CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam
Expanded Bronze · EPO · CareSource (Common Ground Healthcare) · Wisconsin
At age 40 it costs between $448.86 and $583.29 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What CMS publishes about it
| Plan ID | 87416WI0060003 |
|---|---|
| Insurer | CareSource (Common Ground Healthcare) |
| Metal level | Expanded Bronze |
| Plan type | EPO |
| Standardised design | Design 1 — a plan CMS defined the benefits of, so it can be compared like for like |
| Deductible (individual) | $7,500 |
| Deductible (family) | $15,000 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $10,000 |
| Family maximum | $20,000 |
| Primary care visit | $50 |
| Specialist visit | $100 |
| Emergency room | 50% Coinsurance after deductible |
| Inpatient stay | 50% Coinsurance after deductible |
| Generic drugs | $25 |
| Preferred brand drugs | $50 Copay after deductible |
| Specialty drugs | $500 Copay after deductible |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 99.72% |
| Network directory | Who is in network |
| Summary of benefits | Summary of benefits and coverage |
| Drug list | Formulary |
| Customer service | 1-877-514-2442 · TTY 1-844-472-2442 |
Where it is sold, and what it costs there
13 counties. The premium is the price before any tax credit; what you pay depends on your income.
| County | At 21 | At 30 | At 40 | At 50 | At 60 |
|---|---|---|---|---|---|
| Brown County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Door County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Kewaunee County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Manitowoc County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Marinette County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Oconto County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Shawano County | $351.22 | $398.64 | $448.86 | $627.28 | $953.21 |
| Ozaukee County | $373.42 | $423.84 | $477.23 | $666.93 | $1,013.47 |
| Washington County | $373.42 | $423.84 | $477.23 | $666.93 | $1,013.47 |
| Waukesha County | $373.42 | $423.84 | $477.23 | $666.93 | $1,013.47 |
| Jefferson County | $448.76 | $509.35 | $573.52 | $801.49 | $1,217.94 |
| Walworth County | $448.76 | $509.35 | $573.52 | $801.49 | $1,217.94 |
| Green Lake County | $456.41 | $518.02 | $583.29 | $815.14 | $1,238.69 |
Open enrollment for 2026 coverage runs 1 November 2025 to 15 January 2026 in most states. Outside that window you need a qualifying life event — losing other coverage, moving, marrying, having a child — to enrol.
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When this plan’s price or benefits change.
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Premiums, deductibles, out-of-pocket maximums and cost sharing are reproduced from the HealthCare.gov Qualified Health Plan landscape file published by the Centers for Medicare & Medicaid Services for plan year 2026. Nothing on this page is calculated by us. This is not a complete list of your options and it is not advice: to see every plan and to enrol, use HealthCare.gov or call 1-800-318-2596.