What Is Cost Sharing?
Cost sharing is the portion of healthcare costs that you pay out of pocket rather than your insurance paying. It's the umbrella term for all three major ways you share costs with your insurer:
- Deductible: What you pay before insurance starts helping
- Copay: Fixed dollar amount per visit or prescription
- Coinsurance: Your percentage share after deductible is met
How Cost Sharing Works Together
- You pay 100% of costs until your deductible is met
- After deductible, you pay your copay or coinsurance percentage
- Once you hit your out-of-pocket maximum, you pay nothing more for covered care
Cost-Sharing Reductions (CSRs)
If your income is between 100–250% of the federal poverty level and you're enrolled in a Silver Marketplace plan, you may qualify for Cost-Sharing Reductions — subsidies that lower your deductible, copay, and coinsurance to Gold or Platinum levels at Silver plan prices.
💡 CSRs are only available on Silver plans. If you qualify, they can be more valuable than the premium tax credit — check your eligibility.
Calculate Your Cost Sharing
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