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CareSource Marketplace Gold
Healthcare.gov Individual Medical Plan Finder
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CareSource Marketplace Gold

Overview
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CareSource Marketplace Gold is an individual health health plan issued by CareSource West Virginia Co. and is available for the year 2019. This health plan is offered by the federal government through HealthCare.gov and the Affordable Care Act (ACA).

Where Do I Need to Live to Quality for this Plan?

This plan is available for qualifying individuals who live in Roane county, West Virginia.

What Type of Health Plan Is This?

This plan is an HMO plan, which is also known as a "Health Maintenance Organization." An HMO is a type of insurance plan that generally limits coverage to care from doctors who contract with the HMO. Out-of-network doctors are usually not covered.

You may be required to live or work in a particular service area in order to be eligible for the HMO's coverage. In an HMO, you will usually need to have a primary care doctor (PCP) and you need referrals in order to see specialists.

Where Can I Buy This Plan?

You can purchase this plan at HealthCare.gov.

About
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Issuer
CareSource West Virginia Co.
Plan ID
50328WV0010022
Coverage area
Roane County, West Virginia
Phone
Local Phone:
Toll-Free:
TTY:
Plan type
HMO
Coverage type
Medical deductible
$2,000
Out-of-pocket maximum
$6,500
Generic drug co-pay
$10
Preferred brand drug co-pay
$50
Primary care physician visit cost
No Charge
Specialist doctor visit cost
$35
Doctor Visits
Primary Care Visit No Charge
Specialist Visit $35
Emergency Room Visit 20% Coinsurance after deductible
Inpatient Facility Visit 20% Coinsurance after deductible
Inpatient Physician Visit 20% Coinsurance after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $50
Non-preferred Brand Drugs $200
Specialty Drugs 40% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $2,000
Medical Maximum Out Of Pocket (Individual) $6,500
Medical Deductible (Family) $4,000
Medical Maximum Out Of Pocket (Family) $13,000
Drug Deductible
Drug Deductible (Individual) Included in Medical
Drug Maximum Out Of Pocket (Individual) Included in Medical
Drug Deductible (Family) Included in Medical
Drug Maximum Out Of Pocket (Family) Included in Medical
Premium Rates
EHB Percent of Total Premium 100.00%
Premium Child Age 0-14 451
Premium Child Age 18 538
Premium Adult Individual Age 21 590
Premium Adult Individual Age 27 618
Premium Adult Individual Age 30 669
Premium Adult Individual Age 40 754
Premium Adult Individual Age 50 1,054
Premium Adult Individual Age 60 1,601
Premium Couple 21 1,180
Premium Couple 30 1,339
Premium Couple 40 1,508
Premium Couple 50 2,108
Premium Couple 60 3,203
Couple+1 child, Age 21 1,632
Couple+1 child, Age 30 1,791
Couple+1 child, Age 40 1,960
Couple+1 child, Age 50 2,559
Couple+2 children, Age 21 2,083
Couple+2 children, Age 30 2,242
Couple+2 children, Age 40 2,411
Couple+2 children, Age 50 3,011
Couple+3 or more Children, Age 21 2,535
Couple+3 or more Children, Age 30 2,694
Couple+3 or more Children, Age 40 2,863
Couple+3 or more Children, Age 50 3,462
Individual+1 child, Age 21 1,041
Individual+1 child, Age 30 1,121
Individual+1 child, Age 40 1,205
Individual+1 child, Age 50 1,505
Individual+2 children, Age 21 1,493
Individual+2 children, Age 30 1,572
Individual+2 children, Age 40 1,657
Individual+2 children, Age 50 1,957
Individual+3 or more children, Age 21 1,944
Individual+3 or more children, Age 30 2,024
Individual+3 or more children, Age 40 2,108
Individual+3 or more children, Age 50 2,408
Reference
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  • HealthCare.gov. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov
  • The 'metal' categories: Bronze, Silver, Gold & Platinum. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plans-categories
  • Health insurance plan & network types: HMOs, PPOs, and more. U.S. Centers for Medicare and Medicaid. Accessed June 11, 2019. https://www.healthcare.gov/choose-a-plan/plan-types