ACA health insurance
Cost-sharing reductions: why a Silver plan can beat a Gold plan for some people
People with lower incomes who choose a Silver plan can get cost-sharing reductions, which lower the deductible, copays and out-of-pocket maximum. You only get them on Silver plans, so choosing another metal tier can mean giving them up.
Who qualifies
Eligibility is based on household income within a range set by the Marketplace, and you must also be eligible for premium tax credits. The Marketplace decides when you apply, and the reductions are applied automatically to Silver plans you pick.
Why it changes the comparison
- A Silver plan with reductions can have a deductible and copays closer to a Gold or Platinum plan.
- A Bronze plan may look cheaper per month but leave you with high costs when you use care.
- If you rarely use care, a lower-premium plan might still fit. It depends on your needs.
Have this ready when you call
- Your household income estimate
- Number of people in your household
- The care and medicines you expect to use
Common questions
Do I need to apply for cost-sharing reductions separately?
No. If you qualify, they are applied to Silver plans when you enroll through the Marketplace.
What if my income changes?
Your eligibility can change. Update your application when your income changes.
Related answers
Rather talk it through?
Call 855-367-1095 and a licensed agent will go through your situation with you. There is no charge to ask, and no obligation to enroll.
- Licensed insurance help
- No guaranteed eligibility, pricing, or availability
- Educational starting point
Information on this site is educational and does not guarantee eligibility, enrollment, pricing, or availability. It is not a recommendation to buy any specific plan or policy.