Understanding Health Insurance Subsidies & Cost-Sharing Reductions (CSR)
Many Virginians qualify for financial help to make health insurance more affordable. This post explains how subsidies and cost-sharing reductions (CSR) work on the Health Insurance Marketplace, who qualifies, and how you can save money on your coverage.
What Are Health Insurance Subsidies?
Subsidies, also called Premium Tax Credits, are available to help lower the monthly cost of health insurance for individuals and families who meet certain income requirements. These credits are applied directly to your premium, reducing what you pay each month.
- → Available for those with incomes between 100% and 400% of the federal poverty level (FPL), and sometimes higher.
- → Amount is based on your income, household size, and the cost of coverage in your area.
- → You can choose to apply the subsidy monthly or claim it at tax time.
What Are Cost-Sharing Reductions (CSR)?
CSR are extra savings that lower your out-of-pocket costs—like deductibles, copayments, and coinsurance—when you get care. These are only available if you enroll in a Silver plan through the Marketplace and your income qualifies.
- → Available for those with incomes between 100% and 250% of the federal poverty level (FPL).
- → CSR can significantly reduce your deductible, copays, and maximum out-of-pocket costs.
- → You must choose a Silver plan to receive CSR benefits.
Who Qualifies for These Savings?
Eligibility for subsidies and CSR is based on your household income, size, and whether you have access to other affordable coverage (like through an employer or government program).
- → Most people who buy their own health insurance in Virginia qualify for some level of subsidy.
- → CSR is only available to those who enroll in a Silver plan and meet income guidelines.
- → Even if you didn't qualify in past years, expanded subsidies may make coverage more affordable now.
How to Apply
You can apply for subsidies and CSR when you enroll in a Marketplace plan. The application will determine your eligibility and show your savings automatically.
- → Apply online at HealthCare.gov or Marketplace.Virginia.gov.
- → Be ready to provide income and household information.
- → Review plan options carefully—Silver plans are required for CSR benefits.
Need Help?
Understanding your options can be confusing, but you don’t have to do it alone. Akins Advisory Partners is here to help you navigate subsidies, CSR, and all your health insurance questions. Contact us for free, expert guidance.