If you meet the rules for a Medicaid program, you can get coverage any time.
For a Qualified Health Plan (QHP), there are 3 times when you can get coverage:
(1) Any time IF you meet certain income rules
People who meet income and other rules can sign up or change their Plan any time. You must meet the rules to get financial help paying for a Plan. AND your income must be at or below 200% of the Federal Poverty Level.
Example: In 2024, your income is below 200% of the Federal Poverty Level if it is:
- At or below $29,160 a year for a single person
- At or below $39,440 a year for a couple
- At or below $60,000 a year for a family of four
Do you meet the income rules? There are two ways to find out. Online by clicking here to see our Eligibility Tables. Or you can call us at 1-855-899-9600.
(2) During OPEN ENROLLMENT
Open Enrollment is from November 1 to January 15 every year. During this time, you can sign up for a new health plan. Or you can change the Plan you have.
- If you sign up by December 15, coverage begins on January 1 of the following year.
- If you sign up between December 16 and January 15, coverage begins on February 1.
(3) During a SPECIAL ENROLLMENT PERIOD if you have a life event
Some life events let you have a Special Enrollment Period (SEP). Most of the time, this period lasts 60 days after the date of the life change. For some life changes, you may apply up to 60 days before the change. During this time, you can enroll in a Qualified Health Plan. OR you can change the plan you have. Life changes include:
- Loss of health coverage, including Medicaid or Dr. Dynasaur
- Change in members of your household which can come from -
- Marriage or Divorce
- Having or adopting a child
- Moving to Vermont
- Change in immigration status
- Special Circumstances
So don't wait! If you miss the deadline, you may not be able to sign up until Open Enrollment.
There are other life changes that give you a Special Enrollment Period. See the full list on our qualifying life events chart.
Exceptional Circumstances
In addition to our standard qualifying life events, special enrollment periods can be granted under additional exceptional circumstances. Vermonters should apply for the Exceptional Circumstance SEP only if an event such as a medical issue, natural disaster, or a system interruption prevented them from enrolling in a QHP during their enrollment period (like Open Enrollment or a Special Enrollment Period). Below are some examples:
- Example #1 -- A Vermonter qualified for a Special Enrollment Period that expired March 31. This person was in the hospital from March 14 to April 1 and was too sick to enroll in a QHP at that time. This person may be eligible for the Exceptional Circumstance SEP. They should complete the Exceptional Circumstances application, as well as the medical incapacity verification form.
- Example #2 -- A Vermonter qualified for a Special Enrollment Period that expired May 31. This person got sick in July after their original SEP expired and now needs health coverage. This person was not sick during their original Special Enrollment Period and was not prevented from enrolling prior to May 31. This person would not qualify for the Exceptional Circumstance SEP.
Apply for an Exceptional Circumstances SEP here. If you have a question, or need to change an existing application, please call 1-855-899-9600.