Benefits and Services
CareSource plans provide comprehensive, quality coverage that you can afford, understand and use. We offer individual and family plans with optional dental and vision coverage for adults.
CareSource is a Qualified Health Plan issuer on the Health Insurance Marketplace.
For 2019, CareSource Marketplace Plans feature the following benefits:
- CSR-eligible Silver plans come in three different packages – Low Premium, Standard or Low Deductible – to fit your lifestyle and budget.
- Low copays for primary care visits.
- Active&Fit® Fitness benefit included with all Dental & Vision plans at no extra charge. Includes access to a network of participating fitness centers, including select LA Fitness®, Snap FitnessTM, Anytime Fitness®, Planet Fitness® – plus more! To get more information about the Active&Fit program, visit www.ActiveandFit.com.
- NEW for 2019 – TruHearing® hearing coverage included with all 2019 plans.
We are here to help you. Your services include:
- Member Services: Our Member Services representatives are available toll-free to answer your questions and provide assistance Monday through Friday, from 7 a.m. to 7 p.m. Eastern Standard Time (EST). We also provide TTY access for members who are deaf or hearing impaired. Please call us at 1-855-202-0622 (TTY: 711).
- CareSource24® Nurse Advice Line – Members may call any time of the day or night to speak to a registered nurse about health and medical concerns. Call the number on your member ID card 24 hours a day, 7 days a week.
- Care Management Services – CareSource offers care management services to children and adults with special health care needs. Registered nurses, social workers and outreach workers can work with you one-on-one to help coordinate your care.
For more specific information about your benefits and services, please see your Evidence of Coverage and Member Handbook, found on the Plan Documents & Resources page. You can also contact us directly. We are happy to help.
Call for additional information:
- If you need more information about your health benefits, call CareSource Member Services at 1-855-202-0622 (TTY: 711)
- For help or more information about your pediatric and optional adult vision benefits, call EyeMed at 1-833-337-3129 or visit www.EyeMed.com
- For help or more information about the TruHearing discount program, call TruHearing at 1-866-202-2561 or visit www.TruHearing.com
- If you have our optional Dental & Vision coverage and would like more information about Active&Fit®, call 1-877-771-2746 or visit www.ActiveandFit.com
In order to have your health care services covered by CareSource, you must get them from a network provider. The only exceptions are:
- In cases of emergency;
- If you need medically necessary, covered urgent care services when traveling out of our service area; or
- When specifically authorized by CareSource.
For more information, please see your Member Handbook or Evidence of Coverage on the Plan Documents & Resources page. Use our Find a Doctor/Provider tool to find CareSource marketplace network providers.
CareSource is a Qualified Health Plan issuer in the Health Insurance Marketplace. This is not a Health Insurance Marketplace website. This website does not display all available Marketplace plans. To see all available Qualified Health Plan options available, go to www.healthcare.gov.
This website is subject to change at any time without prior notice. This website is intended only as general information and is not an offer or invitation to contract.
This is a solicitation for health insurance. All covered health care services must be received by in-network providers, except as otherwise required by applicable law, and subject to policy limitations and exceptions. Benefits, premiums, deductibles and copays may vary based on individual circumstances and plan selection. For complete details of coverage, limitations and exclusions, please review the CareSource Marketplace 2019 Evidence of Coverage and Schedule of Benefits documents at CareSource.com/marketplace.
Specific policy benefits listed on this website are intended to be a summary of coverage and do not list or describe all the benefits covered under specific policies nor is every limitation, exclusion or reduction of benefits listed. The overview of benefits, coverage and member cost shares are based on benefits being received from an in-network provider. To be eligible for reimbursement, all health care services must be provided by an in-network provider, except when applicable federal and state law or the applicable Evidence of Coverage for each policy provide otherwise.
Rates, benefits, premiums, deductibles, co-payments, co-insurance, and out of pocket expenses may vary based upon a variety of factors, including but not limited to, age, county of residence, smoking status, and level of policy selected.
References to CareSource pertain to each individual company or other CareSource affiliated companies, such as CareSource, CareSource Kentucky Co., CareSource Indiana Inc., and CareSource West Virginia Co. Each company is a separate entity and is not responsible for another’s financial condition or contractual obligations.
CareSource does not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of the plan, including enrollment and benefit determinations.
WVOIC Approved 04/03/2019
Last updated 06/04/2019