Cost-Sharing Reduction (CSR) Silver Plans in Maryland: How to Get Lower Deductibles and Copays

Cost-Sharing Reductions (CSR) are federal subsidies that lower your deductible, copays, and out-of-pocket maximum.
CSR benefits are exclusively available on Silver-tier health plans purchased through the Maryland Health Connection.
Maryland residents with household income between 100% and 250% of the Federal Poverty Level (FPL) qualify for CSR. For a single person in 2026, this is an income range of $15,060 to $37,650.
Choosing a Bronze plan instead of a CSR-eligible Silver plan often results in higher total healthcare costs for low-income individuals, despite potentially lower monthly premiums.

Updated July 2026 · MarylandPlanFinder.com — Licensed Health Insurance Producer (NPN #21249133)

Navigating health insurance can feel overwhelming, especially when you’re trying to balance monthly premiums with the costs you pay when you actually use care. In Maryland, if your income falls within certain levels, you have access to a powerful benefit called Cost-Sharing Reductions (CSR) that can significantly lower your out-of-pocket expenses like deductibles, copayments, and your annual out-of-pocket maximum. These reductions are built into specific Silver-tier plans available only through the Maryland Health Connection, making quality healthcare much more affordable. Understanding how CSR works and if you qualify is crucial for maximizing your health insurance value.

Get Your Free Health Insurance Quote

A licensed agent can compare coverage options for you at no cost.

✓

You're all set!

A licensed agent will reach out shortly.

Understanding Cost-Sharing Reductions (CSR) Eligibility in Maryland

Cost-Sharing Reductions are a vital part of the Affordable Care Act (ACA), designed to make healthcare more accessible for individuals and families with moderate incomes. Unlike Advanced Premium Tax Credits (APTC), which lower your monthly premium, CSR directly reduces the costs you pay when you receive medical care. To qualify for CSR benefits in Maryland, your household income must be between 100% and 250% of the Federal Poverty Level (FPL). Maryland is a Medicaid expansion state, meaning adults with income up to 138% FPL may qualify for Maryland Medicaid (HealthChoice), which offers comprehensive coverage with very low or no out-of-pocket costs. If your income is above 138% FPL but still below 250% FPL, CSR Silver plans become your best option.

2026 Federal Poverty Level (FPL) Guidelines for Maryland

The following table illustrates the 2026 FPL thresholds used to determine eligibility for ACA subsidies and CSR in Maryland. Your eligibility is based on your household's Modified Adjusted Gross Income (MAGI).

Household Size	100% FPL	138% FPL	150% FPL	200% FPL	250% FPL	400% FPL
1 person	$15,060	$20,783	$22,590	$30,120	$37,650	$60,240
2 people	$20,440	$28,207	$30,660	$40,880	$51,100	$81,760
3 people	$25,820	$35,632	$38,730	$51,640	$64,550	$103,280
4 people	$31,200	$43,056	$46,800	$62,400	$78,000	$124,800
5 people	$36,580	$50,480	$54,870	$73,160	$91,450	$146,320
6 people	$41,960	$57,905	$62,940	$83,920	$104,900	$167,840
7 people	$47,340	$65,329	$71,010	$94,680	$118,350	$189,360
8 people	$52,720	$72,754	$79,080	$105,440	$131,800	$210,880
+1 additional	+$5,380	+$7,424	+$8,070	+$10,760	+$13,450	+$21,520

Source: HHS 2025 Federal Poverty Guidelines (applied to 2026 ACA plan year).

Choosing the Right Plan Tier with Cost-Sharing Reductions

For those eligible for Cost-Sharing Reductions, the Silver plan tier offers significantly enhanced benefits compared to other metal tiers. This table illustrates how CSR can impact your plan choice and out-of-pocket costs.

Income Level (Single Person, 2026)	FPL %	Recommended Tier	Monthly Net Premium	Why This Choice?
Under $20,783	Under 138% FPL	Maryland Medicaid (HealthChoice)	~$0	Eligible for comprehensive, low-cost state Medicaid program.
$20,783–$22,590	138–150% FPL	Silver (CSR Tier 1)	~$0–$30	Highest CSR level; $0-premium eligible with APTC; deductible as low as $0-$150, OOP max ~$1,000.
$22,590–$30,120	150–200% FPL	Silver (CSR Tier 2)	~$30–$100	Significant CSR benefits; deductible ~$500–$750, OOP max ~$2,000; often beats Bronze value.
$30,120–$37,650	200–250% FPL	Silver (CSR Tier 3) or Gold	~$100–$200	CSR still applies, reducing costs; Gold may offer better value if high expected use and higher income.
$37,650–$60,240	250–400% FPL	Gold or HDHP+HSA	Varies	No CSR benefits; Gold for higher expected use; HDHP+HSA for healthy individuals seeking tax advantages.
Above $60,240	Above 400% FPL	HDHP+HSA (on or off-exchange)	Varies	Reduced or no APTC; HSA offers triple tax advantage; ideal for healthy individuals.

Net premium after APTC. Based on a single adult, benchmark Silver reference. Actual premium varies by state, plan, and specific income.

