Vermont Health Insurance
Are you planning to buy a health insurance plan in Vermont? We will provide you with accurate Vermont health insurance quotes from trusted companies and find out how you can save on high quality health coverage. Start by entering your zip code and read more about Vermont health insurance plans offered in your area.
On This Page
Facts and Figures
-
Place in State
Health Report Card 1st - Insured 552,510
- Uninsured 59,000
-
Insurance
Carriers 3 -
Number of
Primary Care Physicians 1830 -
Number of
Hospitals 14 -
Average Cost of
Health Insurance* $986
Breakdown of Insureds
- Employer-sponsored health insurance 51%
- Private plans 4%
- Medicaid 21%
- Medicare 14%
- Others 10%
Insurance Carriers
- Assurant Health Health Insurance
- MVP Health Care Health Insurance
- Blue Cross and Blue Shield of Vermont
State Health Report Card
Smoking among adults in Vermont went down from 21.5 percent to 15.4 percent in the last years. There are 76,000 adult smokers in the state.
Obesity rose from 18.2 percent to 23.9 percent among adults in the last ten years. There are 119,000 obese adults living in Vermont.
Diabetes among adults went up from 4.4 percent to 6.8 percent in the last ten years. There are 34,000 adults living with diabetes in the state.
Children living in poverty went up from 7.4 percent to 13.5 percent among the 18 and under population in the last five years.
The incidence of infectious disease went down from 8.5 to 3.1 cases per 100,000 population in the past year.
Vermont Health Insurance Laws and Regulations
Vermont health insurance plans are required to be sold with a guaranteed renewability clause. This means that as long as you keep up with your monthly premiums and do not violate your terms of contract, you can renew your coverage whenever you see it fit. Also, health insurers are not allowed to cancel your policy when you get sick or injured. When writing new Vermont health insurance plans, insurers can exclude coverage for a pre-existing condition for a period of up to 12 months. Pre-existing condition can be defined as any health issue diagnosed or treated within the last 12 months before the new policy is activated. Health insurers in Vermont cannot deny an application for coverage based on age, family history, health, or other risk factors of the applicant. In addition, the state limits any increase in health insurance cost and can occur only once a year. All qualified applicants are given access to three state-standardized plans in addition to other policies offered by the health insurer. Plans are available for singles, couples, and families. State laws require health insurers to also offer family policies to individual health coverage applicants upon request as long as the applicant does not have a family coverage available through work-related group health plan. Small businesses with two to fifty employees are given access group health plans comparable to the ones offered to other small companies in the state. Small businesses in Vermont are also given the option of choosing between two identical health plans with different payment schemes. To maintain group coverage, small businesses must meet certain requirements like having a minimum level of employee participation or a minimum contribution made by the employer. Vermont health insurance quotes for group coverage can vary according to the risk factors of its members. However, small group health plans cannot be cancelled due to a member’s health condition. Self-employed individuals in Vermont are not allowed to purchase group health plans being offered to small businesses. However, they can purchase individual health plans, which have the advantage of having a portion of the premium payments tax-deductible.
Heath Care Reform
With the new health care law, children under the age of 26 can choose to stay under their parent’s Vermont health insurance as long as they are not offered an employer-based health insurance. This provision enabled 2.5 million young adults to have insurance nationwide. In Vermont, 4,287 young adults have insurance coverage through this provision as of June 2011.
The new health care law allowed 7,096 Medicare policyholders in Vermont to receive a $250 rebate check to help with prescription drug costs when they fell into the Medicare gap in 2010. In 2011, 6,795 Medicare plan holders were given a 50% discount on brand-name prescription drugs covered by their plans when they hit the donut hole. An average of $714 per person or a total of $4,849,624 was saved in Vermont.
When looking at Vermont health insurance quotes, applicants are assured that at least 80 percent of the price will go directly to health care services and other related improvements. A rebate or premium discount shall be provided if the minimum is not met. All 180,000 private policyholders in Vermont will get greater value for their premium payments because of this 80/20 rule.
Preventive care services like immunizations, colonoscopies, mammograms, or annual wellness doctor visits must be included in all Vermont health insurance with no deductibles or co-pays. In 2011, 81,649 Medicare subscribers and 115,000 individuals with private policies received such services in Vermont.
