Vermont Health Insurance Guide 2025

Medicaid in Vermont

Vermont was among the first states to expand Medicaid and has long been a leader in healthcare coverage. Vermont Medicaid, part of the Green Mountain Care umbrella, provides comprehensive benefits to eligible low-income residents. The state also offers Dr. Dynasaur, an acclaimed program providing health coverage to children and pregnant women.

Who Qualifies for Vermont Medicaid?

• Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals)
• Pregnant women with income up to 213% FPL
• Children under 19 with income up to 317% FPL (Dr. Dynasaur)
• Seniors and people with disabilities meeting income requirements
• Parents/caretakers meeting income requirements

Green Mountain Care Benefits

• Preventive care and wellness visits
• Doctor visits and specialist care
• Hospital inpatient and outpatient services
• Prescription drug coverage
• Mental health and substance abuse treatment
• Dental services (comprehensive)
• Vision care including glasses
• Laboratory and X-ray services
• Home health and community-based services

How to Apply

You can apply for Vermont Medicaid through:

• Online at portal.healthconnect.vermont.gov
• By phone: 1-855-899-9600
• Through Vermont Health Connect
• In person at your local Department for Children and Families office
• Through a certified navigator or enrollment counselor

Health Insurance Marketplace

Vermont operates its own state-based marketplace, Vermont Health Connect. The marketplace integrates with Medicaid eligibility screening, making it easy to find the right coverage based on your income.

Available Plan Types

• Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
• Silver: Moderate premiums and costs (70% coverage) - best for subsidies
• Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
• Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
• Catastrophic: Available for under-30 or hardship exemption

Enrollment Periods

Open Enrollment: November 1, 2024 - January 15, 2025

Enroll by December 15 for coverage starting January 1, 2025. Vermont Medicaid and Dr. Dynasaur accept applications year-round. You can also qualify for a Special Enrollment Period if you have a qualifying life event.

Average Costs in Vermont

Health insurance costs in Vermont vary based on your age, plan type, and tobacco use. Vermont tends to have higher premiums than the national average due to its rural nature and limited carrier competition, but generous subsidies offset costs for most residents.