A Cost-Sharing Reduction (CSR) is a discount that lowers what you pay out-of-pocket when you use health care — your deductible, copays, and coinsurance. CSRs are only available on Silver plans, and only if your household income is between 100% and 250% of the Federal Poverty Level (FPL).
If you qualify, your Silver plan effectively acts like a Gold or Platinum plan. A standard Silver plan covers about 70% of costs, but with CSR, your plan could cover 73%, 87%, or 94% of costs depending on your income level — meaning your deductible drops and your copays shrink significantly.
CSR is automatic when you qualify — but only if you pick Silver. If you choose a Bronze or Gold plan instead, you lose the CSR benefit entirely, even if you're eligible. This makes Silver plans the clear choice for most families in the 100%–250% FPL range.
One important note for 2026: the enhanced premium subsidies that temporarily expanded CSR eligibility expired December 31, 2025. Income limits are back to standard thresholds.
No — they reduce different costs. The APTC lowers your monthly premium (what you pay before you use care). CSR lowers your cost-sharing (what you pay when you actually use care — your deductible, copays, and coinsurance). You can receive both at the same time if you qualify.
You'd lose the CSR benefit. CSR only applies to Silver plans — there's no way to transfer it to another metal tier. For most families in the 100%–250% FPL range, a CSR-enhanced Silver plan outperforms Gold on actual out-of-pocket costs, even though Gold has a higher actuarial value on paper.
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