Core Gold 1500 $10 Generic Drugs

CareSource · 2026 plan year

Gold
Ind. deductible
$1,500
Family deductible
$3,000
Ind. OOP max
$8,000
Family OOP max
$16,000

Compare with other Gold plans in OH

Side by side: deductibles, out-of-pocket limits and copays.

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Monthly premiums by age

Rating Area 11 — the lowest-priced of the 17 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$476$476
21$622$685
30$706$819
40$795$923
50$1,112$1,312
60$1,689$1,993
64 and over$1,867$2,203

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$20.00

Specialist

BenefitIn-network
Specialist Visit$60.00

Hospital

BenefitIn-network
Emergency Room Services15.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)25.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$40.00

Pharmacy

BenefitIn-network
Generic Drugs$10.00
Non-Preferred Brand Drugs40.00% Coinsurance after deductible
Preferred Brand Drugs$50.00
Specialty Drugs50.00% Coinsurance after deductible

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services25.00% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services$20.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNot covered
Accidental Dental25.00% Coinsurance after deductible
AcupunctureNot covered
Allergy Testing$60.00
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy25.00% Coinsurance after deductible
Chiropractic Care$20.00
Cosmetic SurgeryNot covered
Delivery and All Inpatient Services for Maternity Care25.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education25.00% Coinsurance after deductible
Dialysis25.00% Coinsurance after deductible
Durable Medical Equipment25.00% Coinsurance after deductible
Emergency Transportation/Ambulance25.00% Coinsurance after deductible
Eye Glasses for ChildrenNo charge
Habilitation Services$20.00
Hearing AidsNo charge
Home Health Care Services25.00% Coinsurance after deductible
Hospice Services25.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)25.00% Coinsurance after deductible
Infertility Treatment25.00% Coinsurance after deductible
Infusion Therapy25.00% Coinsurance after deductible
Inpatient Physician and Surgical Services25.00% Coinsurance after deductible
Laboratory Outpatient and Professional Services$30.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional Counseling25.00% Coinsurance after deductible
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$20.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Outpatient Rehabilitation Services25.00% Coinsurance after deductible
Prenatal and Postnatal Care$60.00
Private-Duty Nursing25.00% Coinsurance after deductible
Prosthetic Devices25.00% Coinsurance after deductible
Radiation25.00% Coinsurance after deductible
Reconstructive Surgery25.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy$20.00
Rehabilitative Speech Therapy$20.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility25.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services25.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$20.00
Transplant25.00% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders25.00% Coinsurance after deductible
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging25.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 1 geographic area.

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