Cost-sharing reductions are discounts that lower your deductible, copays, coinsurance and out-of-pocket maximum on an ACA Marketplace plan. You can get them if your household income is from 100% to 250% of the federal poverty level and you enroll in a silver plan. They come in three levels, known as the 94%, 87% and 73% silver variants.
Many people never hear the term because HealthCare.gov calls them “extra savings.” They can make a big difference: a silver plan with cost-sharing reductions can behave more like a gold or platinum plan when you get care, for the price of a silver plan. This guide explains who qualifies, how the three variants differ, the 2027 limits, and how to make sure you actually get the savings.
Who qualifies for cost-sharing reductions?
You generally qualify if all of these are true:
- You are eligible for the premium tax credit.
- Your expected household income is from 100% to 250% of the federal poverty level (FPL).
- You enroll in a silver plan through HealthCare.gov or your state’s exchange.
Members of federally recognized tribes and Alaska Native Claims Settlement Act shareholders have special cost-sharing rules, which can include plans with no cost sharing at any metal level. HealthCare.gov has a separate page on these rules.
Income limits for 2026 and 2027 coverage
Marketplace savings for a coverage year use the previous year’s poverty guidelines. These are the cut-offs for the 48 contiguous states and DC; Alaska and Hawaii are higher.
| Household size | 150% FPL (2026 coverage) | 200% FPL (2026 coverage) | 250% FPL (2026 coverage) | 250% FPL (2027 coverage) |
|---|---|---|---|---|
| 1 | $23,475 | $31,300 | $39,125 | $39,900 |
| 2 | $31,725 | $42,300 | $52,875 | $54,100 |
| 4 | $48,225 | $64,300 | $80,375 | $82,500 |
Calculated from the 2025 and 2026 HHS poverty guidelines as published on HealthCare.gov and in the Federal Register (January 15, 2026). Our FPL calculator shows your exact percentage.
How do the 73, 87 and 94 silver variants work?
Every insurer that sells a silver plan on the Marketplace must also offer three versions of it with lower cost sharing (45 CFR 156.420). The version you get depends on your income.
| Silver variant | Household income | Plan pays on average (actuarial value) | Out-of-pocket limit, one person, 2027 |
|---|---|---|---|
| Standard silver | Over 250% FPL, or no CSR | About 70% | Up to $12,000 |
| 73% variant | Over 200% to 250% FPL | About 73% | Up to $9,600 |
| 87% variant | Over 150% to 200% FPL | About 87% | Up to $4,000 |
| 94% variant | 100% to 150% FPL | About 94% | Up to $4,000 |
Sources: actuarial values from 45 CFR 156.420; 2027 limits from CMS guidance dated January 29, 2026. Plans can set lower limits than these maximums.
The 73% variant is a small step up from a standard silver plan. The 87% and 94% variants are large steps: they pay about as much as or more than a gold plan (80%) on average, and the 94% variant pays more than a platinum plan (90%).
What do the savings look like in practice?
HealthCare.gov gives its own simple illustration: a silver plan with a $750 deductible could have a $300 or $500 deductible with cost-sharing reductions, a $30 doctor copay could drop to $20 or $15, and a $5,000 out-of-pocket maximum could fall to $3,000. Your plan’s numbers will differ.
Why do you have to choose a silver plan?
Because the law ties cost-sharing reductions to silver plans only. HealthCare.gov says that if you qualify and enroll in another category, you can still use the tax credit, but you will not get the extra savings.
This creates a common trap. After the tax credit, a bronze plan may cost less per month, or even nothing. That can look like the better deal. But if you qualify for the 87% or 94% variant, the silver plan may save you thousands of dollars if you need care, for a modest extra premium.
| If you qualify for… | Bronze after credit | Silver with CSR after credit |
|---|---|---|
| 94% variant (100% to 150% FPL) | Lowest premium, very high deductible | Usually low premium, very low deductible |
| 87% variant (over 150% to 200% FPL) | Lowest premium, high deductible | Moderate premium, low deductible |
| 73% variant (over 200% to 250% FPL) | Lowest premium, high deductible | Middle premium, slightly lower deductible than standard silver |
A simple rule of thumb many people use: if you qualify for the 87% or 94% variant and expect to see a doctor, fill a prescription or need any test during the year, look closely at silver first. If you are at the 73% level and expect almost no care, bronze can still make sense.
