Qualify for Lower Deductibles, Copayments and Copays

When you get coverage through the Marketplace, you may be able to get lower costs on deductibles, copayments, and coinsurance. This will depend on your income.

The Marketplace cost-sharing reduction lowers the amount you have to pay for out-of-pocket costs like deductibles, coinsurance, and copayments. These are costs you have to pay when you get care.

These savings are based on your income and family size.

Savings depend on your income

Health insurance companies offering coverage through the Marketplace must lower the amount you pay out-of-pocket for essential health benefits if your household income is below 250 percent of the Federal Poverty Level (FPL). The lower your income, the more robust the savings. You can see if your household income falls below 250 percent FPL here.

When you apply for coverage in the Marketplace, you’ll learn if you’re eligible for these savings on out-of-pocket costs.

Out-of-pocket savings apply only to Silver plans

Plans in the Marketplace are separated into 4 different categories: Bronze, Silver, Gold, and Platinum. These categories are based on how many of your medical costs you pay and what the plan pays when you get medical care. They are not based on plan quality. Learn more about plan categories and what they mean.

If you qualify for out-of-pocket savings, you must choose a Silver plan to get the savings. If you qualify for these savings, your copayments, deductibles and coinsurance will be much lower. While you can choose any category of plan you want, these out-of-pocket savings only apply if you enroll in a Silver plan.

You’ll be able to choose your plan category when you fill out your Marketplace application.