Types of Plans

To help you compare costs and coverage, Vermont Health Connect plans are divided into four “metal levels”:

• Platinum
• Gold
• Silver
• Bronze

Platinum plans have the highest premiums and lowest cost-sharing. Bronze plans have lower premiums and higher out-of-pocket costs. “Cost-sharing” describes your out-of-pocket costs for things like deductibles, copays, coinsurance and out-of-pocket maximums. We explain what these words mean on our Understanding Health Care Costs page.

You can pick the metal level that best meets your medical needs and your budget. You should look at more than just the monthly premium. Picking the plan with the lowest monthly premium may not be best for you if you have a lot of medical visits and costs. This is because you may have to pay more out-of-pocket when you get health care services.

You may be able to get help paying your monthly premiums (Premium Tax Credits) or help with your cost-sharing. If you qualify for Premium Tax Credits, you can use them to lower the monthly premium for your platinum, gold, silver or bronze plan. If you qualify for cost-sharing assistance to reduce your out-of-pocket costs, you can only use it if you choose a silver plan.

Essential Health Benefits (Minimum Essential Coverage)

All metal level plans must cover these health benefits:

• Children’s health services, including eye and dental care
• Emergency care
• Being admitted to a hospital
• Lab services
• Maternity and newborn care
• Mental health and substance abuse services
• Outpatient services
• Prescription drugs
• Preventive and wellness services and chronic disease management
• Services and devices to rehabilitate (regain skills) and habilitate (improve skills that may not be developing normally)