FAQs for Vermonters Purchasing Health Insurance on their Own

 

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I selected and confirmed a plan. How do I pay?

You have the choice of paying online or by phone (toll-free 1-855-377-7979) by debit, credit, or ACH, or by mailing a check or money order.

Download our Quick Reference Guides for paying by:

To pay by mail, please send a check or money order made out to Vermont Health Connect for the exact amount of your monthly premium(s) by the last day of the month before your plan starts to: 

Vermont Health Connect
PO Box 1840
Williston, VT 05495-1840

Be sure that the name and mailing address on your Vermont Health Connect account match the name and address on the check (or make a note in the memo section). If possible, please include the payment coupon from your invoice. 
 

Who can use Vermont Health Connect?

Vermont Health Connect is for individuals, families and small businesses in Vermont. This includes:

• Vermonters who do not have health insurance

• Vermonters who currently purchase insurance for themselves

• Vermonters who have Medicaid

• Vermonters who currently have Catamount, VHAP or Dr. Dynasaur

• Vermonters who are offered unaffordable; coverage by their employers

• Small businesses in Vermont that provide coverage for their employees

As of October 1, 2013, small businesses with 50 or fewer employees are able to use Vermont Health Connect to find coverage for their employees. In 2016, small businesses with 100 or fewer employees will be able to offer coverage for their employees through Vermont Health Connect.

 

Will existing Medicare/Medicaid enrollees, also called "dual eligibles," have to re-enroll with Vermont Health Connect?
Individuals who are dually eligible for Medicare and Medicaid will not apply for coverage through Vermont Health Connect. The current application and annual recertification process will stay the same.
 
I qualified for Medicaid through Green Mountain Care. When will I receive my health plan ID card?

Vermonters who have had a Green Mountain Care card in the past will continue to use the same card if they are enrolled in expanded Medicaid. If they need a replacement card, they can request one by calling toll-free 1-855-899-9600.

Vermonters who have never had a Green Mountain Care card in the past will be mailed one by late winter. In the meantime, doctors and other providers can confirm membership through Social Security Numbers.

You can read more information about coverage by clicking on the “Member Handbook.”  

 

Will the website be translated into different languages?

Language assistance for Vermonters who need translation services is available through our toll free Customer Support Center 1-855-899-9600. The website itself will not be translated.

 

How can I apply for coverage?

The easiest way to apply is through our online portal. You can also apply over the phone by calling our toll-free Customer Support Center or get in-person help through a certified Navigator or registered broker. Paper applications are also available but require more time to process. 

 

Eligibility

If a student is offered coverage through their college/university, is she obligated to take that coverage? Can she choose to get coverage through Vermont Health Connect regardless of whether their student plan offers the essential benefits or is affordable?

Student health plans are considered “credible coverage” under the ACA. Therefore, if the student is covered by the student health plan she will be considered covered with respect to the individual mandate penalty (i.e., they will not be penalized). A student can always opt to get coverage through VT Health Connect. However, she will not be eligible financial assistance if she is claimed as a dependent on her parents' income taxes.

 

Can an 18 year old enroll on Vermont Health Connect and receive a subsidy for his own Single plan, even though he is still claimed as a dependent by his parents? 

A dependent cannot receive premium assistance for purchasing a plan on his own. He can, however, stay on his parents' plan up to age 26.

I'm wondering about a college student who is not claimed as a dependent by her parents. Can she qualify for a health plan with financial help even if her college offers an insurance plan? 

Yes, as long as she is not enrolled in that college health insurance plan and meets other eligibility requirements, she can qualify for financial help through Vermont Health Connect. 

The same holds true for the military and people who are not automatically enrolled in Medicare Part A because they have an inadequate work history. According to the Department of the Treasury and the IRS, it does not matter if they are OFFERED a student plan, military plan, or Medicare Part A. They are only determined to have minimum essential coverage (and thus are ineligible for additional financial help) if they ENROLL in such a plan.

Because young adult children up to age 26 can also be covered on their parents' plans, it's worth exploring all available options.
 

My husband and I want to apply for coverage for our 20-year-old college student daughter. Can we do that? Do we account for the $2,000 she earned from her summer job?