At the 73% level, the gap between silver and other levels is smaller, so it is worth comparing bronze, silver and gold carefully. Our guide to ACA metal levels walks through that comparison.
How do you get cost-sharing reductions?
You do not apply separately. The Marketplace checks automatically.
- Apply on HealthCare.gov or your state’s exchange and enter your expected income and household.
- Read your eligibility notice. HealthCare.gov says it will say you can choose a plan with lower copayments, coinsurance and deductibles, followed by a code of (04), (05) or (06).
- Filter for silver plans when you shop. The deductibles shown should already reflect your savings.
- Check the network and drug list. Savings only apply to covered, in-network care.
- Enroll and pay your first premium.
You can preview silver plans and estimated savings in your county with our ACA subsidy calculator, which flags when cost-sharing reductions are likely.
What happens if your income changes?
Report changes to the Marketplace as soon as you can. Your income can move you between variants or out of eligibility.
- Income rises above 250% of FPL: you lose the extra savings. HealthCare.gov says you then qualify for a Special Enrollment Period and can pick a bronze, silver or gold plan.
- Income falls and you newly qualify: you can switch to a silver plan to use the savings, even outside open enrollment.
- Income moves within the range: you may move to a different variant of the same silver plan.
Cost-sharing reductions are not reconciled on your tax return, so you do not repay them. The premium tax credit is reconciled, though, and from tax year 2026 there is no cap on repaying excess advance credit. See the Special Enrollment Period guide for deadlines.
Did cost-sharing reductions change after the enhanced credits expired?
The cost-sharing reduction rules themselves did not change. The income range is still 100% to 250% of FPL and the three variants are still 73%, 87% and 94%. What changed is the premium side. The enhanced premium tax credits expired after December 31, 2025, so for 2026 people in the cost-sharing range are expected to pay a larger share of income toward the benchmark silver plan: from 2.10% of income below 133% of FPL up to 8.44% at 250% of FPL, under IRS Rev. Proc. 2025-25. For 2027 the range is 2.15% to 8.66% over the same incomes, under Rev. Proc. 2026-26.
That means a silver plan with cost-sharing reductions may cost more per month in 2026 and 2027 than it did in 2025, while bronze plans after the credit may still look cheap. The trade-off between a low premium and low costs at the doctor is now sharper, so it pays to run the numbers for both a quiet year and a year with major care.
Three example households
These profiles show how the rules apply. Incomes are illustrative and use the 2025 poverty guidelines that apply to 2026 coverage.
Does everyone in the household get the same variant?
Generally yes, because the variant is based on household income. But people in the household who qualify for Medicaid or CHIP, such as children, are usually covered by those programs instead, and anyone with an affordable offer of job-based coverage may not qualify for Marketplace savings at all. The eligibility notice lists each person’s result.
Common questions people get wrong
- “I’m on Medicaid, so I need CSRs.” No. If you qualify for Medicaid, you generally cannot get Marketplace savings. Cost-sharing reductions are for people just above the Medicaid range.
- “A bronze plan is free, so it must be best.” Not if you qualify for the 87% or 94% variant and expect any care.
- “Gold is always better than silver.” For people with cost-sharing reductions, silver often covers more than gold at a lower premium.
- “I’ll get the savings at tax time.” No. They apply only when you get care on a silver plan during the year.
Figures were checked on HealthCare.gov, CMS and the eCFR on October 18, 2026. We are an independent publication, not a broker or enrollment site, and this is not insurance advice. Your exact variant and plan costs appear when you apply on HealthCare.gov or your state’s exchange.
