United States
"Cost Sharing Reduction"
( CSR or Cost-Sharing Subsidies)

What is Cost Sharing Reduction ?

Cost-sharing reduction is a provision of the Affordable Care Act that reduces out-of-pocket costs for eligible enrollees who select Silver health insurance plans in the marketplace.

How the Cost-Sharing Reduction Works ?

CSR is discount that lowers the amount you have to pay for deductibles, copayments, and coinsurance. In Health Insurance Marketplace, CSR are often called extra savings.

CSRs reduce health care costs by lowering annual plan limits or by lowering direct costs. CSR reduce enrollees’ cost-sharing by lowering a health plan’s out-of-pocket maximum, and increasing AV of the plan.

Who is Eligible for Cost Sharing Reduction ?

Individuals qualify for CSR, when they apply for health insurance coverage through the ACA Health Insurance Marketplace. Individuals must choose Silver plans.


Income Limits for Cost Sharing Reduction

Cost-sharing reductions are available to people who's household income between 100% and 250% of the federal poverty level. The federal poverty level changes each year.

How Much is Cost Sharing Reductions ?

CSR plans do have to cap maximum out-of-pocket at levels that are lower than other plans. For 2023, the out-of-pocket limit for an individual is $9,100 & $18,200 for a family.

Maximum allowable out-of-pocket is reduced by 67% for enrollees with household income between 100% & 200% of the FPL, and by 20% for enrollees with household income between 200% and 250% of the FPL.

How to Get Cost Sharing Reduction ?

click here to enroll

When an enrollee applies for a Silver plan, they are enrolled into a Silver plan that has cost-sharing reductions automatically built into the plan design.