Adult children can be included on their parents’ plan through the plan year that includes their 26th birthday, so yes, she can be included on your family health plan. Assuming you claim her as a dependent on your taxes, she is a member of your tax household; her earned and unearned income should be reported along with your other household income if it exceeds the IRS’s dependent filing threshold.  In this particular case, her income falls below the $6,100 earned income threshold for dependents and should not be reported; it will not impact your household’s eligibility for financial help. Read the full IRS guidance on dependent filing requirements, including thresholds for unearned income and gross income, at http://www.irs.gov/publications/p17/ch01.html#en_US_2013_publink1000170430
 

My husband and I want to apply for coverage for our 25-year-old daughter who is not a dependent.  Can we do that? Do we account for her $30,000 salary?

Yes, you can include her on your health plan. According to the Affordable Care Act, adult children can be included on their parents’ plan through the plan year that includes their 26th birthday. As for her income, Vermont Health Connect will ask you to name each person in your family who is applying for health coverage and to list their sources of income.  You will report your daughter’s income at this point.  Because she is a separate tax household, however, her income won’t be lumped together with your tax household’s income.  Rather, this is one case where two tax households can receive Advance Premium Tax Credits (APTC) to purchase one plan.  The system will calculate your tax household’s APTC based on your income, it will calculate your daughter’s APTC based on her income, and then it will combine the two APTC and apply them to the cost of your family plan.  In effect, this means that a family with an adult child might receive more financial help than they’d get on their own, but they will never receive less. 

I'm eligible for Tri-care through the military. Do I need to get an additional health plan through Vermont Health Connect to avoid paying the federal penalty?

As long as your health plan meets minimum essential coverage requirements, you are not liable to pay a tax penalty. Many Tri-care plans provide minimum essential coverage. See details on the Tri-care website

It’s important to note, however, that you still might be eligible for financial help through Vermont Health Connect. According to the Department of the Treasury and the IRS, it does not matter if you are OFFERED a military plan, you are only determined to have minimum essential coverage (and thus are ineligible for additional financial help) if you ENROLL in such a plan.  For that reason, it might be worthwhile to check out Vermont Health Connect plans, see how much financial help you qualify for, and compare the costs and benefits to Tri-care.

What income should I enter into the application?  What will tax subsidies be based on?  

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

Your household's MAGI will determine whether you are eligible for Medicaid, Advanced Premium Tax Credits (APTC), and/or cost-sharing reductions.

Your 2014 subsidies will ultimately be based on your 2014 income.  Because you may not know your future income, you will be asked to report your current income.  You'll also be asked if you expect that to change in 2014. If your income changes over the course of 2014, you should call or log-in to Vermont Health Connect to report the change. When you file your taxes in 2015, the IRS will reconcile what you received as APTC with what you actually are eligible for.  If you under or over reported your income, you would end up owing taxes or receiving a credit for the difference.

 

If my income changes mid-year, can my premium change or be adjusted mid-year?

Yes.  Changes in income should be reported to Vermont Health Connect throughout the year. It is not necessary to wait until the open enrollment period.  It is possible that the income change will impact the premium tax credit and the cost- sharing reductions. 

 

 

Financial Help

What kind of financial help is available?

Premium Assistance: If you purchase a health plan through Vermont Health Connect, you may qualify for a subsidy in the form of a tax credit. This tax credit will help you pay for part of your monthly premiums starting in 2014. You can choose to apply your subsidy to your monthly premiums or you can get it all at once when you file your federal income taxes.

Cost-sharing reductions: If you purchase coverage as an individual (not through your employer) and your household income is less than 300% FPL ($34,470 for an individual or $70,650 for a family of four), 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. The table below shows how your deductible and out-of-pocket caps will be reduced by cost-sharing reductions.  If you are unsure how your income translates into FPL, view the FPL chart in our glossary or try out our Subsidy Calculator.

 

 

cost-sharing reductions with Silver Plans

 

I'm wondering about a college student who is not claimed as a dependent by her parents. Can she qualify for a health plan with financial help even if her college offers an insurance plan? 

Yes, as long as she is not enrolled in that college health insurance plan and meets other eligibility requirements, she can qualify for financial help through Vermont Health Connect.

The same holds true for the military and people who are not automatically enrolled in Medicare Part A because they have an inadequate work history. According to the Department of the Treasury and the IRS, it does not matter if they are OFFERED a student plan, military plan, or Medicare Part A. They are only determined to have minimum essential coverage (and thus are ineligible for additional financial help) if they ENROLL in such a plan.

