WE GOT YOU.
Life is complicated. Your health insurance shouldn’t be. That’s why all CareSource Marketplace plans are simple and affordable with coverage for pre-existing conditions and no annual or lifetime dollar limits for essential health benefits. Every plan also includes pediatric vision benefits or coverage, plus our optional adult Vision through EyeMed® and fitness benefits. New, in 2025, we’ve expanded our offering to include enhanced plans for members with diabetes and heart conditions. We’ve even added a high deductible health plan option. So, if you need health insurance this open enrollment period, CareSource can help. We’ve been helping our members through uncertain times for over 30 years.
CARESOURCE MARKETPLACE PLANS COVER ESSENTIAL HEALTH BENEFITS
With CareSource’s Marketplace plans, you’ll get affordable health insurance that covers what you need, when you need it. All of CareSource’s Marketplace plans are ACA (Affordable Care Act) Compliant with all of the protections afforded by the ACA and coverage for all Essential Health Benefits.
If your plan is not ACA compliant, you might not have the coverage you need. For around $4* more per month, adults on your plan get access to benefits to treat the whole person – Vision and Fitness.
MARKETPLACE PLANS COVER ESSENTIAL HEALTH BENEFITS
Preventive & wellness services
Emergency services
Hospitalization
Prescription drugs
Outpatient care
Pregnancy, maternity and newborn care
Mental health and substance use disorder services
Rehabilitative and habilitative services and devices
Laboratory services
Pediatric services, including vision
Optional Adult Vision and Fitness benefit plans are also available
^Based on a single 30-year-old member. Your premium difference may be more or less based on your member and plan characteristics.
NEW AND ENHANCED PLANS IN 2025!
Chronic Condition and High-Deductible Health Plans
In keeping with our commitment to making a lasting difference in our member’s lives, CareSource is excited to offer new chronic condition health plans. These innovative plans support members living with diabetes and heart conditions, in addition to overall improved plan options.
DIABETES
Gold and Silver Plans
Living with Diabetes is easier with CareSource by your side. Our new enhanced diabetes plans offer $0 cost for selected drugs, $0 cost for self-management monitors, tests and supplies, and $0 cost for select medical services like counseling and screenings.
HEALTHY HEART
Gold and Silver Plans
CareSource has always been “Health Care with Heart®.” We’re also “Health Care For Your Heart” with $0 cost for select heart drugs, $0 cost for select self-management items like blood pressure cuffs∞ and $0 cost for select heart care services and testing.
∞Limit of one per member.
PREVENTIVE HIGH-DEDUCTIBLE HEALTH PLAN
Silver Health Plans
There can be significant benefits to having a high-deductible health plan, especially if it’s from CareSource. In addition to lower premiums, members can also enjoy $0 cost for select drugs, self-management tools and services.
EXTRA WAYS TO SAVE MONEY
**One out of two customers can get a Caresource Marketplace Silver plan for under $10 a month with financial help! **Over 98% of people who enroll in a CareSource Health Insurance Marketplace plan also qualify for a government-funded subsidy that substantially lowers the overall cost of the plan. When you enroll, you’ll see if you qualify. Eligibility for these funds is determined by the Health Insurance Marketplace, and not by CareSource. There are two ways in which the funds are distributed:
| Advance Premium Tax Credit (APTC) |
|---|
A tax credit based on income level that lowers monthly premium payments. This can be used no matter which plan you enroll in. |
| Cost-Sharing Reduction (CSR) |
|---|
CSRs are discounts or “extra savings” that lower the amount you have to pay for deductibles, copayments, and coinsurance. CSRs only apply to Silver plans†, so if you qualify for a CSR, you must enroll in a Silver plan to get them. |
Service Area
CareSource Marketplace plans are available statewide in West Virginia:
Barbour, Berkeley, Boone, Braxton, Brooke, Cabell, Calhoun, Clay, Doddridge, Fayette, Gilmer, Grant, Greenbrier, Hampshire, Hancock, Hardy, Harrison, Jackson, Jefferson, Kanawha, Lewis, Lincoln, Logan, Marion, Marshall, Mason, McDowell, Mercer, Mineral, Mingo, Monongalia, Monroe, Morgan, Nicholas, Ohio, Pendleton, Pleasants, Pocahontas, Preston, Putnam, Raleigh, Randolph, Ritchie, Roane, Summers, Taylor, Tucker, Tyler, Upshur, Wayne, Webster, Wetzel, Wirt, Wood, and Wyoming
Marketplace Plan Benefits
Marketplace Plans
Marketplace plans are separated into metal levels of Gold, Silver, and Bronze. The metal levels are based on how you and CareSource share the cost of your health care. Note: many CareSource members are also eligible for helpful government subsidies, which will lower your cost for health care.
Are You a Member?
Get quick access to prescription coverage, find a doctor or provider, use health and educational tools, and discover what you can do with your My CareSource® account.