CareSource Marketplace Gold Dental, Vision, & Fitness

Plan Type: HMO
Plan Tier: Gold
Individual Deductible $2,000
Family Deductible $4,000
Individual Out of Pocket Max $6,500
Family Out of Pocket Max $13,000
Primary Care Visit: $10
Specialist Visit: $45
Emergency Room: 20% Coinsurance after deductible
Hospital - Physician: 20% Coinsurance after deductible
Hospital - Facility: 20% Coinsurance after deductible
Link to Full SBC: https://www.caresource.com/documents/Marketplace-2021-GA-Standard-GoldBase-Enhanced-sum
Plan Brochure: https://www.caresource.com/documents/Marketplace-2021-GA-brochure

Other Coverage:

Child Dental: Yes
Adult Dental Yes

Prescription Drug Pricing:

Generic Drugs: $15
Non-Preferred Brand Drugs: 40% Coinsurance after deductible
Preferred Brand Drugs: $50
Specialty Drugs: 40% Coinsurance after deductible
Summary of Benefits https://www.caresource.com/documents/Marketplace-2021-GA-formulary

About The Carrier

CareSource plans provide comprehensive, quality coverage that you can afford, understand and use. They 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.

Marketplace Plan Benefits

Optional Adult Dental, Vision, & Fitness Benefits

Need to take a trip to the eye doctor or dentist? Interested in no-cost gym memberships? Adults get enhanced benefits by adding optional Adult Dental, Vision & Fitness Benefits*** to any Silver, Bronze or Gold plan. The Fitness Benefit provides access to multiple fitness centers and gyms, digital fitness choices with home fitness tools, including one home fitness kit per benefit year with some kits including a wearable device (e.g. Fitbit® or Garmin®), digital workouts and live lifestyle coaching. All plans include pediatric dental and vision coverage.

Low Copays

CareSource plans have some of the lowest in-network primary care or retail clinic copays. Plus, many benefits, including primary and specialist care, retail clinic, telemedicine, urgent care, retail generic and retail preferred brand drugs, are available before you satisfy your deductible on most of our plans^.

Prescription Drug Benefits

Our prescription drug coverage includes copays as low as $0 for generic drugs and an extensive list of brand name drugs.

Preventive Care Coverage

Health insurance should help you stay healthy. That’s why there are no copays or coinsurance fees for defined preventive health services with CareSource Marketplace plans.

Hearing Benefits

All CareSource Marketplace plans include TruHearing® coverage with hearing aid discounts and $0 copay for routine hearing screenings.

CareSource24®

A team of nurses who can answer health questions 24/7/365.

Health and well-being services

Including 24 hour nurseline, wellness advocates, incentive programs, specialty care teams, and other innovative support like our MyHealth and myStrength tools.

Telehealth

Through our Zero Cost Telemedicine Partner Program, you have access to $0 copay telehealth office visits. Other Telehealth Office Visits have the same cost share as your Primary Care Physician and non-office visits have the same cost share as an in person visit. CareSource fully supports your choice to use telehealth and is willing to partner with your Provider and we provide access to services to all members through Teladoc®. Teladoc® provides 24/7 access to US licensed physicians who can consult, diagnose, and prescribe medications by phone or video for short-term illnesses.

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