Because young adult children up to age 26 can also be covered on their parents' plans, it's worth exploring all available options.

 

It’s great that tax credits are in place to make my monthly premiums more affordable.  Out-of-pocket costs can be expensive, however. Is anything be done to reduce these costs?

Today, many insurance plans do not have limits on out-of-pocket expenses or the limits are high. Beginning in 2014, under federal law, there are also limits on the out-of-pocket expenses an individual or family would be responsible for in plans purchased through Vermont Health Connect. For most Vermonters, total cost-sharing per year (deductibles, co-pays, and co-insurance) is capped at $6,350 for an individual and $12,700 for families. For some Vermonters, out-of-pocket expenses may be subsidized further through a form of financial help called Cost-Sharing Reductions (see next question). 

 

Is there a penalty if I don't have health coverage?

Under the Affordable Care Act's Individual Mandate provision, almost everyone is required to either have health coverage or pay a fee on their following year's taxes.  In 2014, the federal fee is either 1% of yearly income or $95 per adult, whichever is higher. The fee for an uninsured child is $47.50.  The fee increases in future years. Read more on the federal healthcare.gov website.

Is it true that there are special benefits for Native Americans?

Under the Affordable Care Act, member of federally recognized tribes are eligible for special benefits, including no cost-sharing for those under 300% FPL and enrollment period flexibility.

 

How do cost-sharing reductions work? Is it taken off the patient’s bill at the time of service? Or does the patient have to pay the full cost and then get reimbursed?

Cost-sharing reductions reduces a person’s out of pocket cost at the time of service.

 

Does end of the year reconciliation also affect cost-sharing reductions?

No, unlike premium tax credits, there is no individual reconciliation for cost-sharing reductions.

 

Individual & Family

 

Do I have to have insurance?

As of January 1, 2014, federal law now requires all Americans to have health insurance. Many Vermonters will be eligible for public programs or financial assistance to help pay for their care through Vermont Health Connect.  Anyone who does not have health insurance, starting in 2014, will face a tax penalty. There are some exceptions to this requirement, including individuals who 1) have an income that is low enough that they do not file income taxes (this equals an annual income of about $9,500 for an individual), 2) have specific religious beliefs, or 3) are unable to find an affordable plan.  You must apply to the federal government directly for an exemption. Learn more about the individual mandate on healthcare.gov.

 

How can I find an insurance plan similar to my old plan?

As of January 1, 2014 all individuals who get health insurance on their own (not from their job) will likely need to shop for a new plan during Vermont Health Connect's open enrollment, which runs from October 1, 2013 through March 31, 2014. The Affordable Care Act changed the requirements about what benefits health insurance carriers must have in their products. Given this change, the plans on Vermont Health Connect are different than the plans formerly available for purchase in Vermont. If you have any questions about whether you need to switch your plan, the timing of this change, or how to find a plan similar to the one you currently have, call our Customer Support Center toll free at 1-855-899-9600.

 

My employer does not offer health insurance. Can I get health coverage through Vermont Health Connect?

Yes! If your employer does not offer health coverage, you will be able to get health insurance through Vermont Health Connect. You can use Vermont Health Connect to compare plans and select the one that fits your needs and budget. On Vermont Health Connect, you can find out if you are eligible for Medicaid or financial assistance to help you pay for private plans.

 

What if my employer offers coverage, but I can’t afford it?

Under Vermont Health Connect employer-sponsored health coverage is considered “unaffordable” if the employee's premium is more than 9.5% of household income. If your coverage meets this definition of "unaffordable"; you may be eligible to find an alternative plan through Vermont Health Connect that works better for your budget.  The coverage your employer offers must also meet minimum value standards, meaning it covers at least 60% of your medical costs. Employers can check to see if the coverage they offer meets the minimum value standard by clicking here: http://www.cms.gov/CCIIO/Resources/Regulations-and-Guidance/Downloads/mv-calculator-final-4-11-2013.xlsm

 

If I served in the military, am I eligible for low cost health insurance?

Yes, you may be eligible for health insurance through the Department of Veteran's Affairs. Learn more about Vermont's health coverage resources for those who have served in the military.

 

I’m on Medicare – do I need to interact with Vermont Health Connect?

No, Vermont Health Connect does not offer Medicare. As a Medicare recipient, you will receive your benefits and Medicare information the same way you do now. Read more information about the federal health care law’s implications for Medicare on HealthCare.gov.

