Cost Sharing Reduction

If your family size and income ranks you at under 250% of the Federal Poverty Level, this cost reduction will reduce your total out of pocket responsibilities in overall medical costs. You’ll get additional financial assistance to cover more of your portion of the medical expenses for your “Silver” plan (70/30.) So in addition to getting the “Advanced Premium Tax Subsidy,” you’ll also have the “Cost Sharing Reductions” to reduce deductibles, co-pays, and co-insurance. Your overall medical costs will be a smaller percentage of your income to pay for medical bills and expenses.
The Cost Sharing Reduction is ONLY available on SILVER Plans.

Health Insurance Subsidy

aka Advance Premium Tax Credit

A “Subsidy” is where the Government and you share in paying your monthly health insurance payments. The Government helps you pay your health insurance payments monthly, by sending a certain dollar amount of your insurance payment (premium) to the insurance company, and you send in the other portion of your monthly insurance payment to the insurance company. This is called “APTC” (Advance Premium Tax Credit). The factors that affect the percentage or portion of the health insurance premium you pay is your household income and household size (members of your family on your tax return).

Federal Poverty Level

Everyone has a “federal poverty level” (FPL), even wealthy people. They just have a higher FPL. People that have a “household” income that falls between 138% up to 400% of the FPL (Federal Poverty Level), can get assistance with paying for their health insurance premiums called an “Advanced Premium Tax Credit.” If you make less than 138% of the FPL, in Nevada you qualify for Medicaid which is Free.
The less money you make the more financial help you will get, the more money you make, the less financial assistance you get. If you make over 400% of the FPL, you won’t qualify for any financial assistance (AKA – subsidy.) You can buy your “qualified health plan” (see definition) insurance anywhere you want, but if you want a “subsidy” your income must be between 138% – 400% FPL. Call us for help with all subsidized and unsubsidized health plans.