Cost Sharing Reductions: Do You Qualify?

At times people are unaware if they qualify for cost-sharing reductions. Cost-sharing reductions are a discount that lowers your deductibles, copayments, and coinsurance. Your household and income is what determines if you qualify for these extra savings in health insurance. When you sign up for health insurance, you will find out if you qualify to receive cost-sharing reductions. It only applies with a Silver plan.


Cost-sharing subsidies, also called “extra savings” are designed to reduce the amount of a claim that the insured will have to pay. Eligibility for cost-sharing reductions is available to enrollees with incomes between 100 percent and 250 percent of the federal poverty level.

How It Works

CSR household income qualifications
CSR household income qualifications

If your income is under 250 percent of the federal poverty level, then you qualify for the extra savings of a silver plan. For 2018, the federal poverty level us $30,150 for a single person and $61,500 for a family of four.

  •         Lower Deductible– The insurance plan pays its share of your medical costs sooner.  If you qualify for cost-sharing reductions, your deductible for a Silver plan can be as low as $300-500, depending on your income. Originally the Silver plan has a $750 deductible.
  •         Lower Copayments or Coinsurance– Every time you go to the doctor, you must pay a copayment. If your copayment for a doctor visit is $40 for the Silver plan and you qualify for CSR, you may only have to pay $15 or $20.
  •         Lower out-of-pocket maximums– The unsubsidized out of pocket maximum for an individual is $7,350 and $14,700 for a family of four in 2018. Silver plans for those who qualify for CSR (depending on income) can have a maximum from anywhere of $2,450-$5,850 for an individual, and $4,900-$11,700 for a family.

CSR benefits extend to people with an income up to 250 percent of the poverty level. It is not as beneficial for those unless their income does not exceed 200 percent. This would be $24,120 for a single person and $49,200 for a family of four. These people with an income between 200 and 250 percent will be eligible. You might find a lower-cost bronze or gold plan for the same price as the silver, with better benefits.

Need Help?

CSR's will help you save money with health insurance.
CSR’s will help you save money with health insurance.

If you fall within the range to receive CSR’s, the amount of money you will save depends on your specific income estimate. The lower your incomes, then the more you will save. Once you speak to a representative from EZ.Insure, they will determine if you qualify for extra savings and guide you in the best direction. Our highly trained and knowledgeable agents will help you shop, compare, and sign up for any plan that works best for you or your family. We promise to help you save money without the hassle of bouncing around different agents and companies. We make things easy for you. Enter your zip code in the bar abovefor instant quotes, or call 888-350-1890 or email replies@ez.insure to speak to an agent. 

About The Author: Cassandra Love

With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.
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