 

I am currently on Medicaid, what do I do?

If you are currently enrolled in Medicaid and are below 133% of the Federal Poverty Level (FPL), you will remain on Medicaid until your next review, unless you report a change in your income that changes your eligibility. Any change in circumstance should be reported to ESD per current procedures.

 

When can I enroll in a health plan through Vermont Health Connect?

For most individuals and families, the first open enrollment period for Vermont Health Connect began on October 1, 2013 and runs to March 31, 2014. During this time, you will be able to enroll in a plan directly on this website. If you need help, you can call our toll free Customer Service Center at 1-855-899-9600 or connect with a one-on-one Navigator to guide you through the enrollment process.

 

What happens if I need health insurance outside of the open enrollment period?

If you experience a qualifying event, you are entitled to a 60 day special enrollment period on Vermont Health Connect. A qualifying event includes:

·         If you or one of your tax dependents loses minimum essential coverage

·         You gain or become a dependent through marriage, birth, adoption, or placement for adoption

·         An individual, not previously lawfully present, gaining status as a citizen, national, or lawfully present individual in the U.S.

·         A qualified individual experiencing an error in enrollment.

·         An individual enrolled in a QHP adequately demonstrating to the Exchange that the QHP in which he or she is enrolled substantially violated a material provision of its contract.

·         An individual becoming newly eligible or newly ineligible for advance payments of the premium tax credit or experiencing a change in eligibility for cost-sharing reductions.

·         New QHPs offered through the Exchange becoming available to a qualified individual or enrollee as a result of a permanent move.

·         The individual is an Indian, as defined by the Indian Health Care Improvement Act. We solicited comment on the potential implications on the process for verifying Indian status for purposes of this special enrollment period.

·          A qualified individual or enrollee meeting other exceptional circumstances, as determined by the Exchange or HHS.

Note that loss of coverage does not include failure to pay premiums on a timely basis, including COBRA premiums prior to expiration of COBRA coverage.

 

How many plans will there be on Vermont Health Connect?

Each participating insurance company will be required to offer a total of six standard plans—two bronze, two silver, one gold and one platinum metal level plan. Insurance companies will also have the opportunity to offer additional “choice” plans that give companies the flexibility to provide new, innovative options to Vermonters. Vermont Health Connect plans will offer a range of different choices and prioritize low cost-sharing for primary care services and generic drugs.

See the Vermont Health Connect plans.

 

I’m enrolling in a plan on my own, not through my job. When will my plan take effect?

If you enroll between the first and fifteenth day of the month - and postmark your premium by the last day of the month - your plan will take effect the first day of the following month. If you enroll between the sixteenth and the last day of the month, your plan will take effect the first day of the second following month.

For example, if you select a plan by January 2, 2014, your plan will take effect on February 1, 2014 OR if you select a plan on January 16, 2014, your plan will take effect on March 1, 2014.

 

How often can I change my plan?

Most people will only be able to update or change their health plan selection once during the annual open enrollment period. However, you may be able to enroll in health coverage or change your health coverage at other times throughout the year if you or your family has a major life change such as getting married, giving birth, or a change in income. This is known as a qualifying event.

The first open enrollment period for Vermont Health Connect will be October 1, 2013 to March 31, 2014. For coverage starting in 2015, the proposed Open Enrollment Period is November 15, 2014–January 15, 2015. For employees of a small business, your open enrollment period will run for 30 days prior to your employer’s insurance enrollment anniversary date.

Vermonters who are eligible for Medicaid or Dr. Dynasaur can enroll at any time throughout the year.

 

What is a Navigator?

A Navigator is a state-trained and certified person who offers Vermonters in-person, one-on-one assistance with selecting a health plan. Navigators will provide information about health insurance, qualified health plans, Medicaid and other public programs, and offer impartial application assistance.

Vermont’s Navigators will complement the help that will be available through the website and call center. Find a Navigator in your area

 

How much will I pay for health insurance in 2014?

Thanks to Vermont Health Connect’s new Subsidy Calculator, it’s now easy for many Vermonters to find an answer. Most Vermonters who access coverage through Vermont Health Connect as individuals or families will qualify for financial help. The Subsidy Calculator asks a few simple questions then estimates what help you'll receive and what you'll pay. If your job does not offer health insurance, estimate your costs with our Subsidy Calculator.

