource Marketplace. I've had nothing but trouble since - they lost my payment in Jan 2023 and denied my claims all month. I spent many hours on the phone with them and spent $$ to mail them proof of my payment. They have also been denying all my claims for "Anthem primary insurance". Again, I have not had Anthem through my employer since 10/1/22. It's March 2023. Again, I had to Priority Mail them a letter to fix this but when I called to confirm it was fixed, the gentlemen I reached did not understand my question (did not speak English well) and just kept saying "resubmit claim?", which I finally said yes to. I had to go back and forth on this one claim between Caresource and the doctor's office with six phone calls to finally get the doctor's office to resubmit the claim - they wanted confirmation that my "Anthem primary" issue was fixed with Caresource but I never could get that confirmation from them. My favorite and latest issue is that I pay additional for dental care with this insurance and Caresource has now canceled the dentist I usually go to (no longer "in-network") and I cannot find any that are in-network near me. I wound up at a doctor's office today because Caresource gave me their name as an in-network dentist. I can't find a single dentist in-network with them and I'm paying extra each month for dental insurance. Every time I call their "find a doctor" help or look online at this listing, I get names and numbers of dentists who are not in-network with them. One dentist was arguing with me that they were in-network with Caresource Marketplace and then I called Caresource and they said no on that one... UNBELIEVABLE! I have to work to pay their bills but I'm busy doing their job for them and my teeth are past due to be cleaned.
Business Response
Date: 03/22/2023
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 3/22/2023 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
Date:03/07/2023
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.
My complaint is with ******* Caresource Marketplace. I am scheduled to have a steroid nerve block on Friday March 10th. They told my provider that they will not release their pricing information and details to them. I called and spoke to a supervisor ** * on 3/7/23 call reference # ******. She also said that no pricing information can be given. She states that a claim has to be filed and then they can release their pricing information. I asked how am I supposed to know if I can afford the service or not and she said that is a discussion I should have with my provider. I am sure this is illegal in some way. Why am I paying $1000 a month for insurance that doesn't cover anything and cannot even tell me how much something costs?
Business Response
Date: 03/13/2023
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 3/10/2023 to discuss their unresolved concerns in detail. As a result of
the discussion with the member, we believe we were able to fully resolve the issue. We
appreciate the inquiry and believe this resolves the concerns. Please contact us
if we can provide any additional information. Thank you
Initial Complaint
Date:01/26/2023
Type:Customer Service Issues
Status:
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.
Have been recieving illegal robocalls from this company.
Business Response
Date: 02/02/2023
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 01/30/2023 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 Answer
Date: 02/03/2023

Complaint: ********

I am rejecting this response because:
Although I was indeed contacted by this business, their response was not enough for me. Because this type of robocall is illegal, I would like to discuss this matter further with them and be provided the names of their call centers that they contract so I may follow up directly with them.

Sincerely,

***** ********
Business Response
Date: 02/08/2023
Upon review of the concerns noted in the member's follow-up complaint and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly on 02/06/2023 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 Answer
Date: 02/08/2023

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.

Sincerely,

***** ********
Initial Complaint
Date:01/23/2023
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 had CareSource for a few years, however, last year 2022, when applying for coverage through KYNECT, the staff entered me into the wrong plan (Bronze Dental & Vision - $101.61 mthly) when I requested Bronze Only ($69.25 mthly) and when she went back in to correct it, it was too far into January & it would not allow coverage to start until March 1, 2022. Therefore, I had no coverage for January. I called CareSource & spoke to a CareSource Rep on the phone & explained the situation and on January 28th, that representative took a payment from me in the amount of $101.61 w/ payment confirmation ID#025419 for an insurance plan for February and sent an email to start my plan for the Bronze Dental & Vision Plan for the month of February only. The correct plan I requested was to start on March 1st. I had many doctor appointments scheduled in February and my insurance was fine. On or about October 17th, 2022, CareSource reversed ALL insurance payments for the month of February and now I'm receiving ALL bills from my providers. I have spent HOURS & HOURS since October speaking to multiple CareSource Reps and just a handful of them were able to track down my payment on January 28th. They could see that a payment was made on that day for that amount.
The last representative stated that she could see my payment and finally filed an Appeal on November 22nd. I received a letter in stating they would look into it and would hear back in 30 days. It is now end of January and after a few more calls, CareSource is denying ever receiving anything from me and denying my coverage.
Business Response
Date: 02/02/2023
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 2/1/2023 to discuss their concerns in detail, however, the Member Services Representative
was not able to reach the member by phone. A secure email was sent with the
plan’s findings in detail on 2/2/2023. We
appreciate the inquiry and believe this resolves the issue. Please contact us
if we can provide any additional information. Thank you
Customer Answer
Date: 02/02/2023

