- State:
- Metal Level:
- Plan Type:
- Primary Care Visit: $80
- Generic Drugs: $30
- Medical Deductible (Individual): $6,850
- Medical Maximum Out Of Pocket (Individual): $7,900
CareSource Marketplace Low Premium Silver 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).
This plan is available for qualifying individuals who live in Raleigh county, West Virginia.
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.
You can purchase this plan at HealthCare.gov.
Primary Care Visit | $25 |
---|---|
Specialist Visit | $50 |
Emergency Room Visit | $500 Copay after deductible |
Inpatient Facility Visit | $500 Copay per Stay after deductible |
Inpatient Physician Visit | $500 Copay after deductible |
Generic Drugs | $20 |
---|---|
Preferred Brand Drugs | $50 |
Non-preferred Brand Drugs | 15% Coinsurance after deductible |
Specialty Drugs | 15% Coinsurance after deductible |
Medical Deductible (Individual) | $6,400 |
---|---|
Medical Maximum Out Of Pocket (Individual) | $7,900 |
Medical Deductible (Family) | $12,800 |
Medical Maximum Out Of Pocket (Family) | $15,800 |
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 |
EHB Percent of Total Premium | 100.00% |
---|---|
Premium Child Age 0-14 | 325 |
Premium Child Age 18 | 388 |
Premium Adult Individual Age 21 | 424 |
Premium Adult Individual Age 27 | 445 |
Premium Adult Individual Age 30 | 482 |
Premium Adult Individual Age 40 | 543 |
Premium Adult Individual Age 50 | 759 |
Premium Adult Individual Age 60 | 1,153 |
Premium Couple 21 | 849 |
Premium Couple 30 | 964 |
Premium Couple 40 | 1,086 |
Premium Couple 50 | 1518 |
Premium Couple 60 | 2,306 |
Couple+1 child, Age 21 | 1,175 |
Couple+1 child, Age 30 | 1,289 |
Couple+1 child, Age 40 | 1,411 |
Couple+1 child, Age 50 | 1,843 |
Couple+2 children, Age 21 | 1,500 |
Couple+2 children, Age 30 | 1,614 |
Couple+2 children, Age 40 | 1,736 |
Couple+2 children, Age 50 | 2,168 |
Couple+3 or more Children, Age 21 | 1,825 |
Couple+3 or more Children, Age 30 | 1,940 |
Couple+3 or more Children, Age 40 | 2,061 |
Couple+3 or more Children, Age 50 | 2,493 |
Individual+1 child, Age 21 | 750 |
Individual+1 child, Age 30 | 807 |
Individual+1 child, Age 40 | 868 |
Individual+1 child, Age 50 | 1,084 |
Individual+2 children, Age 21 | 1,075 |
Individual+2 children, Age 30 | 1,132 |
Individual+2 children, Age 40 | 1,193 |
Individual+2 children, Age 50 | 1,409 |
Individual+3 or more children, Age 21 | 1,400 |
Individual+3 or more children, Age 30 | 1,457 |
Individual+3 or more children, Age 40 | 1,518 |
Individual+3 or more children, Age 50 | 1,734 |
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