Cost Sharing Reductions (CSRs) are discounts that reduce the cost of co-pays and coinsurance.
The savings you might get from a CSR benefit are different than those you might get from other subsidies like premium tax credits. First, CSRs are only available for those enrolled in a silver tier plan (see Metal Tiers). Silver plans fall on the lower-cost side of the spectrum for monthly premiums, but they provide more coverage than Bronze and catastrophic plans, which offer lower premiums but higher costs for care.
There are different variations of CSRs, and your eligibility can vary. Catch can help narrow down and locate the best CSR plan for you.
Is it worth applying for a silver plan in order to qualify for CSRs?
While there’s no one answer that applies to everyone, two factors you can consider in the decision are your income and expected healthcare needs.
Silver plans offer slightly more coverage than bronze plans, but they also generally cost more. CSRs help offset that higher price.
A silver plan with CSRs might be for you if your income is under 250% of the Federal Poverty Level and you expect to have a fair amount of medical needs (access to prescriptions, doctor appointments, ongoing care). That could offer the best coverage at the best price.
A bronze plan might be for you if you’re healthy and don’t expect much medical care, because it would be less expensive overall, even though you wouldn’t receive CSRs.
If your income changes during the course of the year, that can also change your eligibility for CSRs. If you lose your job or find yourself making less than you anticipated, it’s possible that you qualify for new or increased CSR benefits. If you happen to earn over 250% of the Federal Poverty Level, you are not required to back back the CSR on your tax return.