Under the new law, insurance companies are no longer allowed to impose an annual dollar limit-a cap on the yearly spending for your benefits, or a lifetime dollar limit-a lifetime cap for spending for your covered benefits. This law frees chronically ill individuals like cancer patients from worrying about getting further treatment because of such limitations. In 2011, 215,000 Vermont residents have benefited from this law.
If insurance companies want to raise their premium rates by ten percent or more, they are required by federal law to publicly announce and justify their actions. To guard against such unreasonable increases, the state of Vermont received a total of $4.8 million.
All fifty states receive increases in funding for community health centers under the Affordable Care Act. This will help construct new health centers, provide medical services to more patients, improve preventive and primary health care services, and fund infrastructure projects. In Vermont, 56 community health centers received a total of $8.5 million to fund these improvements.
In 2010, the Affordable Care Act created the Prevention and Public Health Fund. This new fund was created for wellness promotion, disease prevention, and protection against public health emergencies. Vermont has already received a total of $5.3 million to support its policies, programs, and communities to help its residents lead healthier lives.
State Government Insurance Programs Offered
Medicaid
800-250-8427
Medicaid offers health coverage for those who cannot afford to pay for medical care. Benefits and services include doctor visits, hospital care, lab and X-rays, prescriptions, mental health and substance abuse, dental care, eye care, therapy (occupational, physical, and speech), and many more. Eligibility: 1. Must be a U.S. citizen or qualified resident living in Vermont. 2. Must not exceed income limits: Pregnant women: 200% of the federal poverty level (FPL). Children aged 0-18 years: 225% of the FPL. Aged, blind, and disabled Chittenden residents: $1,000/month for singles and couples. $1,183 for household of three and $1,333 for household of four. Aged, blind, and disabled non-Chittenden residents: $925/month for singles and couples; $1,116 for household of three, and $1,258 for household of four. Aged, blind, and disabled: Assets must not exceed $2,000 for singles and $3,000 for couples.
Vermont Health Access Plan (VHAP)
1-800-250-8427
Vermont Health Access Plan (VHAP) is a health insurance program for uninsured adults, age 18 years and older who meet income guidelines. Services covered include doctor visits, hospital care, prescription medicines, mental health, and many more.
Dr. Dynasaur
800-250-8427
Dr. Dynasaur offers health coverage for children 18 and under living in Vermont. Benefits covered include doctor visits, hospital visits, prescription medicines, immunizations, vision care, dental care, skin care, mental health care. Special services for pregnant women are available such as lab work and tests, prenatal vitamins and many more. Eligibility: 1. Must be a U.S. citizen or qualified resident living in Vermont. 2. Children 0 – 18 years old with household income not exceeding 300% of the FPL or Pregnant Women with income not exceeding 200% of the FPL.
Vermont Medicare
800-633-4227
Medicare is administered by the federal government and provides health insurance coverage to Americans aged 65 and above or those younger than 65 but have a disability or end-stage renal disease. Coverage has four parts: Part A: provides inpatient care in hospitals and rehabilitative centers. Part B: provides doctor and some preventive services and outpatient care. Part C: provides Medicare benefits through Medicare Advantage. Part D: provides prescription drug coverage. Eligibility: 1. Must be a U.S. citizen or permanent U.S. resident. 2. Must be 65 years or older, with you or your spouse having worked in a Medicare-covered employment for at least ten years; or have a qualified disability or end-stage renal disease, regardless of age.
Catamount Health & Catamount Health with Premium Assistance (CHAP)
800-250-8427
Catamount Health offers comprehensive, quality health coverage to adults without health insurance or with very expensive health policies. Benefits include doctor visits, hospital visits, emergency care, prescription medicines, checkups and screenings, chronic disease care, and many more. Eligibility: Must be a resident of Vermont, 18 years old or older, and; have been uninsured for at least 12 months; or aged between 18 and 26 years old and currently a dependent under a parent’s health plan; or have insurance that only provides doctors’ visits or hospital care but not both; or have an individual health plan for at least six months with at least $7,500 deductible for singles or $15,000 for families. Catamount Health Premium Assistance is available for those enrolled in Catamount Health for at least 12 months, do not have access to comprehensive insurance through an employer, and have an income not exceeding 300% of the FPL.