With the unique health insurance market in Vermont, you will need all the help you can get to find the best option available. HealthQuoteInfo aims to provide the support you need in this process. With the numerous Vemont health insurance plans we can offer from carriers like Cigna, Cigna PDP, Blue Cross Blue Shield of Vermont, and MVP, you don’t have to worry about getting insured within your means.
Vemont Health Insurance Basics: What Every Resident Needs to Know
Comparing and differentiating each plan can be easily done by entering your zip code in the search bar. You’ll then be presented with a list of available health insurance plans in your location that you can compare with the other items on the list. Click on their links and you’ll see what each package has to offer.
Before getting into the details of the different insurance packages that you can enjoy, there are a few things that everyone must know about health insurance in Vermont. For one, medical underwriting is not allowed in the state. This means that the insurance provider can’t look at your medical history to determine whether you’re eligible for coverage or not. It’s a part of the state law that requires every policy to be “Guaranteed Issue” which ensures that you can get insurance in the state.
They also use community rating instead of basing their rates on the consumer’s age. This is why policies also tend to have fixed prices no matter how old an individual is or what their medical conditions are. However, a nine-month lookback and a 12 month exclusionary period limit for pre-existing conditions apply.
The state is also quite diligent in ensuring that its residents are covered by an insurance policy. Aside from making every individual eligible for an insurance policy, it also has other measures to make sure that everyone’s health is insured. For starters, the state subsidizes certain policies. They also require small businesses with 100 or fewer employees to pay for a fraction of their employee’s health insurance.
Private Health Insurance in Vemont
Their rules for private insurance providers are also quite similar to the ones in place for individual plans. For group health insurance that covers 1 to 50 employees, Vermont insurance providers use community ratings as well. They base their rates on the community’s age and gender. While medical underwriting doesn’t apply, they have a 6-month lookback and 12-month exclusionary period for pre-existing conditions applicable to those without health coverage beforehand.
COBRA Health Insurance Coverage in Vemont
The state also has a Continuation of Coverage law that provides additional benefits to some group plan holders. It mandates the extension of a job-based insurance plan for up to 6 months for group plans with two to 19 employees. It offers similar benefits offered by the Consolidated Omnibus Budget Reconciliation Act of 1985 or COBRA, except it applies to those who aren’t eligible for the said law.
These benefits include the option of continuing the insurance policy instead of looking for a new one right away. With this continuous coverage, you can still avail of the protection your old policy provides despite losing your job.
For plans taken for 20 employees and more, the COBRA coverage applies. This extends your coverage for up to 18 months after parting ways with your former employer. Like the Vermont Continuation of Coverage Law, this also extends to dependents.
Continuous coverage can be a bit pricier, however, than most other policies as you will be paying for the rate that you and your former employer used to share. This is why plan holders also have the option to drop the COBRA coverage.
Medicaid & Low Income Health Insurance Vermont
Low-income individuals and families, as well as the elderly, college students, and people with disabilities can also get health insurance through Medicaid. This is a state/federal program that takes on the financial burden for medical and long-term care for those who are eligible for the services.
To qualify for Medicaid, you should meet certain requirements. Household income of infants aged zero to 12 months should be at 300% of the Federal Poverty Level (FPL). For children aged one to 19 years, the household income should be below 225% of the FPL. 200% of the FPL is the starting point for pregnant women while working parents should be at least at 192% of FPL. Non-working parents should be at 185% of the FPL.
For other populations like the medically needy individual, their household income should be at 102%. Medically needy couples, however, qualify at 76%. Those who receive Supplemental Security Incomes should be at 74% of the FPL.
Medicaid covers the services of hospital outpatient departments, rural health clinics, laboratory and x-ray, nursing homes, federal health centers, dental clinics, physicians, prescription drugs, family planning clinics, case management, early periodic screening for diagnosis and treatment, ambulatory prenatal care, medical transportation, nurse midwives, and extended services for pregnant women. Note that most services, except for emergency services, are only covered within the state of Vermont. If you need a plan that can cover all medical services when you travel, there are other more comprehensive plans available.
Co-payments are also available. However, they do not apply to children, pregnant women, nursing home residents, and those receiving family planning services.
Dr. Dynasaur is another health insurance option available in Vermont for children. It covers children under the age of 19 with a household income 302% below the FPL and pregnant women with an income that falls below 208% of the FPL. Pregnant women with qualifying incomes are also eligible to get this policy for free. To know more about this program, visit this site.
Vermont Open Enrollment 2019 & Vermont Obamacare Insurance
The Vermont Open Enrollment period for health insurance in 2019 will run from November 1st, 2018 to December 15th, 2019.
For all your other questions regarding health insurance in Vermont, please do not hesitate to give us a call at 1-855-614-5057. We stand ready to guide you so that you can get the health & medical insurance coverage you need and deserve.