Financial Savings

Cost sharing reductions (CSRs) are discounts that lower the amount you have to pay for deductibles, copayments, and coinsurance. If you qualify for CSRs, you must enroll in a plan in the Silver category to get the extra savings (health plans on the Marketplace are presented in four categories: Bronze, Silver, Gold, and Platinum).

If you qualify for cost sharing reductions, you also have a lower out-of-pocket maximum, which is the total amount you’d have to pay for covered medical services per year. When you reach your out-of-pocket maximum, your insurance plan covers 100% of all additional covered services.

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 reductions.

When you apply for financial assistance with Virginia’s Insurance Marketplace, the first thing you'll need to do is estimate your expected household’s income for the intended year of coverage.

1. Start with your household’s adjusted gross income (AGI) from your most recent federal income tax return.

   You'll find your AGI on line 7 of your last year's IRS Form 1040.

2. Add the following kinds of income, if you have any, to your AGI:

   • Tax-exempt foreign income.
   • Tax-exempt Social Security benefits interest.
   • Tax-exempt interest.

   Don’t include Supplemental Security Income (SSI).

3. Adjust your estimate for any changes you expect. Consider things like these for all members of your household:

   • Expected raises.
   • New jobs or other employment changes, including changes to work schedule or self-employment income.
   • Changes to like Social Security or investments.
   • Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings.

   Make sure to update your application within 30 days if your income changes during the year.