 

As an individual, will my premiums continue to be tax deductible?

Possibly. The answer depends on the tax benefits you receive and the cost of your care. Many Vermonters who enroll in a health plan through Vermont Health Connect will be eligible for tax credits to help pay for the cost of their premiums. Individuals whose medical expenses exceed 10% of their income can deduct premiums paid from their annual federal income tax. Seek advice from your tax professional for additional assistance. 

 

How do I apply for an exemption from the individual shared responsibility payment?

Individuals seeking an exemption will need to apply for one through the federal government. We are still awaiting guidance on how this process will work. Please check back or call our Customer Service Support Center for additional information.

 

Are all QHP premiums due Dec 15, 2013?

To ensure 1/1/14 coverage, individuals must select a plan by the 15th and pay their initial premium by the 31st.  However, any premiums paid after 12/15/13 could result in a delay in receiving insurance cards. Please encourage all to pay by 12/15/13 or earlier so that they will receive their Plan ID card from the carriers by 1/1/14.

 

If someone chooses the wrong plan when they enroll can they change it?

Individuals may switch plans during the open enrollment period, if they have not yet paid their premium.  Once they pay a premium, they cannot select another plan until the next open enrollment or a qualifying event.

 

Who Qualifies as a Child for the Individual Shared Responsibility Payment?

Note: A taxpayer is liable for the shared responsibility payment imposed with respect to any individual for a month in a taxable year for which the taxpayer may claim a personal exemption deduction for the individual (that is, the dependent) for that taxable year. Whether the taxpayer actually claims the individual as a dependent for the taxable year does not affect the taxpayer's liability for the shared responsibility payment for the individual.

Must meet all of the following requirements-

1.            Must have one of the following relationships to the taxpayer:

A)           A child of the taxpayer or a descendant of such a child, 152(c)(2)(A) or

B)            a brother, sister, stepbrother, or stepsister of the taxpayer or a descendant of any such relative 152(c)(2)(B)

2.            Has the same principal place of abode as the taxpayer for more than one-half of the taxable year

3.            Has not provided over one-half of his or her own support for the calendar year

4.            Meets the following age requirements:

A)           The individual is younger than the taxpayer claiming such individual as a qualifying child

B)            The individual has not attained the age of 19 as of the close of the calendar year in which the taxable year of the taxpayer beings, or is a student who has not attained the age of 24 as of the close of such calendar year.

 

Special cases:

Disability: In the case of an individual who is permanently and totally disabled, the age limit does not apply.

Adoption: If a taxpayer legally adopts a child and is entitled to claim the child as a dependent under section 151 for the taxable year when the adoption occurs, the taxpayer is not liable for a shared responsibility payment attributable to the child for the months before the adoption.

Conversely, if a taxpayer who is entitled to claim a child as a dependent under section 151 for the taxable year places the child for adoption during the year, the taxpayer is not liable for a shared responsibility payment attributable to the child for the months after the adoption.

 

Plans

 

What will I be able to compare on the Vermont Health Connect website?

Vermont Health Connect will offer side-by-side comparisons of health plans' benefits and prices. Most plans will have similar benefits because there is a minimum set of benefits required by federal law. These are called “Essential Health Benefits.” Some plans might also have additional benefits that you’ll be able to see and compare. You will also be able to compare costs – like monthly premiums, co-pay, the cost of a hospital visit, the cost of prescriptions and more.

 

On Vermont Health Connect, will there be a summary of what’s included in my health plan?

Yes, it’s called the “Summary of Benefits and Coverage.” Under the Affordable Care Act, insurance companies must provide consumers with this easy-to-understand and easy-to-compare summary of health plans' benefits and coverage. This summary will include information on co-payments, deductibles and out-of-pocket limits. Each health plan’s description will come with an example of a patient’s typical out-of-pocket costs for two sample medical scenarios: having a baby and treating type 2 diabetes. See the Summaries of Benefits and Coverage for all plans on Vermont Health Connect.

 

What’s included in Vermont’s Essential Health Benefits Package?

