Pathways to Coverage

ACA Cost-Sharing Reductions

A second subsidy that drops your deductible, copays, and out-of-pocket max — for Silver-plan enrollees up to 250% FPL.

Last updated: May 2026

Cost-Sharing Reductions (CSRs) are a "second subsidy" most people don't know about. They lower your deductible, copays, and out-of-pocket maximum — not just your monthly premium — and they're available to households earning up to 250% of the federal poverty level. The catch: you have to choose a Silver-tier plan on the ACA Marketplace to get them.

How much CSRs save you (2026)

  • 100–150% FPL — Silver plans behave like Platinum. Deductibles often drop to $0–$250, out-of-pocket max around $3,000.
  • 150–200% FPL — Silver plans pay about 87% of costs. Deductibles around $700, out-of-pocket max around $3,000.
  • 200–250% FPL — Silver plans pay about 73% of costs. Modest savings on deductibles and copays.
  • Native American & Alaska Native households at any income on a Marketplace plan pay $0 cost-sharing.

Why it must be a Silver plan

CSRs are baked into special Silver-plan variants ("CSR 94," "CSR 87," "CSR 73"). If you pick Bronze, Gold, or Platinum you get the premium tax credit but not the cost-sharing reduction. For most eligible households, a Silver CSR plan ends up cheaper overall than a Bronze plan with a $7,000 deductible.

Example: family of three at 175% FPL

  • Household income ≈ $47,000
  • Benchmark Silver plan: $1,400/month list price
  • After premium tax credit: ~$160/month
  • After CSR ("Silver 87"): deductible drops from $5,500 → $750, OOP max from $9,200 → $3,000

How to claim CSRs

CSRs are applied automatically when you enroll in a Silver plan through HealthCare.gov or your state exchange — as long as you report your income honestly. A Zero Gap Health advisor will run the math across every Silver plan in your ZIP and show you the true out-of-pocket cost, not just the headline premium.

See what you qualify for — free, in under 2 minutes.

Answer a few quick questions and a licensed advisor in your state will walk you through your options. No SSN required, no obligation.