CareSource Marketplace Low Premium Silver Dental and Vision
Plan Type: | HMO |
Plan Tier: | Silver |
Medical Deductible - Individual: | $6,400 |
Medical Deductible - Family: | $12,800 |
Drug Deductible - Individual: | Included in Medical |
Drug Deductible - Family: | Included in Medical |
Out of Pocket Max - Individual: | $7,900 |
Out of Pocket Max - Family: | $15,800 |
Primary Care Visit: | $25 |
Specialist Visit: | $50 |
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-lprem-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: | $20 |
Non-Preferred Brand Drugs: | 15% Coinsurance after deductible |
Preferred Brand Drugs: | $50 |
Specialty Drugs: | 15% Coinsurance after deductible |
Link to Full Policy Formulary: | https://www.caresource.com/documents/2019-OH-marketplace-formulary/ |
This Carrier Offers:
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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