The Essential Health Benefits are a basic set of health care services that health plans will be required to cover beginning in 2014. The federal health care law requires that all plans, in every state, include the following benefits:

 

• Ambulatory patient services

• Emergency services

• Hospitalization

• Maternity and newborn care

• Mental health and substance use disorder services, including behavioral health treatment

• Prescription drugs

• Rehabilitative and habilitative services and devices

• Laboratory services

• Preventive and wellness services, and chronic disease management

• Pediatric services, including oral and vision care

Plans available on Vermont Health Connect will also continue to include the same State-mandated benefits that Vermonters have access to now. 

 

What is the difference between the Standard and the Non-Standard plans?

The standard plans all cover the same basic benefits package of ten essential health benefits, although there is some variation in cost-sharing and provider networks between the plans. Non-standard plans are unique to each health insurance carrier. They still cover the same basic benefits package, but they may also include a focus on primary/preventive care, innovative wellness programs, and mental health/substance abuse treatment. The best way to tell the difference between the standard and non-standard plans is to take a look at the Summary of Benefits and Coverage for each plan. Anyone can choose between a standard and non-standard plan depending on your health needs and personal preference.

 

Can I purchase dental and vision coverage on Vermont Health Connect?

Dental and vision coverage is included in medical plans for children up to age 21. Dental coverage is not included in the medical plans for adults. Pediatric and dental coverage can also be purchased separately on Vermont Health Connect.

 

If I have insurance through my employer, can I still buy dental coverage on Vermont Health Connect?

Yes, you may purchase a standalone pediatric or adult dental plan on Vermont Health Connect.

 

What is the difference between an EPO, PPO, and HMO?

PPO (Preferred Provider Organization): With a PPO, you receive more comprehensive benefits by using network providers - doctors, hospitals and other health care providers - that participate in the plan. You have the option of using non-network providers, but with a lower level of benefits and higher out-of-pocket costs.

EPO (Exclusive Provider Organization): Similar to an HMO, with an EPO you must use network providers - doctors, hospitals and other health care providers - that participate in the plan. The only exception is for emergency care. Unlike an HMO, you do not need to select a Primary Care Physician, nor do you need to contact your PCP for referrals to specialists. However, because you are responsible for choosing specialists and hospitals, it is especially important to check with the plan by phone or their website to be sure the provider is in the network.

HMO (Health Maintenance Organization): With an HMO, you must use network providers - doctors, hospitals and other health care providers - that participate in the plan. The only exception is for emergency care. An HMO requires the selection of a Primary Care Physician (PCP) to manage your care. Referrals are usually needed from your PCP to see a specialist, who must also be in the network.

 

Can I keep seeing the same doctor and using the same prescriptions?

You can find out what doctors are in network or out of network by visiting the carriers' websites and using their provider directories (BCBSVT - MVP). You can also visit the carriers' websites to see which prescriptions are covered (BCBSVT - MVP). Additional information about whether a plan is an HMO, PPO, or EPO, cost of services, and in-network/out-of-network details can be found in the Summaries of Benefit and Coverage.

In-network providers are the providers the carriers contract with to provide services to enrollees. The type of plan you select (HMO, PPO or EPO) will dictate how you utilize providers. Typically, your costs will be lower if you stay with in-network providers, but out-of-network providers are available if you need them. Out-of -network providers are those providers not contracted to provide services for the health plan. If you have any questions about whether a provider is in-network or out-of-network, or potential cost of using out of network providers, you should contract your health insurance carrier.

 

What is VBID in relation to prescriptions?

VBID (value based insurance design) is a program associated with MVP’s non-standard plans. VBID is a program that provides very low co-pays for about 35 chronic care drugs. The co-pays range from $1 at the gold level to $3 at the silver and bronze levels.

 

What are examples of Urgent Care services?

Medically necessary services are typically defined as those that are not required for an illness or injury that would not result in further disability or death if not treated immediately, but require professional attention and have the potential to develop such a threat if treatment is delayed longer than 24 hours.

 

Is durable medical equipment an essential health benefit?

No, it is not one of the ten categories of Essential Health Benefits. However, that does not mean that medical equipment is not covered in plans. For additional information, please see the certificates of coverage for each plan on our website.

 

 

Premiums

 

As an individual, will my premiums continue to be tax deductible?

Possibly. The answer depends on the tax benefits you receive and the cost of your care. Many Vermonters who enroll in a health plan through Vermont Health Connect will be eligible for tax credits to help pay for the cost of their premiums. Individuals whose medical expenses exceed 10% of their income can deduct premiums paid from their annual federal income tax. Seek advice from your tax professional for additional assistance.