Plan Documents

CareSource insurance plans for individuals and families provide comprehensive benefits including preventive care. Prior authorization is required for certain services.

Benefits at a Glance

Use this guide to see your benefits and services! You can learn more about these benefits and services in your Certificate of Coverage (below).

 Gold* PlansSilver PlansBronze Plans
10 Essential Health Benefits✓✓✓
Teladoc** Telehealth services✓✓✓
Out-of-Pocket CostsLowestHigherHighest
Monthly PremiumHighestLowerLowest
Health Savings Account (HSA) Compatible** ✓
Off Exchange		✓
On Exchange
Off Exchange
Cost Sharing Reduction (CSR)*** ✓
On Exchange		 
Extra Benefits for Additional Premium
Adult Vision Exam✓
On Exchange		✓
On Exchange		 
Adult Vision Exam & Allergy Testing✓
Off Exchange		✓
Off Exchange		✓
Off Exchange

*Do you expect to need a lot of medical appointments, prescriptions or other health services? A Gold plan may be a good choice for you.

**Teladoc telehealth services are included with all plans. If you select a plan that is HSA compatible, telehealth visits through Teladoc are subject to standard cost-sharing. $0 cost visits will apply after the annual deductible is met.

***Eligibility for a Cost Sharing Reduction (CSR) to lower your out-of-pocket costs (deductibles, copayments, and coinsurance) is determined by the Health Insurance Marketplace. It is based upon your household size and income.

Certificate of Coverage (COC)

The Certificate of Coverage is an important legal document. It serves as your contract with CareSource and describes your rights and responsibilities as a member of the plan. 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.
  • The annual deductible, copayments, and coinsurance you must pay when you receive covered services.

Access the COC below that corresponds to your plan

Schedule of Benefits (SOB) 

The Schedule of Benefits lists the amount of coverage and cost-sharing requirements in a plan.

Summary of Benefits and Coverage (SBC)

The Summary of Benefits and Coverage is an easy-to-read comparison of costs and coverage.

Glossary