How Silver health plans unlock cost-sharing reductions

May 14, 2025
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.

Looking for a Silver plan + cost-sharing reductions?

If you’re shopping for health insurance and hoping to keep your medical bills manageable, qualifying for Silver plans gives you more options.

We can help you find out if you qualify and show you available plans in the Health Insurance Marketplace.

Just give us a call at (800) 827-9990 to speak to a licensed health insurance agent or find a licensed insurance agent in your area.

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© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

52305-U-0625

© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

52305-U-0625

© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

52305-U-0625