SilverEPO

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam

CareSource (Common Ground Healthcare)

Starting at

$547

/month before subsidy

Key facts

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam is a 2026 Silver EPO health insurance plan from CareSource (Common Ground Healthcare), sold on the ACA Marketplace in Wisconsin under plan ID 87416WI0060012. The monthly premium starts at $547 before subsidies, based on a 40-year-old in the plan's lowest-cost rating area. The individual medical deductible is $4,700 ($9,400 for a family), and the individual out-of-pocket maximum is $10,600 ($21,200 for a family). After the deductible, coinsurance is 30% for covered in-network care. The plan is not HSA-eligible.

Plan ID
87416WI0060012
Plan year
2026
State
Wisconsin
Metal level
Silver
Plan type
EPO
HSA-eligible
No

Individual Deductible

$4,700

Family: $9,400

Out-of-Pocket Max

$10,600

Family: $21,200

Coinsurance

30%

You pay after deductible

Network Type

EPO

WIN001

Cost Sharing
What you pay for common services (after deductible unless noted)

Medical Services

Primary Care Visit$55.00
Specialist Visit$120.00
Urgent Care30.00% Coinsurance after deductible
Emergency Room$300.00

Prescription Drugs

Generic Drugs$10.00
Brand Name Drugs30.00% Coinsurance after deductible
Specialty Drugs40.00% Coinsurance after deductible
CMS Quality Rating
The federal government's star rating for this plan, based on clinical data and member surveys — the same rating shown on HealthCare.gov.
4.0overall
Medical care

How well doctors manage and coordinate care

Member experience

Member-survey satisfaction with the plan

Plan administration

Customer service, billing, and access to information

What you'd typically pay
Standardized coverage examples from this plan's official Summary of Benefits & Coverage — your estimated out-of-pocket cost in three common situations (in-network).

Having a baby

Normal delivery

$6,460

your estimated cost

Deductible
$4,700
Copays
$100
Coinsurance
$1,600

Managing type 2 diabetes

A year of routine care

$1,920

your estimated cost

Deductible
$900
Copays
$1,000
Coinsurance
$0

A simple fracture

ER visit + follow-up

$2,700

your estimated cost

Deductible
$2,100
Copays
$600
Coinsurance
$0
Is your medication or doctor covered?
Check this plan against your prescriptions and providers, using live data from the federal Marketplace (CMS). Always confirm with the insurer before enrolling.
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Official Plan Documents
Published by CareSource (Common Ground Healthcare). These are the authoritative source for coverage details.
Who This Plan Is Best For

This Silver EPO plan offers a balanced approach between monthly premiums and out-of-pocket costs, making it a popular choice for many families.

Consider this plan if you:

  • Visit the doctor a few times per year
  • Take regular prescription medications
  • Want moderate protection against high medical bills
  • May qualify for Cost-Sharing Reductions (CSR) to lower deductibles

This summary is generated based on plan attributes for educational purposes only.

Worst-Case Monthly Cost
What you'd pay if you hit your out-of-pocket maximum

If you max out this year

$1,430/month

Annual Premium

$6,564

OOP Maximum

$10,600

💡 What this means:

With a $4,700 deductible, you pay 100% of costs until you've spent that much. After that, you pay 30% (coinsurance) until you hit $10,600 total. Then insurance covers everything else for the year.

More plans from CareSource (Common Ground Healthcare) in Wisconsin

View all Marketplace plans in Wisconsin

Frequently asked questions about CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam

How much does CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam cost per month?

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam from CareSource (Common Ground Healthcare) starts at $547 per month before any subsidy in Wisconsin. Most Marketplace enrollees qualify for a premium tax credit that lowers what they actually pay — estimate your subsidy to see your net premium.

What is the deductible for CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam?

The individual medical deductible is $4,700, and the family deductible is $9,400. You pay for covered care out of pocket until you meet the deductible, after which the plan shares costs with you.

What is the out-of-pocket maximum for CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam?

The most you would pay in a year for covered in-network care is $10,600 for an individual and $21,200 for a family. Once you reach it, the plan pays 100% of covered services for the rest of the year.

Is CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam HSA-eligible?

No. CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam is not classified as an HSA-eligible high-deductible health plan, so it cannot be paired with a Health Savings Account.

What type of network does CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam use?

CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam is a EPO plan. EPO plans cover in-network care only (except emergencies) and usually do not require referrals to see specialists.

Understand what you'd actually pay

Important Notice

Plan details and costs shown are estimates for educational purposes only. Actual costs, coverage, and availability may vary. Always verify plan details and enroll through official channels at HealthCare.gov or your state marketplace.