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See if You Qualify for Cost Sharing Reductions:
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Cost Sharing Reductions:

Save on Your Out-of-Pocket Costs

Cost Sharing Reductions help lower the amount you pay out-of-pocket when using medical services or receiving health care. Common out-of-pocket costs include deductible, coinsurance, and copayment fees.

Like the Premium Tax Credit, which lowers the costs of your monthly insurance rate, Cost Sharing Reductions are an additional type of subsidy, or "discount", paid for by the government. Those who qualify for both subsidies find that they can substantially save on their total cost of health care.

To qualify for Cost Sharing Reductions, you must choose a Silver plan, and your income must be at or below 2.5x the Federal Poverty Line. You may qualify if your income falls within the following ranges:

United States residents living in the contiguous states (e.g. not living in Alaska or Hawaii):

Household Size
Yearly Household Income Range
1
$11,880 - $29,700
2
$16,020 - $40,050
3
$20,160 - $50,400
4
$24,300 - $60,750
5
$28,440 - $71,100
6
$32,580 - $81,450
7
$36,730 - $91,825
8
$40,890 - $102,225

Alaska residents only:

Household Size
Yearly Household Income Range
1
$20,479 - $51,198
2
$27,628 - $69,070
3
$34,776 - $86,940
4
$41,924 - $104,810
5
$49,073 - $122,683
6
$56,194 - $140,485
7
$63,370 - $158,425
8
$70,546 - $176,365

Hawaii residents only:

Household Size
Yearly Household Income Range
1
$18,865 - $47,163
2
$25,433 - $63,583
3
$32,002 - $80,005
4
$38,571 - $96,428
5
$45,140 - $112,850
6
$51,709 - $129,273
7
$58,277 - $145,693
8
$64,874 - $162,185

Within these ranges, the lower your income, the more you can save on your out-of-pocket costs. That is because those with lower incomes qualify for greater Cost Sharing Reductions. If your income falls below these levels, you may be eligible for Medicaid depending on the state you live in. Check with the Federal Health Insurance Marketplace or your state’s exchange to learn more.

To see if you qualify, enter your zip code or call (877) 781-8601 to speak with an agent.

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Third Party Material (TPMO) (Medicare.gov) We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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The plans represented on MassHealthplans.com are Medicare Advantage HMO, PPO and PFFS organizations and stand-alone prescription drug plans with a Medicare contract. Enrollment in any plan depends on contract renewal. If you are paying Medicare Part B premium, you must continue to pay it to maintain coverage.

Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.

Every year, Medicare evaluates plans based on a 5-star rating system.

Part B Premium give-back is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

Based on median Medicare Advantage benefit amounts for dental available across multiple plans and metro areas. Not all benefits available in specific plans or regions.

This information is not a complete description of benefits. Contact the plan for more information.

Limitations, copayments, and restrictions may apply.

[Benefits, premiums and/or copayments/coinsurance] may change on January 1 of each year.

Advertised Pricing:

There are several factors that impact your monthly premium; including your age, geographical location, annual income, dependents, and the type of plan you choose. Monthly premiums do not include out-of-pocket costs.

The advertised price may not be typical. It was generated using the Kaiser Family Foundation's subsidy calculator that was accessed on September 16, 2020. The following parameters were used: 21 year old adult, non-tobacco user, annual income of $24,700 in 2020, no children, and no available coverage through a spouse's employer. The resulting monthly premium was $30 per month (or $360 per year after $2,751 in subsidies) for a Bronze Plan. Even when using the same parameters, the resulting premium and subsidy calculations may be subject to change.