Vermonters who do not qualify for Medicaid may be able to get help that will lower premiums and cost-sharing for Vermont Health Connect plans.
You may get help if:
- your annual income is between 138% and 400% of the previous year's Federal Poverty Level (FPL) — for 2019 plans, use the 2018 FPL,
- your annual income is below 138% and you are an individual from another country who is legally present, but who cannot get on Medicaid because of your immigration status
Federal Poverty Guidelines for 2018
|Persons in Family
Vermont Health Connect will tell you if you qualify for financial help when you apply. VHC will also tell you how much help you can get.
You can use the Vermont Health Connect Plan Comparison Tool right now to find out how much help (Premium Tax Credits) you may be able to get to pay your monthly insurance premiums.
If You Disagree
If you don't think the amount of premium assistance and cost-sharing help are right for your income and household size, you can:
If You or Your Spouse Has an Offer of Insurance
If you have an offer of insurance through your employer or your spouse’s employer, you can still buy insurance through Vermont Health Connect during an open enrollment period. However, you can only get help paying premiums and cost-sharing if you meet the premium and cost-sharing income requirements and if the employer’s insurance:
- doesn't offer the 10 Essential Health Benefits required by law OR
- isn't “affordable” (Affordable means that the cost of the employee-only insurance premium is less than 9.56% of total household income. Use this online tool to see if your insurance is affordable.)
Tax Status, Domestic Violence and Abandoned Spouse
You cannot qualify for Premium Tax Credits if your tax filing status is Married Filing Separately, unless you are a victim of domestic violence* or you are an “abandoned spouse.” Abandoned spouse means that you are married, but you don’t know where your spouse is.
*Under the IRS rule, domestic abuse includes physical, psychological, sexual, or emotional abuse, including efforts to control, isolate, humiliate, and intimidate, or to undermine the victim's ability to reason independently. The IRS considers all facts and circumstances in determining whether an individual is abused.
Domestic violence victims and abandoned spouses should call Vermont Health Connect at 1-855-899-9600 or work with a navigator to apply for help paying your monthly insurance premium (Premium Tax Credits.)
To find out how much help (Premium Tax Credits) you may be able to get to pay your monthly insurance premiums, use this online tool. Only include you and your dependent children and only count your income when you fill it out.