CareSource vs. Anthem Insurance

If you’re looking for a large network, many different options when it comes to selecting the type of plan you want and a policy management app with outstanding reviews, Anthem should be better for you than CareSource.

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Anthem beats CareSource on numerous metrics including the size of its network, the number of states it operates in, the quantity of health insurance coverage types it offers and the quality of its mobile app according to online reviews, meaning many shoppers will likely find Anthem to be the better of the two health insurance companies.

Nevertheless, CareSource’s unique background of providing coverage for Medicaid members and other historically underserved communities may make it an appealing option for lower-income families in certain states.

Continue reading for more CareSource vs. Anthem comparisons that can help you decide which of the two health insurance providers is likely to be a better fit for your circumstances.

Key Takeaways

  • While CareSource specializes in providing Medicaid coverage and has also expanded its repertoire to include other coverage types, Anthem offers a wider array of health plan structures.
  • Both insurers are limited to a small handful of states, with Anthem operating in 14 states and CareSource operating in eight.
  • Anthem shares a network of about 1.7 million providers with the rest of the Blue Cross Blue Shield Association, dwarfing CareSource’s network of around 100,000 providers.
  • CareSource and Anthem have both received very good reviews for their mobile apps and very bad customer satisfaction ratings on online review platforms.

CareSource History

CareSource was founded in 1989 with the support of the Ohio state government. Then known as the Dayton Area Health Plan, it was a managed care program designed for Medicaid members.[1] The nonprofit later changed its name to CareSource and expanded its offerings to include other types of plans such as Medicare and Marketplace health plans.

Click here to read our full CareSource review.

Anthem History

While it has existed under many different names, Anthem has been providing health insurance coverage in the United States since the 1940s. Anthem Insurance Company merged with WellPoint Health Networks in 2004 to form WellPoint, Inc. However, in 2014, the corporation reverted its name to Anthem, Inc.[2]

Then, the company changed its name again in 2022 and remains Elevance Health to this day, although it still sells health plans under the Anthem Blue Cross Blue Shield brand name.[3] As of 2019, Anthem is the largest of all the for-profit managed health care companies that are part of the Blue Cross Blue Shield Association.[2]

Click here to read our full Anthem review.

CareSource vs. Anthem: Quick Glance




Plan Structures

HMO, PPO, CDHP, HDHP, HSA, Medicaid, Medicare

HMO, PPO, EPO, POS, HMO-POS, CDHP, FSA, HDHP, HSA, Indemnity, Medicaid, Medicare


Arkansas, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, West Virginia

California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, Wisconsin

Coverage Limit






Maximum Annual Benefit



Waiting Period



In-Network Providers


1.7 million

Covers Telehealth



Policy Management

Mobile app, online account, phone

Mobile app, online account, phone

CareSource Pros and Cons



Specialized experience providing managed health care for Medicaid members and other low-income individuals

Coverage limited to eight states

Solid reviews for the CareSource mobile app

Poor customer satisfaction ratings

Anthem Pros and Cons



Larger number of available plan structures than CareSource

Coverage limited to 14 states

Access to a huge network consisting of more than 1.7 million providers

Poor customer satisfaction ratings

Near-perfect reviews for the Sydney Health mobile app


CareSource vs. Anthem: Plan Structures

While CareSource and Anthem offer many of the same categories of health insurance coverage, CareSource is more limited in that it doesn’t provide coverage through employers, which is how the majority of Americans obtain health insurance.[4] Additionally, CareSource doesn’t offer as many different Marketplace plan structures or supplemental health insurance coverage types as Anthem does.




Individual & Family

Medicare Advantage




Employer Group


CareSource vs. Anthem: Plan Availability

Anthem solidly beats out CareSource when it comes to availability, although both insurers are limited to a fairly small number of states. You may be able to enroll in an Anthem health plan if you live in one of the following 14 states:[5]

  • California
  • Colorado
  • Connecticut
  • Georgia
  • Indiana
  • Kentucky
  • Maine
  • Missouri
  • Nevada
  • New Hampshire
  • New York
  • Ohio
  • Virginia
  • Wisconsin

However, you should note that Anthem Blue Cross Blue Shield coverage is not necessarily available in every county in all of the states listed above. For example, Anthem does not operate in 30 counties around Kansas City, Missouri.[5]

