Ohio Medicare Advantage Laboratory Testing Policies

These laboratory testing policies apply to Medicare Advantage plans. These CareSource policies are published by Avalon Healthcare Solutions on behalf of CareSource.

These policies offer guidance on determination of medical necessity and appropriateness of care for approved benefits. Benefit determinations and coverage decisions are subject to all the terms and conditions of CareSource including eligibility, definitions, specific inclusions or exclusions, and applicable state or federal laws. Policies are considered guidelines and are not intended to infer benefits or coverage for a specific member. 

Policy Hierarchy

Decision making for Medicare Advantage plans are based upon the following hierarchy: 

The policies below are only effective for Ohio Medicare Advantage plans from 01/01/2022 through 12/31/2022.


Register for the September Webinar

Tuesday, September 17
2 – 3 p.m. EDT

Connect With Us

Want to get in touch? We’d love to hear from you.