What is true about Cost Sharing Reductions eligibility?

Cost Sharing Reductions (CSRs) are designed to help lower the out-of-pocket costs for individuals and families purchasing health insurance through the Marketplace. One key aspect of CSR eligibility is that customers must be eligible for Advanced Premium Tax Credits (APTC). The eligibility for APTC is generally based on household income and is structured to assist those with lower incomes relative to the Federal Poverty Level (FPL).

To qualify for CSRs, individuals must already qualify for APTC, as the two programs are linked; CSRs provide additional financial assistance specifically to those who meet the APTC requirements. This means that if a customer is not eligible for APTC, they will not be able to receive cost-sharing reductions, reinforcing the importance of this connection.

The other options do not accurately reflect the requirements for CSR eligibility: household income must actually be at or below 250% of the FPL to qualify for CSRs, not above 350%. Additionally, not all customers can receive these reductions automatically; they must meet specific criteria related to their income and APTC eligibility. Finally, customers can select Silver plans in order to access CSRs, as these reductions are specifically designed to work with Silver-level plans in the Marketplace.