Meanwhile, CareSource insurance is only available in Arkansas, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio and West Virginia. Furthermore, CareSource does not offer all of its plan structures in all eight of these states. For example, members in Kentucky and West Virginia can only sign up for Affordable Care Act (ACA) Marketplace plans through CareSource.[6]

caresource vs. anthem availability

CareSource vs. Anthem: In-Network Providers

Anthem also has access to significantly more in-network providers than CareSource. As part of the Blue Cross Blue Shield Association, Anthem can tap into a massive network that includes over 1.7 million doctors and hospitals.[7] Conversely, CareSource has a more modest network consisting of over 100,000 health care providers.[8]

CareSource vs. Anthem: Cost

The cost of health insurance can vary significantly depending on your circumstances, making it difficult to compare prices between CareSource and Anthem plans. Generally speaking, the average cost of a Marketplace benchmark plan in 2024 is $477 per month.[9]

If you shop for coverage through the Health Insurance Marketplace, companies like CareSource and Anthem are only allowed to take the following factors into account when setting your health insurance premiums:[10]

  • Age
  • Location
  • Tobacco use
  • Number of people covered by the plan
  • Plan tier

The health insurance tiers are a set of four categories that classify health plans based on how they balance premiums with out-of-pocket costs. Bronze and silver plans cost less up front but come with higher out-of-pocket costs such as deductibles, copays and coinsurance. Conversely, gold and platinum plans are more expensive when it comes to your regular premium payments but don’t require you to pay as much out of pocket whenever you receive medical services.[11]

health insurance tiers

CareSource vs. Anthem: Coverage Limits

Similarly, coverage limits are not uniform across plans for either CareSource or Anthem, so it’s hard to pinpoint an expected coverage limit for all plan members. Keep in mind that annual and lifetime limits legally cannot be applied to the following 10 essential health benefits:[12][13]

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health and substance use disorder services
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services (including dental and vision care for children)

CareSource vs. Anthem: Policy Management

Both CareSource and Anthem allow policyholders to manage their plans online, over the phone or by mail. In addition, they both have mobile apps that allow users to access ID cards, check the status of their claims, find in-network health care providers and more.

The CareSource mobile app and Anthem’s Sydney Health app have both been reviewed quite favorably overall but Sydney Health has a slight edge over CareSource with near-perfect ratings across thousands of reviews on both Google Play and the App Store.


Google Play Store Rating

Apple App Store Rating


3.8/5 stars[14]

4.1/5 stars[15]

Sydney Health

4.7/5 stars[16]

4.8/5 stars[17]

CareSource vs. Anthem: Medical Loss Ratio

Under the ACA, health insurance companies are required to meet certain requirements regarding their medical loss ratio (MLR), which is the percentage of their revenue from premiums that they use to cover medical care or otherwise improve the experience of their plan members.

Insurers in the individual and small group health insurance markets must maintain a three-year rolling average MLR of 80% or more, while the threshold is set at 85% for insurance carriers in the large group market. Any health insurance company that fails to meet these standards at the end of any given year must pay rebates to all of its policyholders in the affected market.[18]

CareSource has not announced any MLR rebates since 2015 and the company’s most recent stakeholder report indicates that it has maintained an MLR of 87.8%.[19][20] Meanwhile, Elevance Health reported an MLR of 87% for 2023, so Anthem plan members shouldn’t expect to receive rebates in 2024.[21]

CareSource vs. Anthem: Enrollment Process

To enroll in a Marketplace health insurance plan through either CareSource or Anthem, you will generally need to sign up during open enrollment, which takes place from November 1 to January 15 in the majority of states.[22] Meanwhile, if you qualify for a Medicare Advantage plan, you should keep the Medicare open enrollment dates explained below in mind.[23]

Enrollment Period

What You Can Do

Three months before your Medicare coverage starts to three months after your Medicare coverage starts

Enroll in a Medicare Advantage plan as long as you have already signed up for Medicare Parts A and B

October 15 to December 7

Switch from Original Medicare to Medicare Advantage, switch from one Medicare Advantage plan to another or drop Medicare Advantage and go back to Original Medicare

January 1 to March 31 (or any time during your first three months on Medicare)

Switch from one Medicare Advantage plan to another or drop Medicare Advantage and go back to Original Medicare

Outside of these dates, you may still be able to sign up for health insurance if you qualify for a special enrollment period. Special enrollment periods are triggered by major life events that significantly affect your health insurance needs such as the following:[24]

  • Getting married, divorced or separated
  • Giving birth to or adopting a child
  • Changing or losing your job
  • Moving to a new home
  • Losing your existing health coverage due to the death of a family member
  • Aging out of your parents’ health plan by turning 26
  • Becoming a United States citizen
  • Leaving prison

qualifying life events for special enrollment period

CareSource vs. Anthem: Policyholder Experience

Although CareSource has garnered marginally better reviews than Anthem on online review platforms like Best Company and the Better Business Bureau, both carriers have very poor ratings overall. However, you should note that these ratings come from a relatively small sample of reviews, so they may not be representative of the experience of the majority of CareSource or Anthem plan members.