Complaint: ********

I am rejecting this response because I paid for an nsurance policy for February to cover me until my plan I selected started on March 1st.
Please see attached documents of the payment confirmation on both my bank statement & payment confirmation # I received from CareSource on January 28th.
A CareSource Rep contacted me yesterday to let me know they were reviewing complaint, but had no clue what the situation is. She told me she only was to call me to inform me my case was being looked at. She had no info on the complaint whatsoever. Therefore, there was nothing close to a resolution on this case.
I am really disappointed in the handling of this.

Sincerely,

******* *******
Business Response
Date: 02/08/2023
Thank you for sharing Ms *******'s complaint. Upon review of the concerns in the members rebuttal and to protect the members PHI a secure email was sent to the member on 2/7/2023 advising of the plan's findings and providing information to reflect the findings. We appreciate the inquiry and believe this resolves the matter. Please contact us if we can provide any additional information. Thank you
Customer Answer
Date: 02/08/2023

Complaint: ********

I am rejecting this response because CareSource is flat out wrong in this matter. I am currently working w/ KYNECT on my CareSource healthplan from February 2022, I spoke w/ a KYNECT agent in January of 2022 to enroll in a healhtplan, The agent accidently enrolled me in the Bronze, Vision & Dental for $101.61 per month (w/ tax credit) However, I had requested Bronze basic @ $69.25 per month (w/ tax credit). The agent cancelled enrollment on the Bronze Vision & Dental and when she tried to enroll me in the Bronze Plan, the system would not allow my insurance to start w/ Bronze Basic Plan until March 1st. Therefore, Caresource took a payment from me on January 28th in the amount of $101.61 for the Bronze Vision & Dental for the month of February only until the Bronze Basic kicked in on March 1st. Now, Caresource is stating that the payment made on January 28th was an overpayment and sent me a refund check just last week.......Conveniently after I started this complaint.
CareSource is stating that this case is resolved, but far from it. CareSource needs to acknowledge that I had a separate insurance plan for the month of February and my records show that. There was no "overpayment" made on January 28th, I paid for a plan and in October 2022, CareSource reversed all insurance payments.

Sincerely,

******* *******
Business Response
Date: 02/16/2023
Thank you for sharing Ms. *******’s complaint. To protect the member’s PHI, the CareSource resolution was sent to the member via secure email on 2/16/2023. CareSource appreciates the inquiry and believe this resolves the matter. Please contact us if we can provide any additional information.
Initial Complaint
Date:01/11/2023
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 spoken to a representative 3 times now. I called in later November 2022, mid-December 2022, and early January 2023in regard to canceling my coverage. I was assured that I had nothing else to do and my coverage would end in 2023. It's now Jan 11th, 2023 and I've been charged once for insurance I canceled multiple times.

I've been on hold for roughly 6 hours collectively over 3 phone calls and not a single employee seems to be trained in resolving basic issues. I will not be paying these illegitimate charges.
Business Response
Date: 01/17/2023
Thank you for sharing *** ********** complaint. On 1/13/2023 a Customer Care Resolution Specialist contacted and spoke with the member to advise of the plan's findings. Also the resolution was sent to the member via
secure email on 1/13/2023. CareSource appreciates the inquiry and believe this resolves
the matter. Please contact us if we can provide any additional information.

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