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Is CareSource Medicaid or Medicare?

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

CareSource is best known as a Medicaid managed care company, and it also offers Medicare plans, including plans for people with both Medicare and Medicaid, in some states.

Which CareSource plans you can join depends on your state and whether you qualify for Medicaid, Medicare or both.

See Medicare Advantage Special Needs Plans.

✔ Licensed across all 50 states

✔ Built on CMS 2027 data

✔ No-cost plan comparison

Key Highlights

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Mainly Medicaid managed care.

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Medicare plans in some states.

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Dual plans for Medicare + Medicaid.

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Availability varies by state.

Compare plans and enroll online

Medicaid vs Medicare

Medicaid Medicare
Who People with limited income and resources People 65+ or with certain disabilities
Run by States with federal funding Federal government
Plans State managed care plans Original Medicare or Medicare Advantage

If You Have Both

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP) People who have qualifying conditions like diabetes, heart failure or chronic lung disease Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP) People who live in a nursing home or need that level of care at home Care delivered where the member lives
Deciphering CareSource: Medicaid or Medicare?

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Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

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Run by your state Medicaid office

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May cover your Part B premium, and in some cases deductibles and coinsurance

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Income and asset limits vary by state

Extra Help (Part D)

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Run by Social Security

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Lowers Part D premiums, deductibles and copays

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Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Enrollment Periods

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Reading Your Annual Notice of Change

Check Every Line

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Your 2027 premium and deductible

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Doctor, specialist and hospital stay copays

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The out-of-pocket maximum

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Updates to your formulary, drug tiers and coverage rules

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Whether your doctors, hospitals and pharmacy stay in network

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Updates to dental, vision, hearing and other extras

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Is caresource medicare

Special Enrollment Periods

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

You May Qualify If

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Your plan is leaving your area or ending

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You move outside your plan’s service area

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You lose employer or union coverage

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Your Medicaid status changes, or you qualify for a Medicare Savings Program or Extra Help

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You want to join a 5-star plan, once a year

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Prior Authorization and Referrals

Prior authorization is required by most Medicare Advantage plans for certain services, including some surgeries, advanced imaging, skilled nursing stays and some drugs. While your doctor usually submits the request, ask whether a scheduled service needs approval so you are not caught off guard by a denial.

You or your doctor can appeal a denied request. Medicare rules give plans deadlines for decisions, and those deadlines are shorter when a wait could seriously harm your health.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

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Available any time: Medicare Plan Finder on Medicare.gov

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1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

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Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

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A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

CareSource is mainly a Medicaid plan but offers Medicare options in some states. Check what is available where you live.

Compare plans and enroll online

Frequently Asked Questions

➤ Is CareSource Medicaid?

Mainly, yes. CareSource is best known as a managed care organization that runs Medicaid plans in several states. It may also offer other types of coverage in some areas, so check the plans listed for your state to see exactly what is available.

➤ Does CareSource offer Medicare?

In some states, CareSource may offer Medicare Advantage or plans for people who qualify for both Medicare and Medicaid. Availability varies by state and county, so confirm whether a CareSource Medicare plan is offered at your address before making plans around it.

➤ When can I enroll in a Medicare Advantage plan for 2027?

For coverage starting January 1, 2027, enroll during Annual Enrollment from October 15 to December 7, 2026. If you already have a Medicare Advantage plan, you may also make one change during the January 1 to March 31, 2027 Open Enrollment Period.

➤ What happens if my Medicare Advantage plan is ending?

You stay covered by your current plan through December 31, 2026, and you should get a non-renewal notice in the mail. That triggers a Special Enrollment Period to choose another plan, plus a guaranteed issue right to buy certain Medigap plans in most cases.

➤ What is the difference between Medicaid and Medicare?

Medicare is federal health insurance mainly for people 65 and older or with certain disabilities, regardless of income. Medicaid is a joint federal and state program for people with limited income and resources, and some people qualify for both at the same time.

➤ What is a dual eligible plan?

A dual eligible special needs plan is a type of Medicare Advantage plan designed for people who have both Medicare and Medicaid. These plans may coordinate benefits between the two programs, but availability varies by state and insurer and must be confirmed for your area.

➤ Can I have both Medicare and CareSource Medicaid?

Yes, if you qualify for both programs you can be dual eligible. How your Medicaid coverage works alongside Medicare depends on your state’s rules and the plans offered there, so contact your state Medicaid office or a licensed agent to confirm your options.

➤ How do I know if I qualify for CareSource?

Eligibility for a CareSource Medicaid plan is based on your state’s Medicaid rules, which usually look at income, household size and other factors. For any Medicare plan, you generally must have Medicare and live in the plan’s service area, so check with your state and the plan.

➤ Where can I get unbiased help comparing CareSource and Medicare plans?

Your State Health Insurance Assistance Program, or SHIP, offers free and unbiased Medicare counseling. A SHIP counselor can explain how Medicaid and Medicare work together and help you compare any CareSource plans with other options in your area.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.