A benefit that lowers the out-of-pocket costs associated with accessing healthcare services, including your deductible, co-payments, and co-insurance. Benefits also include a lower out-of-pocket maximum, which is the maximum amount you would have to pay for covered medical services per year. After you reach your out-of-pocket maximum, your insurance plan will cover 100% of all covered services. If you qualify for CSR, you must enroll in a Silver plan through Virginia's Insurance Marketplace to access this benefit.
Your eligibility for CSR is based on the projected income and household information you provide on your Virginia's Insurance Marketplace application. If your estimated income falls between 100% and 250% of the federal poverty level for your household size, you may qualify for CSR, if you otherwise qualify for coverage through Virginia's Insurance Marketplace.
If you're a member of a federally recognized tribe or an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder, you may qualify for additional cost-sharing reduction benefits.