The Three Tiers of Cost Sharing Reductions

While the standard silver metal plan acquired through the marketplace covers 70% of your out-of-pocket costs, cost sharing reductions (CSR) can increase the coverage further, should your household qualify. There are three tiers of CSRs that can further reduce your out-of-pocket costs that you would pay under a standard silver plan.

 

These tiers include the Silver 73, Silver 87, and Silver 94. The Silver 73 covers 73% of your out-of-pocket costs, 3% more than the standard Silver Plan. If you qualify for a Silver 87 or a Silver 94, you will receive 87% or 94% coverage, which is 17% or 24% more of your out-of-pocket costs than the standard silver plan. For those who qualify for CSRs, rarely would it make sense to purchase a Gold metal plan.

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If you qualify for the Silver 87 or 94 but sign up for a gold plan anyway, you will be paying higher premiums for less benefits. The Silver 94 includes even more coverage than the Platinum Plan , which covers 90% of your out-of-pocket costs, compared to the Silver 94's 94% coverage of out-of-pocket costs.