Vermont Health Insurance

Overview

If you live in Vermont and either buy your own health insurance or are currently uninsured, this guide is for you. It will help you:

  • Determine whether you may qualify for a credit to help you pay for health insurance under the Affordable Care Act (also known as Obamacare)
  • Compare private health plans using U.S. News & World Report's health insurance ratings for Vermont

Do I Qualify for a Tax Break on Health Insurance?

Use the calculator below to determine whether you qualify to receive a tax credit (called a subsidy) that you can use to pay for health insurance. The calculator will also help steer you toward health insurance options that may be best for your needs.

What Plan Type is Right For Me?
How Many Need Coverage
Total Annual Income
 
 

You may qualify for Medicaid, a free, state-sponsored health insurance program. Call 802-654-8854 or go to the Vermont Health Connect website to find out if you can enroll in Medicaid.

You qualify for a subsidy (tax credit) that will save you money if you buy a plan on Vermont's new insurance marketplace, called Vermont Health Connect. Plans should be offered there starting October 1, 2013. While your subsidy will cover part of the monthly premium for any of the marketplace's plans, a plan that's in the "silver tier" probably offers the best deal. That's because you also qualify for a second subsidy that increases the value of benefits you'd get from any silver plan.

You qualify for a subsidy (tax credit) that will save you money if you buy a health plan on Vermont's new insurance marketplace, called Vermont Health Connect. Plans should be offered there starting October 1, 2013. Your subsidy will cover part of the monthly premium for any of the marketplace's plans, known as Qualified Health Plans.

You don't qualify for a subsidy. You can either buy a plan on the Vermont Health Connect website or click the button below to compare U.S. News-rated plans in your state's private insurance market. Plans on Vermont Health Connect will generally offer more health coverage than plans in the private market, but they also tend to cost more in monthly premiums. The Vermont Health Connect website should offer plans beginning October 1, 2013.

Any children in your household may be eligible for Medicaid. Call 802-654-8854 or go to the Vermont Health Connect website to find out if your children are Medicaid-eligible.

See Plans

If You Qualify: Plans That Cost Less

Under the Affordable Care Act, you might qualify for a subsidy to help pay for your health insurance. If you qualify, the subsidy can be used to reduce the cost of your monthly premium or can be taken as an annual tax credit. To take advantage of a subsidy, you must choose a health plan that has been approved by the federal government and the government of Vermont. These plans, known as Exchange Plans, meet a set of standards that aim to eliminate benefit loopholes to make sure that people with pre-existing conditions are not being denied coverage. 

Note: you had until March 31 to enroll for coverage for the rest of 2014 (enrolling on March 31 would cover you starting May 1). If you missed this date, with few exceptions, you will pay a penalty.

Premiums on Vermont Health Connect

The average premium rates listed below are the lowest that might be charged to a single adult. You can use the amounts listed to gauge the relative cost of each tier. Higher tiers tend to cost more, but offer better health coverage. Premium rates will vary depending on where you live and whether the plan covers multiple members of your family or just one person. In Vermont, unlike in most states, older residents will not pay higher premiums than younger ones.

Platinum
Average Premium: $588 per month
Gold
Average Premium: $498 per month
Silver
Average Premium: $418 per month
Bronze
Average Premium: $351 per month

If You Don't Qualify: Private Plans

If you don’t qualify for a subsidy, you can still choose among the Health Exchange Plans, or consider one of the many private health insurance plans available in Vermont’s private marketplace. We have rated these private plans on a 1-star to 5-star basis, with 5-star plans providing the most comprehensive coverage.  What’s the biggest difference between a private market health plan and a government-approved one? The trade-off is usually cost. Insurance companies can charge less for private plans with less-extensive network coverage or fewer benefits, which makes more-affordable options available to you.

Private Health Insurers in Vermont

Do I Have To Buy Health Insurance?

You may have heard that everyone in Vermont must have health insurance in 2014 or pay a penalty – Obamacare's so-called “individual mandate.” With a few exceptions, this is true. For 2014, not carrying insurance will cost $95 per adult plus $47.50 per child (up to $285 per family) or 1 percent of your family’s income, whichever is more. 

U.S. News generally recommends getting health insurance of some kind, even if it is only catastrophic coverage. That's because unexpected medical expenses can easily bankrupt anyone who is uninsured.

Where To Buy Health Insurance

Vermont's Official Marketplace

Vermont Health Connect is Vermont’s official portal for buying an Obamacare Health Exchange Plan under the Affordable Care Act. To sign up online for coverage on Vermont Health Connect, be prepared to fill out a form that could take 30 minutes or longer. To complete the process quickly, have this info handy:

  • Social security numbers for everyone in your household
  • Your employer’s name and address
  • Your most-recent pay stub or recent records of your wages
  • Information about other types of income you receive, such as alimony, unemployment benefits or a pension

 

Insurance Companies and Brokers

Some people prefer to buy health insurance directly from an insurance company or through a broker. Thanks to strict regulation, you'll pay the same price for a plan regardless of where you buy it – whether on the Vermont Health Connect website, through a broker or directly from an insurer – and regardless of whether you sign-up via phone, online, or by filling out paper forms.

