CareSource Marketplace Low Deductible Silver Dental and Vision

Plan Type: HMO
Plan Tier: Silver
Medical Deductible - Individual: $4,400
Medical Deductible - Family: $8,800
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $7,500
Out of Pocket Max - Family: $15,000
Primary Care Visit: $10
Specialist Visit: $60
Emergency Room: $500 Copay after deductible
Hospital - Physician: $500 Copay after deductible
Hospital - Facility: $500 Copay per Stay after deductible
Link to Full SBC: https://www.caresource.com/document/mp-2019-OH-lded-silverbase-dv-sum
Plan Brochure: https://www.caresource.com/documents/mp-2019-OH-a-broch

Other Coverage:

Child Dental: Yes
Adult Dental Yes

Prescription Drug Pricing:

Generic Drugs: $10
Non-Preferred Brand Drugs: 30% Coinsurance after deductible
Preferred Brand Drugs: $60
Specialty Drugs: 30% Coinsurance after deductible
Link to Full Policy Formulary: https://www.caresource.com/documents/2019-OH-marketplace-formulary/

About The Carrier

CareSource plans provide comprehensive, quality coverage that you can afford, understand and use. We offer individual and family plans with optional dental and vision coverage for adults. CareSource is a Qualified Health Plan offered through the Health Insurance Marketplace.

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