Choosing the right health insurance can be challenging. Here we will give you a brief overview of the different aspects of health insurance in Vermont to help you make an informed decision.
Health Insurance in Vermont is run by the state and has a hands-on approach in providing health coverage for its residents. Vermont has been a pioneer in this field for a long time and is in the top 10 US states for providing health insurance coverage.
Residents can enter the health insurance marketplace in Vermont and buy coverage during open enrollment by purchasing a plan through a private health insurance company in Vermont. The other option is the state marketplace exchange through the Vermont Health Connect website. If you want to explore more options, make sure to check out our list of best health insurance providers.
The state marketplace offers coverage for both individuals and families. This includes retired people, self-employed, and employees of small companies. The Affordable Care Act (ACA) financial help and subsidies available through Vermont Health Connect depend on the applicant’s household income.
There are currently two Vermont health insurance companies that provide coverage on the individual marketplace state exchange: BlueCrossBlueShield (BCBS) of Vermont and MVP Vermont. The health insurance plans for both companies are broken down into four categories.
Each company is offering a Bronze, Silver, Gold, and Platinum plan and allows consumers to choose their own combinations of coverage, deductibles, copays and coinsurance.
Blue Cross Blue Shield Vermont is one of the largest individual and family health insurance providers. Choosing BCBS, you are gaining access to their online wellness portal which includes a lot of discounts and tips on how to improve your health.
MVP is another company that offers a wide variety of ACA-approved plans with clearly laid out benefits and choices that fit your needs and can help you control your monthly premiums.
The previously mentioned metal tier plans are a standard offering no matter the insurance company you choose. Below is a brief overview of the specifics of every Vermont health insurance plan and how they may fit your needs.
There are cheap health insurance options in Vermont that best fit for young and healthy people. They have the highest level of deductibles and out-of-pocket maximums.
Also called the middle ground plans for most consumers. They have average premiums and manageable deductibles and out-of-pocket maximums. These plans are great for families with new-borns, and people who expect to have some additional medical expenses ahead.
Gold and Platinum are the highest tiers offered in Vermont. The plans have a high monthly premium but also offer affordable deductibles and out-of-pocket maximums. They are useful if you have high medical expenses. This way you will reach the deductible faster and coinsurance benefits will quickly kick-in.
Vermont residents can also qualify for a catastrophic plan, the lowest coverage available in the marketplace. Catastrophic plans have a low monthly premium but high yearly deductibles. It is available for people under 30 years old.
All tiers of health insurance are eligible for ACA premium tax credits. On average, the reductions are available to low-income families and households that earn less than 250% of the federal poverty level.
What is the average cost of health insurance in Vermont? Over the past two years, the average premium in Vermont health insurance rates has gone up for every metal plan offered.
On average, it is expected that the monthly premium for every metal tier that a 40-year-old individual can pay is $476 for the Bronze Plan, $645 for Silver, and $652 for Gold.
Here is the average cost of health insurance by family size in Vermont:
Health insurance quotes in Vermont for a family of two or a couple the average monthly premium by metal tiers can go from $950-$1,090 for a Bronze plan, $1,290-$1,380 for the Silver, and $1,390-$1,400 for Gold. For a family of four, the average prices are $1,337-$1,532 for a Bronze plan, $1,812-$1,942 for the Silver, and $1,955-$1,964 for Gold.
There are three ways in which health insurance is provided for the residents of Vermont.
Medicare helps seniors, while Medicaid covers low-income families and children. Medicaid covers 23% of residents in Vermont, and 16% of the population goes through Medicare.
Residents 65 and over qualify for Medicare. The program offers several coverage options, including parts A, B, C, D, and supplemental coverage plans.
Medicaid is jointly funded by the state and federal government, and it covers low-income adults and their families for a low monthly cost. It offers dental, health, vision, and prescription drug benefits coverage.
Medicaid also has the Children’s Health Insurance Program or CHIP, which is available for children under 19 years old that come from low-income families. CHIP includes primary care, vision care, dental visits, and physicians’ check-ups.
Medicaid for Children and Adults (MCA) and Dr. Dynasaur are two Vermont free health insurance options. Eligibility for both programs is based on family size and household income. The programs are free or provided at a very low cost.
The rules for an MCA eligibility are: An individual must be under 65 years of age, not entitled to or enrolled in Medicare Part A or Part B, and the household must be at or below 133% of the Federal Poverty Level.
Dr. Dynasaur is free for pregnant women with household income below 208% of the Federal Poverty Level, and Dr. Dynasaur for children is free in households with income below 312% according to the Federal Poverty Level.
There are a few cost-effective ways with which you can save while shopping for health insurance in Vermont and protect your investment in the long run.
These are some factors that contribute to your premium costs:
Quitting smoking, losing weight and general care of your overall health are just some of the easiest ways to lower the monthly premiums.
The open enrolment period for buying VT medical insurance in the 2021 plan is November 1 - December 15, 2020. Once you sign up for a health plan, coverage will kick in on January 1.
Vermont expanded Medicaid under the Affordable Care Act in 2014.
Based on the Federal Poverty Level, the Vermont income limit is $31,900 for a single individual, $54,300 for a family of three, and $87,900 for a family of six.
A lot of factors are causing the rise of healthcare costs in Vermont. The most notable factors are administrative costs, pharmacy and drug costs, the cost of CT and MRI scans, and the overall complexity of the US healthcare system.
Short-term health insurance Vermont plans offer health care coverage for a limited period. Vermont law requires they can only be purchased to have terms up to three months and renewal is not allowed.
The total uninsured percentage in the state of Vermont for the year 2020 was 5% of the population.
Once the federal government eliminated the penalty for not having health insurance, some states stepped in to vote state laws that require residents to have health insurance.
As of January 2020, Vermont is one of those states where residents are required to have health insurance. People who do not have health insurance may have to pay a federal fee when they file their taxes.
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