The Critical Advantage of Silver Plans for CSR Eligibility

The most important rule to understand about Cost-Sharing Reductions is that they are only available on Silver-tier plans purchased through the official health insurance marketplace, Maryland Health Connection. This is a crucial distinction, as many people mistakenly choose a Bronze plan because its monthly premium appears lower. However, for those eligible for CSR, a Silver plan with CSR will almost always offer significantly better value and lower total out-of-pocket costs. Here's why choosing Silver with CSR is often the best financial decision if you qualify:

Reduced Deductibles: Your deductible, the amount you pay before your insurance starts covering costs, can be dramatically lower on a CSR Silver plan. For those in the 100-150% FPL range, deductibles can be as low as $0 to $150.
Lower Copayments and Coinsurance: When you visit a doctor or fill a prescription, your copayments and coinsurance amounts will be significantly reduced, making routine care more affordable.
Lower Out-of-Pocket Maximums: The annual cap on what you pay for covered services (your out-of-pocket maximum) is also substantially lowered with CSR. For the lowest income tier, this maximum could be around $1,000 per year, compared to standard Silver plans which can have limits of $9,450 or more.

If you opt for a Bronze plan, even if your income qualifies you for CSR, you will not receive any of these cost-sharing benefits. This means you would pay the full, unreduced deductible, copays, and out-of-pocket maximum associated with the Bronze plan, which are typically much higher than a CSR-enhanced Silver plan. While a Bronze plan might have a slightly lower monthly premium, the increased costs when you actually need care can quickly outweigh any upfront savings, leading to a much higher total cost of healthcare.

Health Insurance in Maryland: What You Need to Know

Maryland operates its own state-based marketplace, the Maryland Health Connection (marylandhealthconnection.gov), which serves as the hub for individuals and families to explore and enroll in health insurance plans. Through this platform, Maryland residents can access financial assistance, including Advanced Premium Tax Credits (APTC) to lower monthly premiums and Cost-Sharing Reductions (CSR) to reduce out-of-pocket costs. The Maryland marketplace offers a variety of plan types, including Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and Exclusive Provider Organizations (EPOs). Importantly, PPO plans ARE available on-exchange in Maryland, with carriers like CareFirst of Maryland and CareFirst BlueChoice offering both PPO and HMO variants. This provides consumers with diverse options depending on their preference for network flexibility. Maryland also expanded Medicaid in 2014, known locally as Maryland Medicaid or HealthChoice, which provides coverage to adults with incomes up to 138% of the Federal Poverty Level. This ensures a robust safety net for low-income residents, preventing a coverage gap.

Steps to Enroll in a CSR Silver Plan in Maryland

If you believe you qualify for Cost-Sharing Reductions, taking action on the Maryland Health Connection is essential. Here's a step-by-step guide to help you enroll:

Estimate Your Annual Household Income: Gather all income sources for your household, including wages, self-employment income, and other taxable income. This will help determine your Modified Adjusted Gross Income (MAGI) for the upcoming plan year, which is crucial for subsidy eligibility.
Visit Maryland Health Connection: Go to marylandhealthconnection.gov during Open Enrollment (typically November 1st to January 15th) or if you qualify for a Special Enrollment Period (SEP).
Complete Your Application: Fill out the application with accurate income and household information. The marketplace will automatically determine your eligibility for APTC and CSR.
Compare Silver Plans: Focus your search on Silver-tier plans. You will see different versions of Silver plans, with varying deductibles, copays, and out-of-pocket maximums, based on your determined CSR eligibility level. Choose the Silver plan that best fits your healthcare needs and budget.
Enroll and Pay Your First Premium: Once you've selected a plan, complete the enrollment process and pay your first month's premium to activate your coverage.
Report Income Changes: If your income or household size changes during the year, report it to Maryland Health Connection immediately. This ensures your subsidies remain accurate and helps avoid issues at tax time.

Remember, a licensed health insurance producer can provide free assistance in comparing plans, understanding your benefits, and navigating the enrollment process on Maryland Health Connection. There is no cost to you for using an agent's expertise.

Frequently Asked Questions

What are Cost-Sharing Reductions (CSR) in Maryland?

Cost-Sharing Reductions (CSR) are federal subsidies that lower the amount you pay out-of-pocket for healthcare services, including deductibles, copayments, and coinsurance. They are only available on Silver-tier plans purchased through Maryland Health Connection and are based on your household income relative to the Federal Poverty Level (FPL).

Who qualifies for CSR Silver plans in Maryland?

Maryland residents with a household income between 100% and 250% of the Federal Poverty Level (FPL) are eligible for Cost-Sharing Reductions. This means for a single person in 2026, income must be between $15,060 and $37,650 to qualify.

Can I get CSR benefits on a Bronze or Gold plan?

No, Cost-Sharing Reductions (CSR) are exclusively available on Silver-tier health insurance plans purchased through the official marketplace, Maryland Health Connection. If you qualify for CSR, choosing a Bronze, Gold, or Platinum plan means you will not receive these valuable cost-saving benefits.

What is the difference between APTC and CSR?

Advance Premium Tax Credits (APTC) reduce your monthly premium, making health insurance more affordable. Cost-Sharing Reductions (CSR) reduce your out-of-pocket costs when you use healthcare services, such as your deductible, copays, and maximum out-of-pocket limit. Both are income-based and can be received simultaneously, but CSR only applies to Silver plans.

Why should I choose a Silver plan if I qualify for CSR?

If you qualify for CSR, choosing a Silver plan is critical because it's the only way to receive these enhanced benefits. CSR significantly lowers your deductible, copays, and out-of-pocket maximum, making healthcare much more affordable when you need it. A Bronze plan, even with a lower premium, will leave you with much higher out-of-pocket costs.