The services of CareSource health insurance include coverage for all medically necessary services, as the company's website explains. CareSource outlines specific services in the member handbook that it provides to individuals enrolled in one of its insurance plans.
Some services that may be covered under CareSource may require a referral, according to the company website. Those services include diagnostic services performed outside the primary care physician's office. Specialist services must also be approved prior to the insured receiving those services.
Other services that require a referral include outpatient hospital services, physical and occupational therapy, and renal dialysis. Some services require both a referral from the patient's primary care physician as well as a prior authorization from CareSouce. The patient's primary care physician asks for a prior authorization form from CareSource Insurance before scheduling the services for the patient, according to the company's website. In some cases, CareSource may allow a specialist to make the referral on the patient's behalf.
The services that require both referrals and pre-authorizations include some health services, in-patient hospital services except for emergency room admissions, nursing facilities for short-term stays and hospice care. Other services that require a referral and pre-authorization include prosthetics, developmental therapy, ambulance transportation and some pain management services, according to CareSource.