CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam
Gold · EPO · CareSource (Common Ground Healthcare) · Wisconsin
At age 40 it costs between $681.62 and $885.75 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 | 87416WI0060025 |
|---|---|
| Insurer | CareSource (Common Ground Healthcare) |
| Metal level | Gold |
| Plan type | EPO |
| Deductible (individual) | $0 |
| Deductible (family) | $0 |
| Drug deductible | Included in the medical deductible |
| Most you could pay in a year | $9,000 |
| Family maximum | $18,000 |
| Primary care visit | $35 |
| Specialist visit | $100 |
| Emergency room | $600 |
| Inpatient stay | 20% |
| Generic drugs | $2 |
| Preferred brand drugs | $60 |
| Specialty drugs | 50% |
| Adult dental included | No |
| Child dental included | No |
| Share of premium buying essential health benefits | 99.82% |
| 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 | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Door County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Kewaunee County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Manitowoc County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Marinette County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Oconto County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Shawano County | $533.35 | $605.35 | $681.62 | $952.56 | $1,447.50 |
| Ozaukee County | $567.06 | $643.61 | $724.70 | $1,012.77 | $1,539 |
| Washington County | $567.06 | $643.61 | $724.70 | $1,012.77 | $1,539 |
| Waukesha County | $567.06 | $643.61 | $724.70 | $1,012.77 | $1,539 |
| Jefferson County | $681.47 | $773.46 | $870.91 | $1,217.10 | $1,849.50 |
| Walworth County | $681.47 | $773.46 | $870.91 | $1,217.10 | $1,849.50 |
| Green Lake County | $693.07 | $786.64 | $885.75 | $1,237.83 | $1,881 |
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.
Get told when this changes
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.