Vermont Health Connect (VHC) is the state of Vermont’s health benefit exchange. Vermonters with qualifying incomes may get financial help paying for their VHC health plan. The tables below show the type of financial help you can if you have an income that qualifies. The tables are based on the Federal Poverty Level, which is updated each year by the federal Department of Health and Human Services (HHS). You can compare your Modified Adjusted Gross Income (MAGI) to the tables below to find out if you’re likely eligible for financial help.
Before the American Rescue Plan: 2021 Income Thresholds for APTC/VPA/CSR (Using 2020 FPLs)
| Vermont Household Income Thresholds for Advanced Premium Tax Credits (APTC), Vermont Premium Assistance (VPA), and Cost-Sharing Reductions (CSR) |
||||||
| Eligibility for 2021 Benefits Determined Based on 2020 Federal Poverty Level (FPL) | ||||||
| Upper FPL% and annual income limits for: | Silver 94 | Silver 87 | Silver 77 | Silver 73 | APTC only | |
| Household Size* | 100% (for reference) | 150% | 200% | 250% | 300% | 400% |
| 1 | $12,760 | $19,140 | $25,520 | $31,900 | $38,280 | $51,040 |
| 2 | $17,240 | $25,860 | $34,480 | $43,100 | $51,720 | $68,960 |
| 3 | $21,720 | $32,580 | $43,440 | $54,300 | $65,160 | $86,880 |
| 4 | $26,200 | $39,300 | $52,400 | $65,500 | $78,600 | $104,800 |
| 5 | $30,680 | $46,020 | $61,360 | $76,700 | $92,040 | $122,720 |
| 6 | $35,160 | $52,740 | $70,320 | $87,900 | $105,480 | $140,640 |
| 7 | $39,640 | $59,460 | $79,280 | $99,100 | $118,920 | $158,560 |
| 8 | $44,120 | $66,180 | $88,240 | $110,300 | $132,360 | $176,480 |
| For each additional person add: | $4,480 | $6,720 | $8,960 | $11,200 | $13,440 | $17,920 |
| *Household size = tax filer + spouse (even if they live apart) + tax filer's dependents. Married couples must file jointly to be eligible for APTC and CSR. | ||||||
After the American Rescue Plan: 2021 Income Thresholds for APTC/VPA/CSR (Using 2020 FPLs)
| Vermont Household Income Thresholds for Cost Sharing Reductions (CSR), Vermont Premium Assistance (VPA), and Premium Tax Credits (PTC)* | ||||||||||
| Eligibility for 2021 Benefits Determined Based on 2020 Federal Poverty Level (FPL) | ||||||||||
| Upper FPL% and annual income limits for: | Silver 94 (94% AV) CSR Tier I* | Silver 87 (87% AV) CSR Tier II | Silver 77 (77% AV) CSR Tier III | VPA & Silver 73 (73% AV) CSR Tier IV | PTC - typical threshold | PTC - expanded for 2021 and 2022 by American Rescue Plan | ||||
| Household Size** | 100% (for reference) | 150% | 200% | 250% | 300% | 400% | N/A | N/A | N/A | N/A |
| Coverage Tier | All | All | All | All | All | Single | Couple | Parent and Child(ren) | Family | |
| 1 | $12,760 | $19,140 | $25,520 | $31,900 | $38,280 | $51,040 | $94,500 | N/A | N/A | N/A |
| 2 | $17,240 | $25,860 | $34,480 | $43,100 | $51,720 | $68,960 | $94,500 | $189,001 | $182,386 | N/A |
| 3 | $21,720 | $32,580 | $43,440 | $54,300 | $65,160 | $86,880 | $94,500 | $189,001 | $182,386 | $265,546 |
| 4 | $26,200 | $39,300 | $52,400 | $65,500 | $78,600 | $104,800*** | $99,946 | $189,001 | $182,386 | $265,546 |
| 5 | $30,680 | $46,020 | $61,360 | $76,700 | $92,040 | $122,720*** | $108,914 | $189,001 | $182,386 | $265,546 |
| 6 | $35,160 | $52,740 | $70,320 | $87,900 | $105,480 | $140,640*** | $117,357 | $189,001 | $182,386 | $265,546 |
| 7 | $39,640 | $59,460 | $79,280 | $99,100 | $118,920 | $158,560*** | $125,372 | $189,001 | $182,386 | $265,546 |
| 8 | $44,120 | $66,180 | $88,240 | $110,300 | $132,360 | $176,480*** | $133,031 | $189,001 | $182,386 | $265,546 |
| For each additional person add | $4,480 | $6,720 | $8,960 | $11,200 | $13,440 | $17,920*** | N/A | |||
| *If you receive any unemployment benefits in 2021, you may qualify for VPA as well as maximum PTC and Silver 94 CSR, even if your income exceeds these thresholds. **Household size = tax filer + spouse (even if they live apart) + tax filer's dependents. Married couples must file jointly to be eligible for APTC and CSR. ***At this income level, you will qualify for PTC if you enroll in a Couple, Parent and Child(ren), or Family plan, but not a Single plan. |
||||||||||
View a detailed Medicaid eligibility chart here.
Modified Adjusted Gross Income (MAGI) relative to the 2020 Federal Poverty Level (FPL) is used to determine eligibility for 2021 Advanced Premium Tax Credits (APTC), Vermont Premium Assistance (VPA), and Enhanced Silver plans with cost-sharing reductions (CSR). MAGI relative to 2021 FPL will be used to determine eligibility for Medicaid and Dr. Dynasaur until April 2021 when 2021 FPL will be adopted.
Income Thresholds for Medicaid and Dr. Dynasaur - April 2021 through March 2022
| Eligibility for Benefits Determined in Relation to 2021 Federal Poverty Level (FPL) | |||
|---|---|---|---|
| Upper FPL% and monthly income limits for: | Medicaid for Adults | Pregnant Women | Children under 19 |
| Household Size* | 133% of FPL + 5% disregard | 208% of FPL + 5% disregard | 312% of FPL + 5% disregard |
| 1 | $1,481.70 | N/A | $3,402.70 |
| 2 | $2,003.60 | $3,092.60 | $4,602.60 |
| 3 | $2,525.50 | $3,898.50 | $5,801.50 |
| 4 | $3,048.45 | $4,704.45 | $7,000.45 |
| 5 | $3,570.35 | $5,510.35 | $8,200.35 |
| 6 | $4,092.25 | $6,316.25 | $9,399.25 |
| 7 | $4,614.20 | $7,122.20 | $10,599.20 |
| 8 | $5,136.10 | $7,928.10 | $11,798.10 |
| *Effective 1/1/14, Medicaid for Children and Adults (MCA) has no resource test. The FPL% limits listed above include the program threshold plus a 5% income disregard. | |||
| Eligibility requirements for the Aged, Blind and Disabled (MABD) can be found at http://www.greenmountaincare.org/mabd | |||