What is a cost sharing reduction (CSR)?

A cost sharing reduction (CSR) is a specific type of health insurance law intended to reduce the out-of-pocket costs of low-income individuals. It is applicable in the state of Washington and other states that have adopted the Affordable Care Act. In general, CSRs help reduce the amount your insurer requires you to pay out of pocket for health care services. Under CSRs, participants receive reduced deductibles, coinsurance, and co-payments. These reductions are funded by the federal government. To qualify for a CSR, individuals must have incomes at or below 250% of the federal poverty level. This benefit applies to both Medicaid and individual health insurance plans. In Washington, individuals who qualify for CSRs may pay a smaller share of their health care expenses than those on regular health insurance plans. This can mean a reduction in covered services including mental health care and prescription drugs. Additionally, certain services may be entirely eliminated from the plan. Not all plans are eligible for a CSR. People should contact their insurance carrier to find out if their plan is eligible and what reductions may apply. To ensure the continuity of your plan, review your plan and check for any changes in cost sharing reductions.

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What is a cost sharing reduction (CSR)?

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