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Who is eligible for financial help on Vermont Health Connect?

  • Individuals without access to affordable and adequate health insurance coverage through other sources. This includes Medicare, employer-sponsored coverage, and individuals enrolled in Veterans' benefits.

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.

All children in household applying for coverage, including any young adult children up to age 26.

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 from Vermont and the federal government 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.

Results

Your household's monthly subsidy:

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


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.

Important note: You also likely qualify for cost-sharing reductions [and Dr. Dynasaur]. Read below for more details.

View the chart below for the average costs of other metal level plans.

Product Full Premium Your Cost
Platinum
Gold
Silver
Silver HDHP
Bronze
Bronze HDHP

Premiums shown are averaged across insurers, and are for illustration only.

Bronze plans have low premiums and higher out of pocket costs and platinum plans have the highest premiums and the lowest out of pocket costs, but for some families silver plans may be eligible for lower out of pocket costs.

HDHP is High-Deductible Health Plan

Catastrophic plans are not listed. 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 from Vermont Health Connect.

Dr. Dynasaur (Income below 300% FPL)

Your children may qualify for Dr. Dynasaur, the state’s public health coverage program that provides quality low-cost or free coverage to kids under 18. You can apply for Dr. Dynasaur coverage on Vermont Health Connect through our single-streamlined application online, over the phone, or on paper, beginning October 1.

Cost-Sharing Reductions (Income below 300% 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.

Pregnant Women (under 200% FPL)

If you are pregnant, you may qualify for Dr. Dynasaur, the State’s public health coverage that provides quality low-cost or free coverage to kids under 18 and pregnant women. You can apply for Dr. Dynasaur now by visiting www.greenmountaincare.org or through our single-streamlined online application beginning October 1.