Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.

Diabetes Silver 5000 $0 Chronic Care Drugs & Services

CareSource · 2026 plan year

Silver
Ind. deductible
$5,000
Family deductible
$10,000
Ind. OOP max
$9,500
Family OOP max
$19,000

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Monthly premiums by age

Rating Area 12 — the lowest-priced of the 15 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$333$333
21$435$478
30$493$572
40$556$645
50$777$916
60$1,180$1,392
64 and over$1,304$1,539

Live premium estimate

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Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$30.00

Specialist

BenefitIn-network
Specialist Visit$50.00

Hospital

BenefitIn-network
Emergency Room Services50.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)$600.00 Copay per Stay after deductible
Outpatient Surgery Physician/Surgical Services50.00% Coinsurance after deductible
Urgent Care Centers or Facilities$70.00

Pharmacy

BenefitIn-network
Generic Drugs$15.00
Non-Preferred Brand Drugs40.00% Coinsurance after deductible
Preferred Brand Drugs$100.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$600.00 Copay per Stay after deductible
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental50.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$75.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy50.00% Coinsurance after deductible
Chiropractic Care$30.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care$600.00 Copay after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education50.00% Coinsurance after deductible
Dialysis50.00% Coinsurance after deductible
Durable Medical Equipment50.00% Coinsurance after deductible
Emergency Transportation/Ambulance50.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services$30.00
Hearing AidsNo charge
Home Health Care Services50.00% Coinsurance after deductible
Hospice Services50.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)$300.00 Copay after deductible
Infertility Treatment50.00% Coinsurance after deductible
Infusion Therapy50.00% Coinsurance after deductible
Inpatient Physician and Surgical ServicesNo Charge after deductible
Laboratory Outpatient and Professional Services$75.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Rehabilitative Occupational and Rehabilitative Physical Therapy$30.00
Nutritional Counseling50.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)50.00% Coinsurance after deductible
Outpatient Rehabilitation Services50.00% Coinsurance after deductible
Prenatal and Postnatal Care$50.00
Private-Duty Nursing50.00% Coinsurance after deductible
Prosthetic Devices50.00% Coinsurance after deductible
Radiation50.00% Coinsurance after deductible
Reconstructive Surgery50.00% Coinsurance after deductible
Rehabilitative Speech Therapy$30.00
Skilled Nursing Facility50.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services$600.00 Copay per Stay after deductible
Substance Abuse Disorder Outpatient Services$30.00
Transplant50.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders50.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$400.00 Copay after deductible

Service area

This plan covers 77 geographic areas.

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