Vermont Health Insurance
The Affordable Care Act and changes to state law will deliver some big changes to the way many people access Vermont health insurance. According to a July 2013 Kaiser Family Foundation profile of Vermont health insurance, Gov. Peter Shumlin signed a comprehensive health reform bill into law in May 2011.
This law created a state health insurance marketplace and it may put the state on the path to a single-payer health insurance system in the future. Also, Vermont is one of 27 states including Washington, D.C., to expand Medicaid in 2014.
The state health insurance marketplace is called Vermont Health Connect; you can visit this website to register and apply for private marketplace health insurance plans during open enrollment. After you complete the application, you’ll also find out if you and your family members qualify for Medicaid, the Children’s Health Insurance Program or subsidies to offset the cost of marketplace plans.
If your family qualifies for tax credits, you can immediately apply the subsidy to marketplace plan premiums. If you do not care to apply online, you can also contact Vermont brokers and navigators.
Do you qualify for a Vermont health insurance subsidy?
A January 2014 Kaiser Family Foundation profile of the uninsured in Vermont reports that because of the Affordable Care Act, about 72 percent of formerly uninsured people in Vermont can get health insurance.
Family size and income are the main criteria that determine who gets financial assistance; people who can already access affordable medical plans through their employer or other public programs may not qualify.
The following outlines the groups of Vermont residents who might be eligible for financial assistance:
- Typically, eligibility for Medicaid and CHIP is determined using 2014 poverty level guidelines, and subsidy eligibility is based on 2013 limits.
- Vermont families with an income between 100 and 400 percent of the federal poverty level may qualify for tax credits that can be used to help pay for private marketplace health insurance. This is between $23,550 and $94,200 for a family of four and $11,490 and $45,960 for an individual.
- Vermont adults with incomes below 138 percent of the federal poverty level, or about $32,915 for a family of four, might be eligible for Medicaid.
- Children from Vermont families with an income below 318 percent of the poverty level, or about $75,845 for a family of four, might qualify for Medicaid or CHIP.
You can sign up for private marketplace health insurance even if you earn too much money to qualify for subsidies or have other ways to access health insurance. Qualified marketplace plans must provide basic coverage, and insurers cannot deny you coverage based on pre-existing health issues.
Marketplace health insurance companies in Vermont
These insurers provide qualified health insurance plans on the state marketplace for Vermont residents:
- Blue Cross and Blue Shield of Vermont
- MVP Health Care
Vermont health and coverage statistics
Vermont population (2013): 626,630
Population 65 and older (2012): 15.7 percent
Life expectancy (2010): 80.5 years
Number of Medicaid beneficiaries (2012): 150,500
Number of Medicare beneficiaries (2012): 94,100
Estimated number of uninsured residents (2012): 47,900
Overall state health ranking (2014): 2
Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.
Vermont health insurance resources
Vermont Health Connect: https://portal.healthconnect.vermont.gov/VTHBELand/welcome.action
Vermont Department of Health: http://healthvermont.gov/
Department of Disabilities, Aging and Independent Living: http://www.dail.vermont.gov/
