Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness
CareSource · 2026 plan year
Silver
- Ind. deductible
- $5,000
- Family deductible
- $10,000
- Ind. OOP max
- $9,500
- Family OOP max
- $19,000
Compare with other Silver plans in WV
Side by side: deductibles, out-of-pocket limits and copays.
Other cost-sharing reduction variants for this plan:
More CareSource plans in WV
Monthly premiums by age
Rating Area 6 — the lowest-priced of the 11 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $584 | $584 |
| 21 | $763 | $839 |
| 30 | $866 | $1,005 |
| 40 | $975 | $1,131 |
| 50 | $1,363 | $1,608 |
| 60 | $2,071 | $2,443 |
| 64 and over | $2,289 | $2,701 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $30.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | 50.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | $600.00 Copay per Stay after deductible |
| Outpatient Surgery Physician/Surgical Services | 50.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $70.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $15.00 |
| Non-Preferred Brand Drugs | 40.00% Coinsurance after deductible |
| Preferred Brand Drugs | $100.00 |
| Specialty Drugs | 50.00% Coinsurance after deductible |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | $600.00 Copay per Stay after deductible |
| Mental/Behavioral Health Outpatient Services | $30.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Routine Dental Services (Adult) | Not covered |
| Accidental Dental | 50.00% Coinsurance after deductible |
| Acupuncture | Not covered |
| Allergy Testing | $75.00 |
| Bariatric Surgery | 50.00% Coinsurance after deductible |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | Not covered |
| Chemotherapy | 50.00% Coinsurance after deductible |
| Chiropractic Care | $50.00 |
| Chronic Pain Treatment | $30.00 |
| Cosmetic Surgery | Not covered |
| Delivery and All Inpatient Services for Maternity Care | $600.00 Copay after deductible |
| Dental Check-Up for Children | Not covered |
| Diabetes Education | 50.00% Coinsurance after deductible |
| Dialysis | 50.00% Coinsurance after deductible |
| Durable Medical Equipment | 50.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 50.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Habilitation Services | $30.00 |
| Hearing Aids | Not covered |
| Home Health Care Services | 50.00% Coinsurance after deductible |
| Hospice Services | 50.00% Coinsurance after deductible |
| Imaging (CT/PET Scans, MRIs) | $300.00 Copay after deductible |
| Infertility Treatment | 50.00% Coinsurance after deductible |
| Infusion Therapy | 50.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | No Charge after deductible |
| Laboratory Outpatient and Professional Services | $75.00 |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | Not covered |
| Nutritional Counseling | 50.00% Coinsurance after deductible |
| Orthodontia - Adult | Not covered |
| Orthodontia - Child | Not 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 Services | 50.00% Coinsurance after deductible |
| Prenatal and Postnatal Care | $50.00 |
| Private-Duty Nursing | 50.00% Coinsurance after deductible |
| Prosthetic Devices | 50.00% Coinsurance after deductible |
| Radiation | 50.00% Coinsurance after deductible |
| Reconstructive Surgery | 50.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | $30.00 |
| Rehabilitative Speech Therapy | $30.00 |
| Routine Eye Exam (Adult) | No charge |
| Routine Eye Exam for Children | No charge |
| Routine Foot Care | Not covered |
| Skilled Nursing Facility | 50.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | $600.00 Copay per Stay after deductible |
| Substance Abuse Disorder Outpatient Services | $30.00 |
| Transplant | 50.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | 50.00% Coinsurance after deductible |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | $400.00 Copay after deductible |
Plan rules
Service area
This plan covers 1 geographic area.
Open enrollment coming up?
Get notified when it opens — we'll remind you so you don't miss your window.