CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam
Silver · EPO · CareSource (Common Ground Healthcare) · Wisconsin
At age 40 it costs between $547.21 and $711.09 a month before any subsidy, depending on which county you live in — a marketplace plan is priced per rating area, not per state.
What this Silver plan costs if your income qualifies
Below certain incomes the marketplace improves a Silver plan's cost sharing automatically — you do not apply for it, and it happens on Silver and on no other metal level. The premium does not change; the deductible and what you pay at the doctor do.
| If your income is | Deductible | Most you could pay in a year | Primary care | Generic drugs |
|---|---|---|---|---|
| Above 250%, or not applied for | $4,700 | $10,600 | $55 | $10 |
| up to 150% of the federal poverty level | $0 | $3,500 | $5 | No Charge |
| 150% to 200% | $825 | $3,500 | $20 | $5 |
| 200% to 250% | $4,600 | $8,400 | $45 | $10 |
CMS calls these cost-sharing reductions. The percentages are actuarial values, not discounts. HealthCare.gov works out which one you get from the income you report when you apply.
What CMS publishes about it
| Plan ID | 87416WI0060012 |
|---|---|
| Insurer | CareSource (Common Ground Healthcare) |
| Metal level | Silver |
| Plan type | EPO |
| Deductible (individual) | $4,700 |
| Deductible (family) | $9,400 |
| Drug deductible | $5,000 |
| Most you could pay in a year | $10,600 |
| Family maximum | $21,200 |
| Primary care visit | $55 |
| Specialist visit | $120 |
| Emergency room | $300 |
| Inpatient stay | 30% Coinsurance after deductible |
| Generic drugs | $10 |
| Preferred brand drugs | $80 |
| Specialty drugs | 40% Coinsurance after deductible |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 99.78% |
| 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 | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Door County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Kewaunee County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Manitowoc County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Marinette County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Oconto County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Shawano County | $428.18 | $485.98 | $547.21 | $764.73 | $1,162.08 |
| Ozaukee County | $455.25 | $516.70 | $581.80 | $813.07 | $1,235.54 |
| Washington County | $455.25 | $516.70 | $581.80 | $813.07 | $1,235.54 |
| Waukesha County | $455.25 | $516.70 | $581.80 | $813.07 | $1,235.54 |
| Jefferson County | $547.09 | $620.95 | $699.19 | $977.11 | $1,484.81 |
| Walworth County | $547.09 | $620.95 | $699.19 | $977.11 | $1,484.81 |
| Green Lake County | $556.41 | $631.53 | $711.09 | $993.75 | $1,510.10 |
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.