CareSource has announced changes to its market and product offerings effective 2027. Agents and brokers with clients enrolled in CareSource plans in Indiana or Georgia should review the details below and prepare to assist affected members during the upcoming fall Open Enrollment period.
What is changing?
Effective January 1, 2027, CareSource is making the following changes:
Indiana: CareSource is exiting the Marketplace in Indiana entirely (ACA and Medicare)
Georgia: CareSource is discontinuing its Dual Eligible Special Needs Plan (D-SNP) in Georgia. (Medicare)
Ohio: CareSource is exiting the Marketplace in Ohio. *This does not impact CareSource's Medicaid or MyCare Ohio plans. (ACA)
West Virginia: are source is exiting the Marketplace in West Virginia. (ACA)
When do these changes take effect?
These changes take effect starting in 2027. Members affected by these changes will continue to receive their current CareSource benefits through December 31, 2026.
What does this mean for affected members?
Members enrolled in impacted CareSource plans will need to select an alternative plan for 2027 coverage. During the upcoming fall Open Enrollment period, affected members will have the opportunity to choose a new plan to ensure their coverage continues without interruption.
CareSource will be sending notifications directly to all impacted members at a later date.
What should agents do?
Inform their clients of the upcoming change and their current coverage end date of December 31, 2026.
Review available alternative plans during Open Enrollment to ensure continued coverage starting January 1, 2027.
Assist with plan selection and enrollment before the end of the Open Enrollment period.
Indiana — Additional Updates
Network Change: Effective July 10, 2026, Baptist Health System will no longer be part of the CareSource Indiana Marketplace network. This includes hospitals, urgent care offices, specialty practices, and primary care practices.
Agents with Indiana clients on CareSource plans should be aware of this network change ahead of the full exit. Clients who rely on Baptist Health System providers should be informed so they can plan accordingly for the remainder of their 2026 coverage year.
Wisconsin — Auto Pay Update
Action Required for WI Members on Auto Pay: As of April 1, 2026, all Wisconsin CareSource members on auto pay have been migrated to the CareSource payment platform. Due to banking laws, these members must re-enter their bank account information in order to continue on auto pay.
Members who do not re-enter their banking info will be moved to direct bill. Members have been notified directly by CareSource. Agents with Wisconsin clients on auto pay should follow up to ensure their clients are aware and have taken action to avoid any disruption to their payment setup.
Members can update their banking information through the My Life member portal.
Nevada — Pinnacle Medical Group Network Removal
Effective Immediately: Pinnacle Medical Group has formally withdrawn their provider contract with CareSource. All Pinnacle Medical Group locations and clinics have been removed from the CareSource Find A Doctor tool and are now considered out of network.
Agents with Nevada clients enrolled in CareSource plans who use Pinnacle Medical Group providers should inform those clients of this change as soon as possible. Clients should use the CareSource Find A Doctor tool to locate in-network alternatives.
Compliance Update — New CMS Background Check Requirement
Effective Immediately: Per new CMS requirements, all new agents seeking to appoint with CareSource are now subject to a background check. This requirement previously applied only to Medicare agents and has been expanded to all new appointments.
This applies to all markets and states. Agents who are already appointed are not affected, but any new agent onboarding through CareSource going forward will need to complete a background check as part of the appointment process.
CareSource contact information
For questions about any of these changes, contact CareSource directly:
Phone: 833-230-2002
Email: [email protected]
Additional Resources
If you have any questions please contact Producer Support. Producer Support is available by phone at (866) 568-9649, by email at [email protected], or by chat directly from your MyMFG account.