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CareSource Marketplace Standard Silver Dental and Vision
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CareSource Marketplace Standard Silver Dental and Vision

Overview
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CareSource Marketplace Standard 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
50328WV0020023
Coverage area
Lincoln 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 96.53%
Premium Child Age 0-14 426
Premium Child Age 18 509
Premium Adult Individual Age 21 557
Premium Adult Individual Age 27 584
Premium Adult Individual Age 30 632
Premium Adult Individual Age 40 712
Premium Adult Individual Age 50 995
Premium Adult Individual Age 60 1,513
Premium Couple 21 1,115
Premium Couple 30 1,265
Premium Couple 40 1,425
Premium Couple 50 1,991
Premium Couple 60 3,026
Couple+1 child, Age 21 1,541
Couple+1 child, Age 30 1,692
Couple+1 child, Age 40 1,851
Couple+1 child, Age 50 2,418
Couple+2 children, Age 21 1,968
Couple+2 children, Age 30 2,118
Couple+2 children, Age 40 2,278
Couple+2 children, Age 50 2,844
Couple+3 or more Children, Age 21 2,394
Couple+3 or more Children, Age 30 2,545
Couple+3 or more Children, Age 40 2,704
Couple+3 or more Children, Age 50 3,271
Individual+1 child, Age 21 984
Individual+1 child, Age 30 1,059
Individual+1 child, Age 40 1,139
Individual+1 child, Age 50 1,422
Individual+2 children, Age 21 1,410
Individual+2 children, Age 30 1,485
Individual+2 children, Age 40 1,565
Individual+2 children, Age 50 1,848
Individual+3 or more children, Age 21 1,837
Individual+3 or more children, Age 30 1,912
Individual+3 or more children, Age 40 1,992
Individual+3 or more children, Age 50 2,275
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