State RegulationsTX specificDifficulty 1/5
Cost-sharing reductions lower an enrollee's out-of-pocket cost at the point of service. To receive them, an eligible enrollee generally must be enrolled in which level of Marketplace coverage?
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Under ACA Section 1402, cost-sharing reductions are delivered only through silver-level qualified health plans, where they lower the deductible, coinsurance and copayments and the annual out-of-pocket maximum for an eligible enrollee. They are entirely separate from the premium tax credit under Section 1401, which lowers the monthly premium and can be used at any metal level; an agent who confuses the two will steer a low-income client into the wrong plan.
Why the other options are wrong
- B) Catastrophic plans do not carry cost-sharing reductions under ACA Section 1402.
- C) Bronze plans may be bought with the premium tax credit, but they do not deliver cost-sharing reductions.
- D) A stand-alone dental plan is not a qualified health plan and carries no cost-sharing reductions.
Memory hook
Silver unlocks the cost-sharing help; the credit alone lowers the premium.