WE GOT YOU.
CareSource Marketplace plans are simple and reliable with coverage for pre-existing conditions and no annual or lifetime dollar limits for essential health benefits. Every plan also includes pediatric vision benefits, plus our optional adult vision through EyeMed® and fitness benefits.
Recent regulatory actions have changed with health insurance from availability of tax credits, to enrollment rules, and beyond. The one thing that hasn’t is CareSource’s commitment to you. So, if you need health insurance this open enrollment period, CareSource can help. We’ve been helping our members through uncertain times for over 30 years.
MARKETPLACE PLANS COVER ESSENTIAL HEALTH BENEFITS
Preventive & wellness services
Emergency services
Hospitalization
Prescription drugs
Outpatient care
Pregnancy, maternity and newborn care
Mental health and substance use disorder services
Rehabilitative and habilitative services and devices
Laboratory services
Pediatric services, including vision
Optional Adult Vision and Fitness benefit plans are also available
ENHANCED PLANS IN 2026!
In keeping with our commitment to making a lasting difference in our member’s lives, we offer $0 chronic care health plans. These innovative plans support members living with diabetes and heart conditions, in addition to overall improved plan options. Ensuring we have your back every step of the way. We Got You! Like our other plans, if you qualify for Advance Premium Tax Credits (APTC), they can help lower your premiums. Select your specific state at the top of this page to learn more about each plan.
DIABETES
Gold and Silver Plans
Living with Diabetes is easier with CareSource by your side. Our diabetes plans offer $0 chronic care drugs, $0 chronic care self-management supplies, and $0 chronic care medical services.
HEALTHY HEART
Gold and Silver Plans
CareSource has always been “Health Care with Heart®.” We’re also “Health Care For Your Heart” with $0 chronic care drugs, $0 chronic care medical supplies like a blood pressure cuff** and $0 chronic care medical services.
**Limit of one
HDHP PREVENTIVE AND PREVENTIVE
Gold and Silver Plans
There can be significant benefits to having a high-deductible health plan, especially if it’s from CareSource. In addition to lower premiums, members can also enjoy $0 preventive drugs, self-management supplies and medical services.
GOVERNMENT SUBSIDIES
EXTRA WAYS TO SAVE MONEY
**Over 70% of people who enroll in a CareSource Health Insurance Marketplace plan also qualify for a government-funded subsidy that substantially lowers the overall cost of the plan. When you enroll, you’ll see if you qualify. Eligibility for these funds is determined by the Health Insurance Marketplace, and not by CareSource. There are two ways in which the funds are distributed:
| Advance Premium Tax Credit (APTC) |
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A tax credit based on income level that lowers monthly premium payments. If you qualify, this can be used no matter which plan you enroll in. |
| Cost-Sharing Reduction (CSR) |
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CSRs are discounts or “extra savings” that lower the amount you have to pay for deductibles, copayments, and coinsurance. CSRs only apply to Silver plans†, so if you qualify for CSR, you must enroll in a Silver plan. |
While APTCs will be reducing in plan year ’26, they will still be available for members. There will be no changes to CSRs.
LOW PREMIUM BRONZE OPTION
While a lean plan design, this plan option still provides better than going uninsured.
OFF EXCHANGE
CareSource now offers Off Exchange health insurance plans outside the usual government exchanges. It’s important because it gives you more choices and often better prices. This means you can pick the plan that fits your needs and budget best, helping you get the coverage you want without extra hassle. Benefits:
- Wider Plan Selection – Access a broader variety of insurance plans beyond what’s available on government exchanges, giving you more options to find the perfect fit.
- Competitive Pricing – Benefit from potentially lower premiums and flexible pricing options that can better suit your budget.
- No Income Restrictions – Unlike exchange plans that often require income verification for subsidies, Off Exchange plans have fewer eligibility limits.
- Flexible Enrollment Periods – Take advantage of more flexible enrollment windows, making it easier to get coverage when you need it.
- Direct Provider Relationship – Work directly with insurers or brokers, simplifying communication and support for a smoother purchasing experience.
OFF EXCHANGE ONLY
For those without access to subsidy, be it APTC or CSR, going off exchange can provide savings over on exchange while simplifying the process.
SUPPORT FOR ICHRA AND QHSERA
Looking for flexible health coverage that works with your employer’s benefits? Off Exchange Marketplace plans are a great choice if your company offers an ICHRA (Individual Coverage Health Reimbursement Arrangement) or QHSERA (Qualified Health Plan Status for Employee Retiree Arrangements). These plans let you pick the insurance that fits your needs, while your employer helps cover the cost through reimbursement. That means you get personalized, affordable coverage with the freedom to choose what works best for you—all while staying compliant with important healthcare rules. Enjoy more control, flexibility, and support with Off Exchange Marketplace plans!
HSA COMPATIBLE PLANS
These plans provide tax advantaged savings that can reduce your cost of care. All Bronze plans are HDHP qualified and look for HDHP or HSA Eligible for other metal level options.
Marketplace Plan Benefits
Telehealth
Through Teladoc®, you have access to $0 medical and behavioral health telehealth visits*. Other telehealth visits have the same cost share as your Primary Care Physician and virtual care 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. CareSource and our partners provide access to U.S. licensed physicians who can consult, diagnose and prescribe medications by phone or video for short-term illnesses. Benefits include:
- Receive confidential care from the comfort of your home, reducing exposure to illnesses.
- Convenient access to quality healthcare anytime, anywhere, without the need to travel to a doctor’s office.
- Fast Access – Connect with licensed medical professionals quickly, often with same-day or immediate appointments.
*Doesn’t include HSA plans.
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, telehealth, urgent care, retail generic and retail preferred brand name 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.
24-Hour Nurse Advice Line
Our nurse advice line has a team of nurses who can answer health questions 24/7/365.
Health and well-being services
Including our 24-hour nurse advice line, wellness advocates, incentive programs, specialty care teams, and other innovative support like our MyHealth and myStrengthSM tools.
Hearing Benefits
All CareSource Marketplace plans include TruHearing® coverage and $0 copay for routine hearing screenings.
Marketplace Plans
Marketplace plans are separated into metal levels of Gold, Silver and Bronze. The metal levels are based on how you and CareSource share the cost of your health care. Note: many CareSource members are eligible for helpful government subsidies, which will lower your cost for health care.
SEE HOW CARESOURCE CAN SAVE YOU MONEY ON HEALTH INSURANCE
CareSource offers a variety of Marketplace plans to fit your lifestyle and budget. Browse and compare to find a plan that’s right for you.
1-844-539-1733
(TTY: 1-833-711-4711 or 711)
You can also call your local insurance agent or agency.