If you’ve ever looked at Marketplace plans and wondered why one Silver plan looks so much better than another, you’re not imagining things.

The difference often comes down to something called a Cost-Sharing Reduction, or CSR — one of the most misunderstood benefits on the Marketplace.

What Is a CSR?

A Cost-Sharing Reduction is extra financial help built into certain Silver Marketplace plans.
While the subsidy (APTC) lowers your monthly premium, a CSR lowers what you pay when you actually use your plan — things like:

• Deductibles

• Copays

• Coinsurance

• Maximum out-of-pocket limits

Think of it this way:
👉 APTC helps you get coverage.
👉 CSR helps you use it affordably.

Who Qualifies for CSR?

You may qualify if your household income is between 100% and 250% of the Federal Poverty Level (FPL).

For 2025, that means roughly:

• Single: $15,060 – $37,650

• Couple: $20,440 – $51,100

• Family of 4: $31,200 – $78,000

(Exact numbers may vary slightly by year and state.)

If you fall in that range, you can qualify for enhanced Silver plans — often labeled Silver 94, Silver 87, or Silver 73 — depending on your income level. The lower your income, the better your cost-sharing benefits.

Example

Let’s say Maria earns about $28,000 a year.
She qualifies for a Silver 87 plan.

That means instead of:

• A $6,000 deductible → hers might be around $800

• A $40 doctor visit → hers could be $10

• A $9,000 max out-of-pocket → hers could be $2,000–$3,000

Those savings can easily add up to thousands of dollars in a year.

Important: CSR Only Applies to Silver Plans

This is where many people make a mistake.
Even if you qualify for CSR, you only get those benefits if you enroll in a Silver plan.

If you choose a Bronze or Gold plan, you’ll still get your premium subsidy (APTC), but you’ll lose the CSR benefits entirely.

Why It Matters in 2026

If the enhanced subsidies expire after 2025, it will become even more important to understand your CSR level — because it directly impacts your real, out-of-pocket costs.

Two people could have the same premium but very different coverage levels based on whether they used CSR or not.

What You Should Do

• Check your income estimate before applying.

• Ask your agent (that’s us!) to confirm which Silver CSR level you qualify for.

• Don’t skip Silver just because it’s a few dollars more — it might save you thousands later.

The Bottom Line

Your income doesn’t just affect how much your plan costs — it affects how much your plan covers.
Cost-Sharing Reductions make Marketplace coverage far more affordable for working families and individuals.

If you’re not sure which CSR level you qualify for, or want help comparing Silver 94, 87, or 73 plans, reach out to our team at Mere Benefits.
We’ll help you find the best balance between premium and protection — with no cost to you.

📞 904-654-5450
🌐 www.merebenefits.com
#simplyforyourbenefit