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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 Lincoln 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
Lincoln 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 0-14 446
Premium Child Age 18 532
Premium Adult Individual Age 21 583
Premium Adult Individual Age 27 611
Premium Adult Individual Age 30 661
Premium Adult Individual Age 40 745
Premium Adult Individual Age 50 1,041
Premium Adult Individual Age 60 1,582
Premium Couple 21 1,166
Premium Couple 30 1,323
Premium Couple 40 1,490
Premium Couple 50 2,083
Premium Couple 60 3,165
Couple+1 child, Age 21 1,612
Couple+1 child, Age 30 1,770
Couple+1 child, Age 40 1,936
Couple+1 child, Age 50 2,529
Couple+2 children, Age 21 2,058
Couple+2 children, Age 30 2,216
Couple+2 children, Age 40 2,383
Couple+2 children, Age 50 2,975
Couple+3 or more Children, Age 21 2,505
Couple+3 or more Children, Age 30 2,662
Couple+3 or more Children, Age 40 2,829
Couple+3 or more Children, Age 50 3,421
Individual+1 child, Age 21 1,029
Individual+1 child, Age 30 1,108
Individual+1 child, Age 40 1,191
Individual+1 child, Age 50 1,487
Individual+2 children, Age 21 1,475
Individual+2 children, Age 30 1,554
Individual+2 children, Age 40 1,637
Individual+2 children, Age 50 1,934
Individual+3 or more children, Age 21 1,921
Individual+3 or more children, Age 30 2,000
Individual+3 or more children, Age 40 2,083
Individual+3 or more children, Age 50 2,380
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