CareSource*

CareSource* | CareSource Just4Me Gold

  • CareSource Just4Me Gold is an Obamacare health insurance plan offered by CareSource* that is available for individuals and families.

  • This plan is a HMO, meaning you will have to stay within the insurance company’s network, and will need to see a primary care doctor first and get a referral in order to see a specialist. (Read more about HMOs.)

  • This plan is a Gold metal level plan, which generally has a higher monthly cost but lower deductible (and co-pay), and provides good insurance coverage for people and families who spend more on health care (doctor visits, Rx, tests) than the average person.

  • Deductible amount of $1,000. A deductible is the amount of healthcare costs you will pay on your own each year before the insurance company.

  • Max out-of-pocket of $2,000, which is the most you will pay in a plan year outside of premiums, out-of-network providers and non-essential health benefits.


Ways to Enroll or Learn More

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Plan Summary

Monthly Cost

Plan Name:
CareSource Just4Me Gold

Plan ID:
77552OH0010029

Plan Type:
HMO

Deductible:
$1,000

Maximum Out-of-Pocket:
$2,000

Summary of Benefits:

Provider Information:

Who is this plan for?

This plan with a higher monthly cost is great for individuals and families who have multiple, serious, or chronic health needs, regularly visit the doctor, and regularly use multiple prescription drugs. The low deductible on this plan means you won't have to pay as much money out of pocket for medical care and prescriptions before your insurance kicks in. The low out-of-pocket maximum on this plan protects you from having to pay a large medical bill if an emergency happens. Plans with this type of provider network tend to have a narrower provider network.

HealthCare.com is a privately-held internet start-up for healthcare consumers. We’re not the government website.

Highlights


Emergency Room:
$250 Copay after deductible

Retail Drugs:
$120

Generic Drugs:
No Charge

Overview


Plan Type:
HMO

Metal Level:
Gold

Health Spending Account:
No

Primary Care Office Visit:
No Charge

Specialist Office Visit:
$50

Out of Network Coverage:
No

Out of Country Coverage:
No

Coverage Details

Preventive Care

Periodic Health Exam
In Network:
No Charge

Out of Network:
Not Covered
Well Baby Care
In Network:
No Charge

Out of Network:
Not Covered

Inpatient

Hospital Services
In Network:
$250 Copay per Stay after deductible

Out of Network:
Not Covered
Physician Fee
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Skilled Nursing Facility
In Network:
$100 Copay per Stay after deductible

Out of Network:
Not Covered
Mental Health
In Network:
$250 Copay per Stay after deductible

Out of Network:
Not Covered
Substance Abuse
In Network:
$250 Copay per Stay after deductible

Out of Network:
Not Covered
Home Healthcare
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered

Outpatient

Surgery
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
X-ray and Diagnostics
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Labs
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Facility Fee
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Mental Health
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Substance Abuse
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Rehabilitation Services
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered

Maternity/Pregnancy

Pre & Postnatal Care
In Network:
$50

Out of Network:
Not Covered
Infertility Treatment
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Labor and Delivery Inpatient Services
In Network:
$250 Copay after deductible

Out of Network:
Not Covered

Dental

Accidental Care
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered

Vision

Eye Exam (Child)
In Network:
No Charge

Out of Network:
Not Covered
Glasses (Child)
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered

Additional Coverage

Chiropractic Care
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Habilitation Services
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Rehabilitation Services (Speech)
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Rehabilitation Services (Occupational Therapy)
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Hospice Service
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Diabetes Care Management
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Durable Medical Equipment
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered
Nutritional Consuleling
In Network:
No Charge

Out of Network:
Not Covered
Reconstructive Surgery
In Network:
20% Coinsurance after deductible

Out of Network:
Not Covered

Doctor Visits

Primary Care Visit
In Network:
No Charge

Out of Network:
Not Covered
Specialist Visit
In Network:
$50

Out of Network:
Not Covered
Other Practitioner Office Visit
In Network:
No Charge

Out of Network:
Not Covered
Preventative Care / Screening / Immunization
In Network:
No Charge

Out of Network:
Not Covered

Emergency Room and Urgent Care

Emergency Room Services
In Network:
$250 Copay after deductible

Out of Network:
$250 Copay after deductible
Urgent Care Services
In Network:
$75

Out of Network:
Not Covered
Ambulance/Transportation Services
In Network:
20% Coinsurance after deductible

Out of Network:
20% Coinsurance after deductible

Drugs

Generic Prescription
In Network:
No Charge

Out of Network:
Not Covered
Retail Brand Drugs
In Network:
$120

Out of Network:
Not Covered
Non Retail Brand Drugs
In Network:
$160

Out of Network:
Not Covered
Specialty Drugs
In Network:
40%

Out of Network:
Not Covered
Drug Maximum Out of Pocket
In Network:
Individual: $1,500 Family: $3,000

Out of Network:
Individual: Not Applicable Family: Not Applicable
Drug Deductible
In Network:
Individual: No Charge Family: No Charge

Out of Network:
Individual: Not Applicable Family: Not Applicable

Additional Plan Information

Summary Of Benefits:

Provider Information:

HealthCare.com is a privately owned website, and monthly costs shown above are estimates only. Your monthly premium may change based on the data provided, outside fees, optional benefits or if other factors take effect before your coverage start date. Note that insurance companies reserve the right to change your premium rate and the policy terms at any time. Effective date, benefit amounts and other conditions may apply at the discretion of the insurance carrier you select. Depending on your state of residence, this website may not display all plans available by state. The Obamacare Tax Subsidy Calculator amounts are estimates only and the actual amount of subsidy eligibility may differ. Access to your physician depends on network selected, and networks can change without notice. Contact your health insurance company to confirm your healthcare provider is still available in the network you select.

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