HDHP Preventive and Preventive Silver Plans | West Virginia – Marketplace | CareSource

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HDHP Preventive and Preventive Silver Plans

West Virginia
MARKETPLACE
HDHP PREVENTIVE AND PREVENTIVE SILVER PLANS

We Got You.

LEARN ABOUT THE CARESOURCE HDHP PLAN OPTIONS

1-844-539-1733

(TTY: 1-833-711-4711 or 711)

You can also call your local insurance agent or agency.

Transparency in Coverage

The Departments of the Treasury, Labor, and Health and Human Services (the Departments) Transparency in Coverage final rules (85 FR 72158) require non-grandfathered group health plans and health insurance issuers in the individual and group markets (plans and issuers) to disclose in-network negotiated rates and out-of-network allowed amounts in machine readable files. Our files are located here.

‡HDHP drug coverage includes an additional limited no-cost preventive drug benefit. Drugs in this benefit are covered at no cost before you meet the plan’s deductible. If these drugs are prescribed for treatment and not prevention, you will be charged the normal cost. See your plan details online at CareSource.com/plans/marketplace/ for more information.

**HSA eligibility is only available on certain plans based on IRS restrictions.

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 plans. To see all available Qualified Health Plan options, 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.

IMPORTANT REMINDER FOR HDHP HSA PLANS:

Your coverage includes a preventive drug benefit. This means that preventive drugs (medications to help prevent chronic conditions and illnesses) are covered outside of your plan’s deductible.

These drugs can, at times be prescribed for treatment purposes. As a result, the listing of a drug does not mean that it will be covered by your benefit plan before your HDHP deductible is satisfied. If your doctor has prescribed a listed drug for treatment purposes (and not preventive purposes) then your plan does not provide coverage for that drug before your HDHP deductible is satisfied. Please be reminded that Health Savings Accounts (HSAs) have tax and legal ramifications. CareSource cannot guarantee or provide any legal advice on the way these products are prescribed for preventive purposes or that the IRS would agree that all satisfy the definition under §223 NOTICE 2019-45.

As everyone’s medical circumstances are different, and because proper classification is necessary for you to ensure you are complying with applicable HDHP tax regulations, it is important for you to confirm the purpose of the prescription with your doctor. Please call the number on your member ID card when your doctor confirms for you that they prescribed one of the listed drugs for treatment purposes so your claims can be processed correctly. Unless you provide us with this information, claims for the drugs listed in the will be processed as “preventive,” and you or your doctor may be asked by us to provide medical records showing that the drug you’re taking is being used for prevention. Remember, if you improperly classify the drug, it may result in adverse tax consequences so please be sure to take the confirming step to properly classify your claim.

Please follow these steps to make sure you are properly classifying the purpose of your prescription:

1. Find your drug on the list.
2. Talk to your doctor about whether your drug is in fact being prescribed for preventive purposes (and not treatment purposes).
3. If prescribed for treatment purposes, call the number on your member ID card to let us know.
4. If prescribed for preventive purposes, there is no need to call.

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.

Policies offered by CareSource have exclusions, limitations, and reductions of benefits and terms under which the policy may be continued in force or discontinued. The amount of benefits provided depends on the plan selected and the premium will vary with the amount of benefits selected. For complete costs and details of coverage, please call CareSource. Also, please use the link(s) provided to download and review policy information, such as the Evidence of Coverage, Prescription Drug Formulary and Schedule of Benefits (Georgia, Indiana, Michigan, Nevada, North Carolina, Ohio, West Virginia, Wisconsin), for a more complete explanation of benefits, exclusions, limitations and terms under which policies may not be renewed.

References to CareSource pertain to each individual company or other CareSource affiliated companies, such as CareSource, CareSource Georgia Co., CareSource Indiana Inc., HAP CareSource Michigan Co., CareSource Nevada Co., CareSource North Carolina Co., CareSource West Virginia Co., CareSource Wisconsin Co., CareSource Ohio Inc. and CareSource Management Services LLC. 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 determination.

You may view the Access Plan, as required by the Health Benefit Plan Network Access and Adequacy Act, online at CareSource.com/documents/wv-exc-m-1304300-final-public-caresource-access-plan/. You may also contact us at 1-833-230-2099 (TTY: 711) to request a copy.

You may view the Access Plan, as required by the Health Benefit Plan Network Access and Adequacy Act, online at CareSource.com/documents/wv-exc-m-1304300-final-public-caresource-access-plan/. You may also contact us at 1-833-230-2099 (TTY: 711) to request a copy.

ADV-HDHPLanding(WV2026)

WVOIC Approved: 10/8/2025

LAST UPDATED: October 15, 2025

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