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Important Message: Pharmacy claims are now being processed. Information about the past Change Healthcare outage can be found on the Pharmacy and Provider Communications page.

Cost-Sharing Reductions

Eligible Vermonters can save money with cost-sharing reduction plans—also called Enhanced Silver plans. Enhanced Silver plans lower the amount of money you pay out-of-pocket for medical care, including:

  • Lower deductibles (you pay less money out of pocket before your plan starts to pay for covered services)
  • Lower co-pays (you pay less money when you go to the doctor or fill a prescription)
  • Lower max-out-of-pocket limits (you pay less money out of pocket over the plan year)

Enhanced Silver plans cover more of your out-of-pocket costs than regular silver plans, so you pay less. The percent of expenses your plan covers, on average, is called the actuarial value (AV) of your plan. Enhanced silver plans have a higher AV, which means they pay more of your out-of-pocket costs, on average. This means the Enhanced Silver plans will have lower deductibles, copayments, and maximum out of pocket limits than regular silver plans for the same monthly premium as a regular silver plan.

Depending on your eligibility, you could qualify for one of four Enhanced Silver plan levels:

Each level of Enhanced Silver has different plans you can choose from. Once you find out which level of Enhanced Silver you’re eligible for, you can pick any one of the plans in that level. Eligibility for Enhanced Silver plans is based on your household size and income.

Not sure if you’re eligible to get an Enhanced Silver plan? Get an estimate using our Plan Comparison Tool—or call our Customer Service Center at 1-855-899-9600 to apply and learn more.