CareSource Indiana

Plan Overviews

CareSource is a leading non-profit public sector managed care company, meeting the needs of health care consumers for more than 24 years.

Gold Plans

This may be a good choice for you if you expect to have a lot of doctor appointments, need many prescription medicines, or need other health services.

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.

Plan Costs

Plan Type Annual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max Primary Care Visit Copay Retail Clinic Visit Copay Specialist Visit Copay Emergency Copay
Individual $1,000 Medical $2,500 Pharmacy $2,000 20% $0 $0 $40 $250 after deductible
Family $2,000 Medical $5,000 Pharmacy $4,000 20% $0 $0 $40 $250 after deductible

Prescription Drug Coverage

Plan Type Preventive Generic Preferred Brand Non-preferred Brand Preferred Specialty Non-preferred Specialty
Individual/ Family $0 $0 $120 $160 40% Coinsurance (up to $300) 50% Coinsurance (up to $300)

Coinsurance

Service/Supply Examples Coinsurance after Deductible
Ambulance Services, Dental Services (related to accident or injury), Laboratory Services, Diagnostic  Mammogram,X-Rays, Home Health Care Services, Home Infusion Services, Hospice Services, Inpatient Professional Services, Medical Supplies, Durable Medical Equipment and Appliances, Outpatient Services, Therapy Services,   etc. 20%

Required Copays

Service Copay
Outpatient Advanced Imaging (CT/PET Scans, MRI) $150 after deductible
Inpatient Facility Services $150 copay per day for 5 days, $0 days 6 and  beyond
Skilled Nursing Facility for Physical Medicine and Rehabilitation $150 copay per day for 5 days, $0 days 6 and  beyond
Urgent Care Services $75
Pediatric Vision Services – an annual exam is provided at no charge. Copayments apply ONLY if additional office visits are  needed. $40

Pediatric vision and dental (including orthodontia) is included.

Silver Plans

Silver plans are a good middle of the road option, and also the best value when you qualify for cost-sharing reduction.

Plan Costs

Plan Type Annual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max Primary Care Visit Copay Retail Clinic Visit Copay Specialist Visit Copay Emergency Copay
Individual $3,300 $6,400 30% $0 $0 $50 $500 after deductible
Family $6,600 $12,800 30% $0 $0 $50 $500 after deductible

Prescription Drug Coverage

Plan Type Preventive Generic Preferred Brand Non-preferred Brand Preferred Specialty Non-preferred Specialty
Individual/ Family $0 $0 $60 $130 40% Coinsurance (up to $300) 50% Coinsurance (up to $300)

Coinsurance

Service/Supply Examples Coinsurance after Deductible
Ambulance Services, Dental Services (related to accident or injury), Laboratory Services, Diagnostic  Mammogram,X-Rays, Home Health Care Services, Home Infusion Services, Hospice Services, Inpatient Professional Services, Medical Supplies, Durable Medical Equipment and Appliances, Outpatient Services, Therapy Services,   etc. 20%

Required Copays

Service Copay
Outpatient Advanced Imaging (CT/PET Scans, MRI) $150 after deductible
Inpatient Facility Services $150 copay per day for 5 days, $0 days 6 and  beyond
Skilled Nursing Facility for Physical Medicine and Rehabilitation $150 copay per day for 5 days, $0 days 6 and  beyond
Urgent Care Services $75
Pediatric Vision Services – an annual exam is provided at no charge. Copayments apply ONLY if additional office visits are  needed. $40

Pediatric vision and dental (including orthodontia) is included.

A health plan in the bronze level may be a good choice for you if you don’t expect to have many doctor appointments or need many prescription  drugs.

Generally, plans in the Bronze category have the lowest premiums (your monthly insurance bill) but the highest deductibles and other out-of-pocket costs.

 

Plan Costs

 

Plan Type Annual Deductiblea specified amount of money that the insured must pay before an insurance company will pay a claim. Out-of-Pocket MaximumAn out-of-pocket maximum is the most you'll have to pay during a policy period (usually a year) for health care services CoinsuranceWhat % you pay after your deductible has been met and before your out of pocket max Primary Care Visit Copay Retail Clinic Visit Copay Specialist Visit Copay Emergency Copay
Individual $6,650 $6,850 40% $35 $35 $75 $500 after deductible
Family $13,300 $13,700 40% $35 $35 $75 $500 after deductible

Prescription Drug Coverage

 

Plan Type Preventive Generic Preferred Brand Non-preferred Brand Preferred Specialty Non-preferred Specialty
Individual/ Family $0 $25 $100 $250 40% Coinsurance (up to $300) 50% Coinsurance (up to $300)

Coinsurance

Service/Supply Examples

Coinsurance

after Deductible

Ambulance Services, Dental Services (related to accident or injury), Laboratory Services, Diagnostic  Mammogram,

X-Rays, Home Health Care Services, Home Infusion Services, Hospice Services, Inpatient Professional Services, Medical Supplies, Durable Medical Equipment and Appliances, Outpatient Services, Therapy Services,   etc.

40%

 

Required Copays

 

Service Copay
Outpatient Advanced Imaging (CT/PET Scans, MRI) $200 after deductible
Inpatient Facility Services $250 copay per day for 5 days, $0 days 6 and  beyond
Skilled Nursing Facility for Physical Medicine and Rehabilitation $100 copay per day for 5 days, $0 days 6 and  beyond
Urgent Care Services $100
Pediatric Vision Services – an annual exam is provided at no charge. Copayments apply ONLY if additional office visits are  needed. $75

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