Review Platform

CareSource Rating

Anthem Rating

Best Company

1.2/5 stars[25]

1/5 stars[26]

Better Business Bureau

1.25/5 stars[27]

1.11/5 stars[28]

How To File Claims With CareSource and Anthem

CareSource and Anthem both allow you to access and submit claims forms online. The exact form you will need to fill out and submit may depend on your location and the type of plan you have.[29][30] Keep in mind that your medical provider will generally file an insurance claim for you if you receive care in network, meaning you should only have to file your own claim if you receive care out of network.

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What’s better, CareSource or Anthem?

Most shoppers in eligible states will likely find Anthem to be a better option than CareSource due to its massive network, wide array of available plan structures and well-reviewed mobile app.

Is Anthem the same as Blue Cross Blue Shield?

Anthem is one of several companies that are part of the Blue Cross Blue Shield Association.

What type of insurance is CareSource?

CareSource started out as a managed care plan for Medicaid members but now offers additional plan structures such as Medicare and Marketplace health insurance.


  1. Cincinnati Business Courier. “CareSource CEO Named an E&Y Entrepreneur of the Year.” Accessed May 7, 2024.
  2. Library of Congress. “Anthem, Inc.” Accessed May 7, 2024.
  3. United States Securities and Exchange Commission. “Form 8-K for Anthem Inc Filed 05/18/2022.” Accessed May 7, 2024.
  4. United States Census Bureau. “Health Insurance Coverage in the United States: 2022.” Accessed May 8, 2024.
  5. Anthem. “Health Insurance Plans | Health Coverage.” Accessed May 8, 2024.
  6. CareSource. “Find a Doctor | Choose Plans.” Accessed May 8, 2024.
  7. Blue Cross Blue Shield. “The Blue Cross Blue Shield System.” Accessed May 8, 2024.
  8. CareSource. “Find a Doctor.” Accessed May 8, 2024.
  9. KFF. “Average Marketplace Premiums by Metal Tier, 2018-2024.” Accessed May 8, 2024.
  10. “How Health Insurance Marketplace Plans Set Your Premiums.” Accessed May 8, 2024.
  11. “The Health Plan Categories: Bronze, Silver, Gold & Platinum.” Accessed May 8, 2024.
  12. United States Department of Health and Human Services. “Lifetime & Annual Limits.” Accessed May 8, 2024.
  13. “Find Out What Marketplace Health Insurance Plans Cover.” Accessed May 8, 2024.
  14. Google Play. “CareSource Mobile App.” Accessed May 8, 2024.
  15. App Store. “CareSource.” Accessed May 8, 2024.
  16. Google Play. “Sydney Health.” Accessed May 8, 2024.
  17. App Store. “Sydney Health.” Accessed May 8, 2024.
  18. National Association of Insurance Commissioners. “Medical Loss Ratio.” Accessed May 8, 2024.
  19. CareSource. “2015 Health Insurance Premium Rebate FAQs.” Accessed May 8, 2024.
  20. CareSource Stakeholders Report. “Home.” Accessed May 8, 2024.
  21. Elevance Health. “Elevance Health Reports Results for Fourth Quarter and Full Year 2023; Sets Full Year 2024 Outlook.” Accessed May 8, 2024.
  22. “When Can You Get Health Insurance?” Accessed May 8, 2024.
  23. “Joining a Plan.” Accessed May 8, 2024.
  24. “Getting Health Coverage Outside Open Enrollment.” Accessed May 8, 2024.
  25. Best Company. “50+ CareSource Reviews.” Accessed May 8, 2024.
  26. Best Company. “97+ Anthem Reviews.” Accessed May 8, 2024.
  27. Better Business Bureau. “CareSource.” Accessed May 8, 2024.
  28. Better Business Bureau. “Anthem, Inc.” Accessed May 8, 2024.
  29. CareSource. “Claims.” Accessed May 8, 2024.
  30. Anthem. “How To Submit, Track and Access Anthem Claims.” Accessed May 8, 2024.

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