Estimator

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Who is eligible for financial help on Vermont Health Connect?

This includes everyone in your tax household, whether or not they're applying for coverage through Vermont Health Connect.

All adults applying for coverage in the household, NOT including any young adult children up to age 26.

Who is eligible for financial help on Vermont Health Connect?

Individuals without access to affordable and adequate health insurance coverage through other sources, such as Medicare or employer-sponsored coverage.

Under the Affordable Care Act, eligibility for Medicaid and subsidized health insurance is calculated using a household’s Modified Adjusted Gross Income (MAGI). See how to calculate your MAGI

Single
One person (the subscriber may be an adult or a child).
Couple
Two persons who are married to each other or are in a civil union, according to the rules of Vermont.
Parent and Child(ren)
One adult subscriber and one of more child(ren), up to the age of 26.
Family
Couple with one or more children, up to the age of 26.

Notes

  • Children over the age of 26 may be covered if disabled.
  • Dependents include: biological children, adopted children, step-children, and children whom subscriber is legal guardian.
  • Tier eligibility is based upon enrolled members, not actual family composition. For example, a married couple with a child might enroll as a Single, a Couple, a Parent and Child, or as a Family.
  • Spouse and/or dependents of Individuals may enroll in their own unique plans but, in so doing, they would pay for each plan. For example, if a mom enrolls in BCBS Gold while the dad and child enroll in MVP Bronze, they would pay for a Single BCBS Gold plan and a Parent and Child MVP Bronze plan.
This subsidy means that you will pay x% of your household income toward your health insurance premium, should you choose the second-lowest cost silver plan. This cap, for households of your size and income, was determined by federal and state law. Financial help in the form of federal Advanced Premium Tax Credits (APTC) and Vermont Premium Assistance (VPA) will pay for the rest of your monthly premium. If you choose a different plan, you will carry this subsidy with you and apply it to that plan.
The percentage of an average enrollee’s medical costs that an insurance provider is expected to cover. For example, if a plan’s actuarial value (AV) is 80 percent, the insurance company will pay approximately 80 percent of that person’s medical costs and the remaining 20 percent must be paid by the individual. See how AV relates to CSR-eligible Silver plans.

Results

Your household's monthly subsidy:

With this subsidy, the average silver family plan will cost you:

You also qualify for cost-sharing reductions:

Important note: You also likely qualify for Dr. Dynasaur. Read below for more details.


Why is my subsidy zero?

You do not receive a subsidy because the second lowest cost silver plan costs less than of your household’s income. is the cap for households of your size and income. If this plan cost more than of your income, you would receive financial help to bring your contribution down to that level.

View the chart below for the range of costs of the different metal level plans.

Product Full Premium Your Cost Your AV
Platinum
Gold
Silver
Bronze

Premiums shown are from different insurers, and are for illustration only.

Catastrophic plans are not listed here because subsidies cannot be used to purchase Catastrophic plans. Catastrophic plans are only available for individuals who are under age 30 prior to the first day of the plan year or for individuals who have received a certificate of exemption.

Dr. Dynasaur for Children (Income up to 317% FPL)

Based on your answers to these six questions, your children may qualify for Dr. Dynasaur, Vermont's public health program that provides quality low-cost or free health insurance to children under 19. This could explain why the Estimator didn't give you a quote for a family plan. Vermont Health Connect can help you sign up for the right program for you. Learn more about Dr. Dynasaur and how to apply.

Dr. Dynasaur for Pregnant Women (Income up to 213% FPL)

Based on your answers to these six questions, pregnant women in your household may qualify for free high-quality health insurance from Dr. Dynasaur, Vermont's public health program. Vermont Health Connect can help you sign up for the right program for you. Learn more about Dr. Dynasaur and how to apply.

Medicaid for Adults (Income up to 138% FPL)

Based on your answers to these six questions, you may qualify for free high-quality health insurance. Please note that there are additional rules and more information is needed. Vermont Health Connect can help you sign up for the right program for you. Learn more about Medicaid and how to apply.

Cost-Sharing Reductions (Income below 317% FPL)

In addition to the financial help to reduce your monthly premiums, you may be eligible for help to reduce your out-of-pocket medical expenses. In order to qualify for these cost-sharing reductions, you must purchase a silver-level plan on Vermont Health Connect.