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

56 total complaints in the last 3 years.
16 complaints closed in the last 12 months.

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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: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.
Initial Complaint
Date:01/05/2023
Type:Service or Repair 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.
I paid CareSource a total of $340.01 over the course of about two months and never received any service from them. After SEVERAL phone calls, I was promised a callback and my issue resolved three different times and never heard back. Here is the series of events with rough dates: Late October 2022: I enrolled for coverage beginning November 1st 2022, paid my premium, and received a confirmation e-mail for payment. Early November: I receive an e-mail that I should enroll for 2023 coverage, which I do. I do not make a payment because I am told it's not due until January 1st 2023. November/December: I receive an invoice in the mail for $8.28, or the exact difference between the premium for my 2022 and 2023 plans. I call CareSource and find out my 2022 coverage never actually began, and somehow my payment for my 2022 plan was applied to my 2023 plan even though I didn't enroll in my 2023 plan until after I paid my first 2022 premium. I was not contacted about this mistake and assumed I had coverage. I am told the associate will fix this error immediately and will call me as soon as my coverage is active. I never receive a call, but I received an invoice for over $400. I call again, and confirm my coverage is still not active. I cancel my 2022 coverage as I never received any service and do not want to pay for it, which the associate advised me to do. Late December: I am advised to pay the $8.28 so my 2023 coverage can begin Jan 1. I pay it and receive a confirmation e-mail. January: My coverage did not begin as promised. I notice a $120.92 charge on my account, I have no idea what it's for, but I pay it in hopes this nightmare is over. Still, I have no health coverage. I call again, a ticket is submitted for my issue, and I am told I will receive a call within 24 hours. I did not receive a call. January 4th: I have cancelled my 2023 coverage and am seeking a refund because I never received any health care services from them due to no fault of my own.
Business Response
Date: 01/12/2023
Thank you for sharing Ms. ******** complaint. To protect the member’s PHI, the CareSource resolution was provided to the member by a CareSource Specialist who contacted and spoke with the member on 1/11/2023, member advised they had no further questions. The member also received a secure email with the resolution. CareSource appreciates the inquiry and believe this resolves the matter. Please contact us if we can provide any additional information.
Customer Answer
Date: 01/12/2023

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:01/05/2023
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.
This is a general complaint regarding the business practices and customer service of the company. I enrolled with CareSource in August 2022 using HealthCare.gov. They initially enrolled me in a different plan than the plan I signed up for on the Marketplace. I called to have it corrected and after speaking to multiple agents and being on hold for over an hour, I was assured it was corrected. It was not. I called back to try to have it corrected again and the next person I spoke with informed me that there were no notes on my file and we started from scratch. The issue was still not resolved. Then comes the issue of my 2023 enrollment. They messed it up multiple times and each time I waited 45-60 minutes on hold I was connected to a representative who had no idea what they were doing and could not find any information on my policy or enrollment. The final straw was a 1:40 minute phone call where I was repeatedly told that I did not have an active enrollment until someone else was able to pull it up. Even with the enrollment pulled up, they were unable to assist me same day. I called at 3:00pm and by 4:40 the issue was still unresolved. It is truly one of the poorest run companies I have ever worked with and the employees are completely untrained and incompetent.
Business Response
Date: 01/26/2023
Upon review of the concerns noted in the members rebuttal and to protect the members PHI, a Member Services Representative contacted and spoke to the member directly to discuss their concerns in detail. As a result of the discussion with the member, we were able to fully resolve the members issue. We appreciate the inquiry and believe this resolves the issue. Please contact us if we can provide any additional information. Thank you
Business Response
Date: 02/02/2023
Good afternoon,

Unfortunately, CareSource has been unable to satisfy the member. He is requesting something we are unable to do, provide a refund. Mr. ****** states he didn’t receive any invoice or information showing that his plan changed and that his initial payment was required. The member feels that we should refund the $334.47 back because he never received anything for it. A CareSource Issue Resolution Expert explained this was the effectuation payment for which the member stated he never received communication for it until he called the pay by phone line. Upon review of the member’s call history, we found that the member spoke with a Sales Representative, who informed him that his plan information was changing (************) from the previous account member had.

Mr. ****** reiterated that he was upset about the lack of communication and or CareSource reaching out to him whether by phone or letter advising plans had been updated as well as the representatives he is speaking with. We apologized to the member for any miscommunication from the past and reiterated the actions taken internally to ensure he would have a better experience moving forward.

Please find attached the letters sent to the member’s address on file regarding his health insurance with CareSource.

Should you have any questions or require additional information feel free to contact Member Services: 1-855-202-0729 (TTY: 1-800-255-0056 or 711), Monday – Friday 7 a.m. – 7 p.m.
Customer Answer
Date: 02/02/2023

Complaint: ********

I am rejecting this response because:

They refuse to offer any real solutions to make up for the terrible service and lack of communication/follow through. I do not wish to speak with them again as I believe they will continue to be ineffective in their resolutions.

Sincerely,

**** *******
Initial Complaint
Date:12/29/2022
Type:Product 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.
On November 2, 2022 I requested a refund in the amount of $462.51. My primary care physician was not in network and I had to select a different insurance. I canceled on 11/04/2022. CareSource says the money was refunded electronically on 11/09/2022. I HAVE NOT received the refund as of 12/29/2022. I contacted CareSource and opened at least 4 to 5 different "cases" to resolve the issue. CareSource told me that I needed to contact my bank that they had refunded the money and they would not refund again. This was after I provided documentation proving the amount refunded was not in my account. They refused to tell me the full account number or even let me speak with the department that actually handles the refunds. CareSource told me that they refunded the money electronically gave me some sort "tracing" number. My bank said they did not know what that number was and they could not use it to track the refund. Also, I have NOT received a paper check to this day. The dispute is that CareSource will not go back and track where the refund went. I provide documentation that the amount refunded was not in my account. I also sent them the back of the card I used proving that there was not a 1-800 number to call. It is a small local bank. I NEED my money back so I can pay for health insurance going forward. This is HORRIBLE business on their part and I just want my money back so I can move on. If any additional information is needed please let me know. ********* *******
Customer Answer
Date: 01/06/2023
Hello,

I wanted to let you know that the Billing Department at CareSource called and the refund was sent to my bank. Thank You so much for your help with this.

Kind Regards,

**** *******

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