U.S. News & World Report has teamed up with eHealth.com, an online broker licensed to sell health insurance, to help you buy the health plan you want. The eHealth customer service team can answer questions, determine whether you're eligible for a subsidy and help you apply for insurance.

Qualified Plans on Vermont Health Connect

Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.

You should also look at a Vermont Health Connect plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Vermont Health Connect plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"

Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.

Participating Companies

The monthly premiums listed below are the lowest that might be charged to a single adult. Premium rates will vary depending on where you live and whether the plan covers multiple members of your family or just one person. In Vermont, unlike in most states, older residents will not pay higher premiums than younger ones. Depending on your income, you may qualify for a subsidy (tax credit) that covers part of your premium.

Blue Cross and Blue Shield of Vermont. BCBSVT is affiliated with the Blue Cross and Blue Shield Association, the oldest U.S. health insurance company. The Blue Cross and Blue Shield Association offers coverage in all 50 states, Washington, D.C., and Puerto Rico and has 37 Blue Cross and Blue Shield companies that serve over 100 million members (one third of all Americans), according to the company. Nationally, Blue Cross and Blue Shield companies have contracts with over 96 percent of hospitals and 91 percent of providers. Vermont residents who buy a BCBSVT exchange plan may not have access to the entire network of doctors and hospitals. BCBSVT is offering EPO exchange plans in every tier.

MVP Health Care. MVP describes itself as a nonprofit health plan headquartered in Schenectady, N.Y. In addition to covering New York residents, it offers health plans in Vermont and New Hampshire. MVP is offering HMO exchange plans in every tier. 

Platinum

Blue Cross Blue Shield of Vermont | BCBSVT Standard Platinum Deductible Plan
Premium $582

MVP Health Care | MVP Standard Platinum Deductible Plan
Premium $594

Gold

Blue Cross Blue Shield of Vermont | Blue for You
Premium $460

Blue Cross Blue Shield of Vermont | BCBSVT Standard Gold Deductible Plan
Premium $497

MVP Health Care | MVP Standard Gold Deductible Plan
Premium $513

MVP Health Care | HMO
Premium $521   Deductible $500

Silver

Blue Cross Blue Shield of Vermont | Blue for You
Premium $395

Blue Cross Blue Shield of Vermont | BCBSVT Standard Silver High Deductible Plan
Premium $412

MVP Health Care | HMO
Premium $419   Deductible $1,700

Blue Cross Blue Shield of Vermont | BCBSVT Standard Silver Deductible Plan
Premium $425

MVP Health Care | MVP Standard Silver Deductible Plan
Premium $427

MVP Health Care | MVP Standard Silver High Deductible Plan
Premium $428

Bronze

MVP Health Care | MVP Standard Bronze Deductible Plan
Premium $336

Blue Cross Blue Shield of Vermont | Blue for You CDHP
Premium $341

MVP Health Care | HMO
Premium $341   Deductible $3,000

Blue Cross Blue Shield of Vermont | BCBSVT Standard Bronze Deductible Plan
Premium $359

Blue Cross Blue Shield of Vermont | BCBSVT Standard Bronze High Deductible Plan
Premium $362

MVP Health Care | MVP Standard Bronze High Deductible Plan
Premium $366

Need More Help?

If you need help choosing a health insurance plan or filling out your application, Vermont has trained nongovernment groups to guide you through the process. Sometimes called “Navigators,” these groups can answer technical questions on insurance, Medicaid, and tax credits (subsidies on monthly premiums) . Navigators also specialize in assisting non-English speaking populations. For more information, contact the Vermont Health Connect call center at 1-855-899-9600. The center is open Monday through Friday from 8:00 a.m. to 8:00 p.m. and on Saturdays from 8:00 a.m. to 1:00 p.m. Residents can also email questions through an online contact form.

The Vermont Insurance Division Department of Financial Regulation exists to help residents resolve issues with their insurance company, locate a doctor or other provider within their network, appeal a denial of service, and resolve billing problems with insurers and providers. The office can be reached at 800-917-7787 or emailed at dfr.insuranceinfo@state.vt.us. Residents can file an insurance complaint form online.

Health Insurance Guide

U.S. News offers information on how to buy health insurance and publishes plan ratings for every state. If you’re over 65, see the guide to Medicare plans. Otherwise, start by looking up the Health Insurance Guide for your state.

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2014-05-01