Clarity. Confidence. CareSource.
The health insurance Marketplace has changed — premiums are higher, choices are more complex and it’s harder to understand what’s really covered. CareSource cuts through the noise with straightforward answers, real support and coverage that fits your needs. This is what clear, dependable care looks like, when you need it most.
CARESOURCE MARKETPLACE PLANS COVER ESSENTIAL HEALTH BENEFITS
NETWORK UPDATE: SHAWANO & GREEN LAKE COUNTIES
Starting in 2027, CareSource Marketplace plans will no longer be available in Shawano and Green Lake Counties, as ThedaCare has made the decision to leave our network. Coverage for current members in these counties will end December 31, 2026, and CareSource will not offer Off Exchange plans in these counties either.
If you live in one of these counties, you’ll have the chance to choose a new plan during Open Enrollment, beginning November 1, 2026. To make sure your coverage starts January 1, 2027, enroll in a new plan by December 15, 2026. A local agent, broker or navigator can help you compare options at no cost — visit healthcare.gov/find-assistance to get started.
We remain committed to supporting you through this transition, including help with claims, appeals or questions about your current coverage through the end of 2026.
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.
CARESOURCE GOLD
Best for those with frequent doctor visits and need to fill prescriptions.
- Lower out-of-pocket cost
- Higher premium
- APTC is available for On-Exchange Gold plans for members who are eligible.
CARESOURCE SILVER
Best value for anyone who qualifies for an APTC or CSR†.
- CSR and/or APTC are available for On-Exchange Silver plans for members who are eligible.
CARESOURCE BRONZE
Best for those who don’t expect to visit the doctor often or fill prescriptions.
- Lower premium
- Higher out-of-pocket cost
- APTC is available for On-Exchange Bronze plans for members who are eligible.
OFF EXCHANGE ONLY PLAN OPTIONS
While all CareSource Marketplace plans are also available Off Exchange, Off Exchange Only plans are designed and sold directly through CareSource, outside of the Health Insurance Marketplace. These plans are ACA-compliant and offer the same essential health benefits required by the Affordable Care Act.
Off Exchange plans may be a good option for individuals and families who do not qualify for Marketplace financial assistance or who prefer to purchase coverage directly from CareSource. However, unlike Marketplace plans, Off Exchange plans are not eligible for Advance Premium Tax Credits (APTCs) or Cost-Sharing Reductions (CSRs) that can help lower your health care costs.
Interested in an Off Exchange Plan?
To learn more about available Off Exchange plans, compare coverage options and costs, or enroll:
- Visit Enroll.caresource.com
- Contact your insurance agent
- Call CareSource at 1-844-539-1733 (TTY: 711)
Our team can help you understand the differences between Marketplace and Off Exchange coverage and find the option that best fits your needs.
WAYS TO SAVE
Government Subsidies can significantly lower your costs. Over 80% of CareSource Marketplace members qualify for help.
- Advance Premium Tax Credit (APTC): Lowers your monthly premium based on income. Learn about APTC and see if your income qualifies.
- Cost-Sharing Reduction (CSR): Lowers out-of-pocket costs like deductibles and copays (available on Silver plans only). Learn about CSR and find out if you qualify.
Off Exchange Plans – direct from CareSource – great for CHOICE and QHSERA.
These plans are ideal if you don’t qualify for subsidies or if your employer offers reimbursement for individual coverage. Advantages include:
- More Options: On-Exchange plans plus exclusive Off-Exchange Only plans.
- Lower Premiums: Avoid exchange fees and enjoy extra savings.
- No Income Verification: Simplified enrollment.
- Flexible Enrollment: More opportunities to sign up.
- Personalized Support: Direct help from CareSource or your broker.
Health Savings Account (HSA) Compatible Plans
All Bronze plans qualify as High Deductible Health Plans (HDHP). Look for “HSA Eligible” on other metal levels. Learn more about HSAs.
MARKETPLACE PLAN BENEFITS
Telehealth
Through Teladoc Health®, 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, without the need to travel or expose your family to illnesses.
Convenient access to quality health care anytime, anywhere.
Fast Access – Connect with licensed medical professionals quickly, often with same-day or immediate appointments.
OPTIONAL ADULT VISION AND FITNESS BENEFITS
Our plans are available with adult Vision benefits for as little as $1 or $2 per month*.
Vision Exam
Coverage for one annual eye exam, excluding dilation and refraction.
Allergy Testing
Access to allergy evaluation, diagnostic testing and immunotherapy treatment.
*Based on a 30-year-old. Your cost may vary based on your demographics
Low Copays
CareSource plans have some of the lowest copays for in-network primary care or retail clinics. 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
Call our 24-Hour Nurse Advice Line any time you have a health-related question. Not sure where to go for care? We can help and it’s $0 cost to you! Call the number on the back of your ID card or use the mobile app to talk to a nurse.
Health and well-being services
CareSource also offers a rewards program, and personalized support through our specialty care teams, wellness advocates and tools like CareSource MyLifeSM and MyHealth.
Claims, Payment Policies & Other Information
Call Us Today at 1-844-539-1733
(TTY: 1-833-711-4711 or 711)
Or call your local broker.
Let us help you compare CareSource plans and find the right one for you!