Vermont Health Connect's Plan Comparison Tool is updated yearly with the new eligibility rules and extra financial help. It can help Vermonters choose the best health plan for the financial and medical needs.
- What kind of financial help does Vermont Health Connect offer Vermonters?
- I qualify for financial help, but I chose to pay my full monthly premium instead. Can I claim the premium tax credit when I file my taxes?
- What if my income changes?
- Can American Indians and Alaska Natives get special benefits?
Here’s what different categories of Vermonters can do:
|If this statement applies to you:||Here’s what you need to know:|
|I don’t have health insurance||
If you didn’t qualify for financial help in the past, it’s time to look again. Take a few minutes to look at the Plan Comparison Tool. See how much financial help you may get. Choose a plan that will best meet your needs.
Open Enrollment is over but people who have experienced a qualifying life event (such as marriage, divorce, birth or loss of current coverage) may be eligible for a special enrollment period (SEP). This is the only time you can sign up for new coverage or change coverage outside of the Open Enrollment Period. Customers who are eligible for VT Medicaid can enroll anytime throughout the year.
|I’m enrolled in a qualified health plan through Vermont Health Connect||
Many customers enrolled through Vermont Health Connect can get financial help. You can use it to make your monthly bills lower. Or you can get it when you file your taxes. To get it when you file taxes, you don’t need to do anything now. Want to use it to lower your monthly bills? Login to your account or call us at 1-855-899-9600.
|I get health insurance directly from Blue Cross and Blue Shield of Vermont or MVP Health Care||Read our instructions for transferring your health plan into the marketplace. The sooner you transfer your plan, the more tax credits you will get! Eligible direct enrolled customers can transfer to Vermont Health Connect anytime. See details for yourself in the Plan Comparison Tool.|
|I have job-based insurance||You probably can’t get financial help to buy a marketplace plan. To get financial help, you must prove your job-based insurance is not adequate or affordable. Learn more from our Affordability Estimator.|
|I have government-sponsored insurance (Medicaid, Medicare, TRICARE, VA, Peace Corps)||If you have Minimum Essential Coverage, you can’t get financial help to buy marketplace plans. Medicare Part A, Medicare Advantage, Medicaid, TRICARE, VA Health Care Programs, and Peace Corps Health Plans meet the definition of Minimum Essential Coverage.|
What kind of financial help does Vermont Health Connect offer Vermonters?
Advance premium tax credits (APTC)
If you buy a qualified health plan (QHP) through Vermont Health Connect, you may be eligible for advance premium tax credits (ATPC) to help lower your monthly premium. The amount of APTC you can get is based on your income and household size. APTC helps to pay part of your monthly premiums. You can use APTC to lower your premiums every month, or you can get the tax credit all at once when you file your federal income taxes. You must enroll through Vermont Health Connect to get premium tax credits.
The Internal Revenue Service (IRS) runs the APTC program. When you apply for financial help, you tell VHC what you expect your yearly income to be. When you file taxes, the IRS will compare the income you made to the amount of APTC you got. If you got more APTC than you were eligible for, you may have to repay it. To avoid this, call Vermont Health Connect to report any changes of income within 30 days after the change happens.
When you report an income change to Vermont Health Connect, you might find out you have already gotten most, or all, the APTC you can get for the year. This is called APTC exhaustion. This can happen when your income goes up during the year and the total amount of APTC you can get for the year goes down. When your income goes up, Vermont Health Connect will adjust your monthly APTC amount to help prevent you from going over your APTC limit for the year. If you do go over your APTC limit for the year, you may have to pay back your APTC when you file federal taxes.
Cost-sharing reductions (CSR)
You may also be eligible for cost-sharing reduction plans, also called Enhanced Silver plans. Enhanced Silver plans lower your out-of-pocket costs, like deductibles and co-pays. To get cost-sharing reductions, you must be enrolled in a silver plan through Vermont Health Connect.
I qualify for financial help, but I chose to pay my full monthly premium instead. Can I claim the premium tax credit when I file my taxes?
Yes. Enrollees through Vermont Health Connect can choose to wait to claim their premium tax credits. If you do that, you won’t get financial help each month to lower your monthly premium bill. You will get a credit on your federal tax return. You can change your decision at any time. To do so, login to your account or call us at 1-855-899-9600.
What if my income changes?
Vermont Health Connect’s financial help is based on your income and household size. If your income goes down, you may get more financial help to lower your monthly premium bill. If your income goes up, your financial help may go down. Login to your account or call us at 1-855-899-9600 to report any income changes.
Can American Indians and Alaska Natives get special benefits?
Under the Affordable Care Act, American Indians and Alaska Natives (AIAN) who are members of a federally recognized tribe can get special benefits when they apply for a qualified health plan and help paying costs through a state or federal health insurance marketplace—like Vermont Health Connect. Here are some of the benefits:
- Some types of income don’t count toward the limits for getting financial help. This makes it easier for eligible people to get financial help under an AIAN program.
- People who are eligible for AIAN benefits and earn between 100% and 300% of the federal poverty level can get a plan with no cost sharing—which means no deductibles or co-pays.
- People who are eligible for AIAN benefits can enroll at any time and can change plans as often as once per month.