Review your CareSource marketplace plan documents to make sure you get the most from your health insurance plan. You can also contact us with any questions you have about your plan coverage.
CareSource Gold Plans
Higher premiums and lower out of pocket costs.
If you expect to have a lot of doctor appointments, need many prescription medicines, or need other health services, this may be a good choice for you. Gold plans have:
Higher premiums. You pay more each month for a Gold plan than you would for another metal level.
Lower out-of-pocket costs. With a Gold plan, the amount you pay each time you get a health service, such as seeing a doctor or filling a prescription, is less than what you’d pay if you have a Bronze or Silver plan.
- CareSource Gold: aligns to federal standard plan design including copays on prescription drugs.
- CareSource Core Gold: richer benefits than the Gold plan federal standard option, with lower copays on many services.
- CareSource Diabetes Gold: offers preferred coverage for diabetes medications, supplies, and care. There are special programs just for people with diabetes, like our diabetes focused Care Management program. The Diabetes Gold plan lowers your cost for care and gives you a predictable way to control ongoing costs.
CareSource Silver Plans
The only plans offering cost sharing reductions (CSRs).
The CareSource Silver Plan is our most popular plan. In fact, 50% of our members find that it fits best into their lifestyle and budget.
- Low Premium Silver: reduces your overall premium while allowing for CSRs.
- Silver: offers a balance between premiums and out-of-pocket costs.
- Diabetes Silver: offers preferred coverage for diabetes medications, supplies, and care. There are special programs just for people with diabetes, like our diabetes focused Care Management program. The Diabetes Silver plan lowers your cost for care and gives you a predictable way to control ongoing costs.
Financial Assistance – Silver plans are the only plans where you can take advantage of cost sharing reductions (CSRs). If you qualify for CSRs, they will lower your out-of-pocket costs – deductibles, copayments, and coinsurance. Eligibility for CSRs is determined by the Health Insurance Marketplace and is based on your household size and income.
CareSource Bronze Plans
Lowest premiums and highest out of pocket costs.
If you don’t expect to have many doctor appointments or need many prescription drugs, this may be a good choice for you. Bronze plans have:
Lowest premiums. You pay less each month for a Bronze Plan, but these plans have the highest deductibles and other out-of-pocket costs.
- Bronze First: offers first dollar benefits; meaning benefits we cover before you meet your deductible. This is not available with most Bronze plans. This plan focuses on keeping premiums low, while covering preventive services and other more common health care before you satisfy your deductible. This plan offers first dollar benefits for primary care, specialist, convenience care clinic visits and generic prescriptions.
- HSA Eligible: A CareSource marketplace plan designed to be compatible with a tax advantaged Health Savings Account (HSA). Outside of preventive services, you’ll need to satisfy your deductible before CareSource contributes to your health care costs.
The Member Handbook is a quick reference guide to your health care benefits. It allows you to quickly look up information such as how to contact us, how to request an ID card and how to pay your bill.
Evidence of Coverage (EOC)
The EOC is an important legal document that describes the relationship between CareSource, and CareSource members. It serves as your contract with CareSource and describes CareSource members’ rights, responsibilities and obligations. It also tells you how the plan works, the covered services you are entitled to, any conditions and limits related to covered services, the health care services that are not covered by the plan, and the annual deductible, copayments, and coinsurance you must pay when you receive covered services.
Access the EOC below that corresponds to your plan:
- 2024 CARESOURCE EVIDENCE OF COVERAGE
- 2024 CARESOURCE EVIDENCE OF COVERAGE – DENTAL, VISION AND FITNESS PLAN RIDER
- 2023 CARESOURCE EVIDENCE OF COVERAGE
- 2023 CARESOURCE EVIDENCE OF COVERAGE – DENTAL, VISION AND FITNESS PLAN RIDER
We want you to easily find the forms you need for your CareSource marketplace plan. Visit the Forms page to find any form when you need it.