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CareSource Marketplace Standard Silver
Healthcare.gov Individual Medical Plan Finder
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CareSource Marketplace Standard Silver

Overview
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CareSource Marketplace Standard 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).

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
50328WV0010023
Coverage area
Roane County, West Virginia
Phone
Local Phone:
Toll-Free:
TTY:
Plan type
HMO
Coverage type
Medical deductible
$5,700
Out-of-pocket maximum
$7,700
Generic drug co-pay
$15
Preferred brand drug co-pay
$45
Primary care physician visit cost
$15
Specialist doctor visit cost
$40
Doctor Visits
Primary Care Visit $15
Specialist Visit $40
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 $15
Preferred Brand Drugs $45
Non-preferred Brand Drugs 20% Coinsurance after deductible
Specialty Drugs 20% Coinsurance after deductible
Medical Deductible
Medical Deductible (Individual) $5,700
Medical Maximum Out Of Pocket (Individual) $7,700
Medical Deductible (Family) $11,400
Medical Maximum Out Of Pocket (Family) $15,400
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 0-14 352
Premium Child Age 18 421
Premium Adult Individual Age 21 461
Premium Adult Individual Age 27 483
Premium Adult Individual Age 30 523
Premium Adult Individual Age 40 589
Premium Adult Individual Age 50 823
Premium Adult Individual Age 60 1,251
Premium Couple 21 922
Premium Couple 30 1,046
Premium Couple 40 1,178
Premium Couple 50 1,647
Premium Couple 60 2,502
Couple+1 child, Age 21 1,275
Couple+1 child, Age 30 1,399
Couple+1 child, Age 40 1,531
Couple+1 child, Age 50 1,999
Couple+2 children, Age 21 1,627
Couple+2 children, Age 30 1,752
Couple+2 children, Age 40 1,884
Couple+2 children, Age 50 2,352
Couple+3 or more Children, Age 21 1,980
Couple+3 or more Children, Age 30 2,105
Couple+3 or more Children, Age 40 2,236
Couple+3 or more Children, Age 50 2,705
Individual+1 child, Age 21 813
Individual+1 child, Age 30 876
Individual+1 child, Age 40 942
Individual+1 child, Age 50 1,176
Individual+2 children, Age 21 1,166
Individual+2 children, Age 30 1,228
Individual+2 children, Age 40 1,294
Individual+2 children, Age 50 1,529
Individual+3 or more children, Age 21 1,519
Individual+3 or more children, Age 30 1,581
Individual+3 or more children, Age 40 1,647
Individual+3 or more children, Age 50 1,881
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