CareSource Kentucky Co.

Gold 1500 $15 Generic Drugs

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    Plan Overview

    Medical Deductible
    • Individual: $1,500
    • Family: $3,000
    • Per Person: $1,500
    Prescription Drug Deductible
    • Individual: Included in Medical
    • Family: Included in Medical
    • Per Person: Included in Medical
    Medical Out-of-Pocket Maximum
    • Individual: $7,800
    • Family: $15,600
    • Per Person: $7,800
    Drug Out-of-Pocket Maximum
    • Individual: Included in Medical
    • Family: Included in Medical
    • Per Person: Included in Medical

    Office Visit

    Primary Doctor
    • Standard: $30.00
    Specialist
    • Standard: $60.00

    Prescription Drug Information

    Preferred Brand Drugs
    • Standard: $30.00
    Non Preferred Brand Drugs
    • Standard: $60.00
    Generic Drugs
    • Standard: $15.00
    Specialty Drugs
    • Standard: $250.00

    Emergency and Urgent Care

    Emergency Room
    • Standard: Not Applicable