How Silver health plans unlock cost-sharing reductions

May 14, 2025

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3 minute read

Looking for cost-sharing reductions to help lower your healthcare costs?

These valuable savings are only available through Silver plans on the Health Insurance Marketplace.¹

If you qualify, this can significantly reduce what you pay for deductibles, copays, and prescriptions.

Here’s what cost-sharing reductions are, how they work, and why choosing a Silver plan is the key to unlocking them.

What are cost-sharing reductions?

They’re special discounts that lower what you pay out-of-pocket for healthcare. But only if you enroll in a Silver plan through the Health Insurance Marketplace. A Silver plan + cost-sharing reductions can help:²

Lower deductibles
Lower copayments or coinsurance
Offer better coverage for things like prescriptions and doctor visits
Lower out-of-pocket maximum costs

Silver plan qualifications

To qualify for reduced costs available with Silver plans, you must meet certain income requirements. Your household income must be between 100% and 250% of the federal poverty level in 2025, which is approximately:³

$15,060 to $37,650 for an individual
$31,200 to $78,000 for a family of four

How Silver plans unlock cost-sharing reductions

When you review your options in the Health Insurance Marketplace, you’ll notice four levels of plans:

Bronze
Silver
Gold
Platinum

Silver plans typically have moderate premiums and moderate coverage. But if you meet the income requirements, Silver plans may be the best overall value for health insurance.

That’s because the government pays part of your cost when you use your insurance, not just your monthly premium.

Here are a couple of examples to show you how Silver plans + cost-sharing reductions can save you more.²

Lower deductible

This is the amount you pay out of pocket before your plan starts covering most medical costs.
With a regular Silver plan, that might be $750.
But if you qualify for cost-sharing reductions, your deductible could drop to $500 to $300 depending on your income.

Reduce copays and coinsurance

These are the payments you make each time you get care, like when you see a doctor or fill a prescription.
With cost-sharing savings, a $30 doctor visit might only cost you $15 or $20 instead.

Lower out-of-pocket maximum

This is the most you’d have to pay in a year for covered services.
Normally, it might be $5,000.
But with cost-sharing reductions, it could drop to $3,000, limiting your total costs if you have a major illness or injury.

Based on changes to income requirements outlined in the Inflation Reduction Act, an estimated 10.6 million people now receive cost-sharing reductions.⁴

Review your options to choose a plan

You might be tempted to choose a Bronze plan in the Health Insurance Marketplace because the monthly premium is lower.

But if you qualify for cost-sharing reductions, choosing a Bronze plan could mean missing out on hundreds or even thousands of dollars in savings on your medical bills.

Here’s a breakdown to help you evaluate your options:¹

Bronze

Bronze plans have the lowest monthly premiums but the highest out-of-pocket costs when you get care.
They’re a good fit if you’re mostly healthy and want coverage in case of a major medical event.

Gold & Platinum

Gold and Platinum plans offer more coverage but don’t come with cost-sharing subsidies.

Silver

If you qualify, a Silver plan may be the best option.
Why? You get balanced coverage, lower costs when you use it, and access to savings you can’t get with other tiers.