CareSource Marketplace HSA Eligible Bronze

Plan Type: HMO
Plan Tier: Bronze
Medical Deductible - Individual: $5,200
Medical Deductible - Family: $10,400
Drug Deductible - Individual: Included in Medical
Drug Deductible - Family: Included in Medical
Out of Pocket Max - Individual: $6,650
Out of Pocket Max - Family: $13,300
Primary Care Visit: 50% Coinsurance after deductible
Specialist Visit: 50% Coinsurance after deductible
Emergency Room: 50% Coinsurance after deductible
Hospital - Physician: 50% Coinsurance after deductible
Hospital - Facility: 50% Coinsurance after deductible
Link to Full SBC: https://www.caresource.com/document/mp-2019-OH-hsa-bronzebase-bsc-sum
Plan Brochure: https://www.caresource.com/documents/mp-2019-OH-a-broch

Other Coverage:

Child Dental: Yes
Adult Dental No

Prescription Drug Pricing:

Generic Drugs: 50% Coinsurance after deductible
Non-Preferred Brand Drugs: 50% Coinsurance after deductible
Preferred Brand Drugs: 50% Coinsurance after deductible
Specialty Drugs: 50% 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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