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Important Message: Did you get a letter from VT Health Connect asking for information? Act now! See the list of acceptable documents to verify the information you gave us. Log in to your online account and make sure it is up to date.

Exceptional Circumstances Special Enrollment Period

Type your first name here.
Type your last name here.
Select your date of birth.
Address:
Enter your mailing address.
Type your phone number here.
Tell us why you are asking for an Exceptional Circumstance Special Enrollment Period.
Select the date your exceptional circumstance started.
For example: if you became medically incapacitated on 2/15/2020, that is the start date. If you were released from the hospital on 3/1/2020, that is the end date.
Do you need medical care right now? For example, doctor's appointments or prescriptions?
Tell us why you need access to care right now.
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