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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 Preston 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
Preston 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 0-14 417
Premium Child Age 18 497
Premium Adult Individual Age 21 545
Premium Adult Individual Age 27 571
Premium Adult Individual Age 30 618
Premium Adult Individual Age 40 696
Premium Adult Individual Age 50 973
Premium Adult Individual Age 60 1,479
Premium Couple 21 1,090
Premium Couple 30 1,237
Premium Couple 40 1,393
Premium Couple 50 1,947
Premium Couple 60 2,959
Couple+1 child, Age 21 1,507
Couple+1 child, Age 30 1,654
Couple+1 child, Age 40 1,810
Couple+1 child, Age 50 2,364
Couple+2 children, Age 21 1,924
Couple+2 children, Age 30 2,071
Couple+2 children, Age 40 2,227
Couple+2 children, Age 50 2,781
Couple+3 or more Children, Age 21 2,341
Couple+3 or more Children, Age 30 2,488
Couple+3 or more Children, Age 40 2,644
Couple+3 or more Children, Age 50 3,198
Individual+1 child, Age 21 962
Individual+1 child, Age 30 1,035
Individual+1 child, Age 40 1,113
Individual+1 child, Age 50 1,390
Individual+2 children, Age 21 1,379
Individual+2 children, Age 30 1,452
Individual+2 children, Age 40 1,530
Individual+2 children, Age 50 1,807
Individual+3 or more children, Age 21 1,796
Individual+3 or more children, Age 30 1,870
Individual+3 or more children, Age 40 1,947
Individual+3 or more children, Age 50 2,224
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