When you enroll in coverage through the Marketplace, you may be able to save money on out-of-pocket costs – the payments you have to make for doctor’s visits, lab tests, drugs, and other covered services. Whether you save on out-of-pocket costs will depend on your household size and income.

IMPORTANT You can get these savings on out-of-pocket costs only if you enroll in a plan in the Silver category.


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Get Lower Out of Pocket Costs in the Health Insurance Marketplace

If you qualify for savings on out-of-pocket costs, you’ll pay lower deductibles, coinsurance, and copayments. These are costs you have to pay when you get care.

When you apply for coverage in the Marketplace, you'll learn if you’re eligible for savings, which are sometimes called “cost-sharing reductions.”

Savings depend on your 2015 income

If your household income falls in these ranges, you’ll save on out-of-pocket costs. The lower your income within these ranges, the more you’ll save on out-of-pocket costs. Learn how to estimate your income for the Marketplace.

Household income ranges for savings on out-of-pocket costs
Family size Family income

1

$11,670 to $29,175

2

$15,730 to $39,325

3

$19,790 to $49,475

4

$23,850 to $59,625

5

$27,910 to $69,775

6

$31,970 to $79,925

7

$36,030 to $90,075

8

$40,090 to $100,225

Incomes that qualify for cost-sharing reductions are higher in Alaska and Hawaii. See poverty level information for Alaska and Hawaii.

Learn how to estimate your income and report on your household size.

FYI If your income falls between the amounts shown, you also qualify for premium tax credits that lower your monthly premiums.

Out-of-pocket savings apply only to Silver plans

Plans in the Marketplace are grouped into 4 categories: Bronze, Silver, Gold, and Platinum. Learn more about plan categories and what they mean.

IMPORTANTIf your income qualifies you for out-of-pocket savings, you must choose a Silver plan to get the savings. You can choose any category of plan you want, but you'll get the out-of-pocket savings only if you enroll in a Silver plan.

Get more information about cost sharing reductions for American Indians and Alaska Natives.

More answers

Can I save only on out-of-pocket costs?

No. You can save on out-of-pocket costs only if you also qualify for a premium tax credit.

  • Households with income between 100% and 400% of the federal poverty level qualify for premium tax credits.
  • Households with income between 100% and 250% of the federal poverty level also qualify for out-of-pocket savings. This is true only if they enroll in a Silver level plan.