Vermont is a great state for health insurance! Its a guarantee issue state without any unfair legislation to protect health insurance companies, much like the national health insurance plan under Obamacare.
All health insurance companies must offer health insurance to all eligible individuals and accept them without regard to any medical conditions. The only time the Vermont health insurance companies can decline you is when you are eligible for group health insurance.
Additionally Vermont is not a discriminatory state and offers coverage for same-sex couples. Under federal law, Vermont health insurance companies can not issue any pre-existing condition riders. Finally, premiums are guaranteed to not increase for 1 year and can never increase more than 20%!
East Coast Health Insurance is not licensed in Vermont yet, so this page exists to help the consumer find all Vermont health insurance resources in one place as a free tool for you and your family. We hope to offer health insurance coverage in the coming months in Vermont.
Green Mountain Care is a family of low-cost and free health care coverage programs for uninsured Vermonters, including the health insurance marketplace for individuals and small businesses.
Green Mountain Care programs provide coverage for health services such as doctor visits, emergency care, prescription medicines, and more. Programs offer no or low cost co-payments and premiums, to keep out-of-pocket expenses reasonable.
Call 1-800-250-8427 or visit greenmountaincare.org.
Catamount Health provides comprehensive, quality health coverage at a reasonable cost no matter how much you earn. Depending on your income, you may even receive premium assistance.
Who can enroll?
Catamount Health is designed for Vermonters age 18 or older and families who:
- Are not eligible for other Green Mountain Care plans such as Medicaid, Medicare or Vermont Health Access Plan (VHAP);
- Have been uninsured for 12 months or more – with exceptions for Vermonters who recently lost their insurance because of a life change such as a divorce or loss of a job (Read further information on Catamount Health Qualifications) or have been enrolled for at least six months in an individual plan with deductibles of $10,000 or more for an individual or $20,000 or more for a family;
- Are an adult making more than $1,359* a month (higher for larger households) or a parent making more than $1,676* a month (higher for larger households); and
- Do not have access to insurance through an employer (although Vermonters may be eligible even if they have access to your employer’s insurance if their monthly income is $2,718 or less*).
What services are covered?
Benefits include doctor visits, checkups and screenings, hospital visits, emergency care, chronic disease care, prescription medicines and more.
How much does it cost?
Premium assistance is available for Catamount Health based on income and other criteria. (Read further information on Catamount Health Premium Assistance Qualifications). Monthly premiums range from $60-$393 depending on income, office visit co-payments are $10, prescriptions range from $10-$50 and deductibles are $250 for individuals and $500 for families (in network).
Employer-Sponsored Insurance (ESI) Premium Assistance
If you’re an uninsured Vermonter, you can get help paying your employer’s health insurance premiums if all of the following criteria are met:
- You are eligible to enroll in Catamount Health or the Vermont Health Access Plan (VHAP);
- Your income is less than or equal to $2,718* a month for one person (higher for larger households);
- Your employer’s plan has comprehensive benefits; and
- It is more cost-effective for the state to provide premium assistance to enroll in your employer’s plan than to provide premium assistance to enroll in Catamount Health or VHAP.
Assistance for Employees provides more information about Employer-Sponsored Insurance (ESI) Premium Assistance.
* You may still qualify if your monthly income is higher if you have earned income and/or child care expenses.