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CareSource Marketplace Low Deductible Silver Dental and Vision
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CareSource Marketplace Low Deductible Silver Dental and Vision

Overview
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CareSource Marketplace Low Deductible Silver Dental and Vision 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 Raleigh 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
50328WV0020025
Coverage area
Raleigh County, West Virginia
Phone
Local Phone:
Toll-Free:
TTY:
Plan type
HMO
Coverage type
Medical deductible
$4,400
Out-of-pocket maximum
$7,500
Generic drug co-pay
$10
Preferred brand drug co-pay
$60
Primary care physician visit cost
$10
Specialist doctor visit cost
$60
Doctor Visits
Primary Care Visit $10
Specialist Visit $60
Emergency Room Visit $500 Copay after deductible
Inpatient Facility Visit $500 Copay per Stay after deductible
Inpatient Physician Visit $500 Copay after deductible
Prescription Drugs
Generic Drugs $10
Preferred Brand Drugs $60
Non-preferred Brand Drugs 30% Coinsurance after deductible
Specialty Drugs 30% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $4,400
Medical Maximum Out Of Pocket (Individual) $7,500
Medical Deductible (Family) $8,800
Medical Maximum Out Of Pocket (Family) $15,000
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 96.68%
Premium Child Age 0-14 368
Premium Child Age 18 440
Premium Adult Individual Age 21 482
Premium Adult Individual Age 27 505
Premium Adult Individual Age 30 547
Premium Adult Individual Age 40 616
Premium Adult Individual Age 50 861
Premium Adult Individual Age 60 1,308
Premium Couple 21 964
Premium Couple 30 1,094
Premium Couple 40 1,232
Premium Couple 50 1,722
Premium Couple 60 2,616
Couple+1 child, Age 21 1,333
Couple+1 child, Age 30 1,463
Couple+1 child, Age 40 1,601
Couple+1 child, Age 50 2,090
Couple+2 children, Age 21 1,701
Couple+2 children, Age 30 1832
Couple+2 children, Age 40 1,969
Couple+2 children, Age 50 2,459
Couple+3 or more Children, Age 21 2,070
Couple+3 or more Children, Age 30 2,200
Couple+3 or more Children, Age 40 2,338
Couple+3 or more Children, Age 50 2,828
Individual+1 child, Age 21 850
Individual+1 child, Age 30 916
Individual+1 child, Age 40 984
Individual+1 child, Age 50 1,229
Individual+2 children, Age 21 1,219
Individual+2 children, Age 30 1,284
Individual+2 children, Age 40 1,353
Individual+2 children, Age 50 1,598
Individual+3 or more children, Age 21 1,588
Individual+3 or more children, Age 30 1,653
Individual+3 or more children, Age 40 1,722
Individual+3 or more children, Age 50 1,967
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