University of Vermont

The Women's Agricultural Network

For more information, Visit the Campaign for Health Care Security or call its toll-free Helpline at 1-866-482-4723. This article was written in 2008; dollar amounts for premiums, out-of-pocket expenses and income thresholds may have changed since then.

Publicly Supported Health Insurance Options

By Peter Sterling

With the cost of gasoline, heating fuel and food (and just about everything else it seems) going through the roof, the Vermont’s subsidized health care plans—Catamount Health, VHAP, and Medicaid are a better deal than ever. Each of these plans offers comprehensive coverage including hospitalization, prescription drugs, doctor visits for primary and specialty care, mental health and substance abuse treatment and has low or no out-of-pocket costs. The monthly premiums range from free to $185 a month depending on your income. And you are eligible for these programs even if you are working.

Any Vermonter is eligible for Catamount Health if they have been uninsured for more than 12 months or lost your insurance because you retired, lost or quit your job, a spouse died, you left college, you no longer choose to receive COBRA, you no longer are able to be a dependent on someone else’s policy, or had your hours reduced at work. There is no waiting period to enroll in Catamount Health for individuals that lose their insurance for one of these reasons. You are also immediately eligible for Catamount Health if you are enrolled in a plan with a deductible over $10,000.

Catamount Health’s monthly premiums are based on your household’s monthly income only, not your assets. Household income is determined by family size (the number of people living with you under age 21 who are related). In 2008, for those meeting the income criteria for premium assistance (roughly $21,000-$33,000/year for a single person or $43,000-$64,000/year for a family of four), premiums range from $65/month-$185/month. Uninsured Vermonters making less than these amounts are eligible for either VHAP or Medicaid. If you are over these income limits, you can still enroll in Catamount Health but must pay the unsubsidized price.

Catamount Health has a pre-existing conditions clause (VHAP and Medicaid do not) that applies to anyone who has a medically diagnosed condition and has had a gap in insurance coverage in the previous nine months. They must pay out of pocket for all treatment related to this pre-existing condition for the first year they are in Catamount Health.

Any Vermonter whose income is less than roughly $21,000/yr for a single person or $43,000 for a family of four) AND has been uninsured for more than a year or lost their insurance because they retired, lost or quit their job, a spouse died, left college, no longer choose to receive COBRA, no longer able to be a dependent on someone else’s policy or had their hours reduced at work is eligible for VHAP. There is no waiting period to enroll in VHAP for individuals that lose their insurance for one of these reasons. Household income is determined by family size (the number of people living with you under age 21 who are related).

VHAP’s monthly premium amounts range from 0-$49 per month and are based on a household’s income and whether there are dependent children in the family. VHAP’s only out of pocket expenses other than the premium is a $25 emergency room co-pay. Medicaid has very specialized eligibility requirements and premium considerations. Call to find out the details.

Visit to www.catamounthealth.org or call the Vermont Campaign for Health Care Security Education Fund Toll-free Helpline at 1-866-482-4723 about enrolling.

Peter Sterling is the Executive Director of the Vermont Campaign for Health Care Security Education Fund, a non-profit organization working to educate Vermonters about and help them enroll in public health care programs. VCHCSEF is a project of AARP-Vermont, the Vermont NEA, Bi State Primary Care Association and the Vermont Citizens Campaign for Health.

WAgN 2008

Last modified May 27 2009 02:34 PM

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