Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under the Affordable Care Act, cost-sharing reductions (CSR) are available to eligible individuals with household income between 138 and 250 percent of the federal poverty level who:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Cost-sharing reductions lower the out-of-pocket costs — deductibles, copays, and coinsurance — for eligible marketplace enrollees with household incomes between 138 and 250 percent of the federal poverty level. CSRs apply only to Silver-level plans purchased through a health insurance exchange, because the subsidy is built into the Silver plan's cost-sharing design; in California the exchange is Covered California. Bronze plans, Medicare, and Medigap are not CSR vehicles.
Why the other options are wrong
- B) CSRs are available only with Silver plan enrollment through the exchange, not with Bronze plans purchased directly.
- C) Medicare cost-sharing is a separate federal program; CSRs apply to ACA individual market plans, not to Medicare.
- D) Medigap is a Medicare supplement product sold in the private market and does not carry ACA cost-sharing reductions.
Memory hook
Silver is the sweet spot: income 138-250% FPL plus a Silver exchange plan equals lower deductibles and copays.