Frequently Asked Questions
Here are some questions and answers about Green Mountain Care programs. If you do not see an answer to your question, call us at 1-800-250-8427.
Overview of Green Mountain Care
New! Catamount Health
Dr. Dynasaur
Vermont Health Access Plan (VHAP)
Medicaid
Prescription Assistance
Overview of Green Mountain Care
1. What is Green Mountain Care?
Green Mountain Care is a family of low-cost and free health coverage programs for uninsured Vermonters. Offered by the state of Vermont and its partners, Green Mountain Care programs provide quality, comprehensive health coverage at a reasonable cost.
2. How do I apply for Green Mountain Care?
Use the Screening Tool to find out what Green Mountain Care program may be available to you. Download an application and mail or fax it to the address listed on the application. You can also call 1-800-250-8427 to find out what you should apply for or request an application. You can also request an application by mailing in the pre-paid postcard attached to a Green Mountain Care brochure.
3. How much does Green Mountain Care cost?
It depends on which health coverage program you enroll in. Green Mountain Care programs include reasonable deductibles, premiums and co-payments to keep out-of-pocket costs low. Some programs also offer premium assistance. How much you earn may also affect how much the health coverage program will cost.
4. What health services are covered?
Green Mountain Care programs cover basic health services such as doctor visits, hospitalization, emergency care, checkups, screenings, prescription medication, immunizations and more. Depending on which program you are eligible for, the services covered may vary.
5. Is there anything available for uninsured children?
Dr. Dynasaur is a health insurance program designed exclusively for children and teenagers and covers important health services for children including immunizations, checkups, dental care and skin care. Dr. Dynasaur also covers pregnant women.
6. How long does the application process take?
It usually takes no more than 30 days to process an application.
7. Is there anything available for young adults who don’t have children?
You may qualify for one of the Green Mountain Care programs depending on your past and current insurance status and how much you earn. Call 1-800-250-8427 or or use the Screening Tool to find out if you're eligible.
8. Do I have to be a resident of Vermont to apply for a Green Mountain Care program and what is considered a resident?
Yes, you do have to be a resident of Vermont, which is defined as an individual who lives in Vermont with the intent to remain in the state permanently or for an indefinite period of time.
9. I am a student. Is there anything available for me?
You may be eligible for one of the Green Mountain Care programs. Call 1-800-250-8427 or or use the Screening Tool to find out.
10. I am an uninsured parent but my children are insured. Is there anything available to me through Green Mountain Care?
Yes. Green Mountain Care includes several health coverage programs for adults depending on your insurance status and how much you earn. Call 1-800-250-8427 or or use the Screening Tool to find out if you're eligible.
11. Can I apply for Green Mountain Care if I am enrolled in Medicare?
Yes. You can apply for Medicaid, VPharm or Healthy Vermonters.
12. What if I only need help paying for my prescription medicines?
Vermont has several prescription assistance programs to help Vermonters pay for prescription medicines based on their income, disability status and age. These programs include VScript, VHAP-Pharmacy, VPharm and Healthy Vermonters.
13. If I have access to my employer’s insurance but it’s too expensive, is there anything I can apply for?
It depends on your income. If you make less than or equal to $2,613* a month, have access to your employer’s plan but are not enrolled, and you have been uninsured for 12 months or more (or meet one of the exceptions), you can apply for Catamount Health or VHAP. You may even get assistance to pay for your employer's premiums, depending on the benefits of your employer’s plan and the cost to the state.
14. I work. Can I qualify for any of the Green Mountain Care programs?
Catamount Health or VHAP may be good health coverage programs for you. Based on how much you earn, you may be able to get assistance with paying your premiums. In addition, if you have access to your employer’s coverage but can’t afford it, you may get help paying your employer’s premium. Call 1-800-250-8427 or or use the Screening Tool to find out if you're eligible.
15. Can I choose the doctor I want to go to?
Most doctors in Vermont participate in the family of plans offered through Green Mountain Care, and you can choose which doctor to go to within the plan’s network. In the Catamount Health Plans, you can also go to doctors not in the network, but you may have higher out-of-pocket costs.
16. Will I get an insurance card if I enroll in Green Mountain Care?
Yes. You will want to keep this with you at all times and will need to present it when accessing health services.
17. Do I have to go into an office to apply and what things do I need to provide the state in order to apply for Green Mountain Care?
No you do not need to go into an office. You can mail in your application and a Green Mountain Care representative will let you know if they need proof of anything or any additional information.
18. Where can I find out more information about Green Mountain Care?
Information about Green Mountain Care programs are available in the Green Mountain Care Programs section of this Web site. You can also call 1-800-250-8427 to learn more.
* You may still qualify if your monthly income is up to $200 per month higher if you have earned income and/or child care expenses (higher for larger households).
New! Catamount Health
1. What is Catamount Health?
Catamount Health is a new health insurance plan within Green Mountain Care that became available October 1, 2007 for uninsured Vermonters. It offers comprehensive, quality benefits with low co-payments and premiums to keep out-of-pocket costs reasonable. The plan is offered, in cooperation with the state of Vermont, by Blue Cross Blue Shield of Vermont and MVP Health Care. Coverage begins November 1, 2007.
2. Who can qualify for Catamount Health?
Adults (18 and older) who (1) have incomes of more than $1,307 a month (higher for larger households) or parents with incomes of more than $1,612 a month (higher for larger households); (2) are not eligible for Medicaid, Medicare or VHAP; (3) have been uninsured for 12 or more months (certain exceptions apply); and (4) do not have access to employer-sponsored coverage (unless their monthly income is $2,613 or less).*
3. What services are covered through Catamount Health?
Catamount Health provides comprehensive coverage including doctor visits, checkups, screenings, hospital visits, emergency care, care for chronic diseases, prescription medicines and more.
4. How much does Catamount Health cost?
Costs include $10 office visit co-payment; Prescriptions range from $10-50; Monthly premiums range from $60-$393 (based on income); Deductibles of $250 for individuals/$500 for families (in-network).
5. Can I qualify for Catamount Health if I work?
Yes. However, it depends on whether your employer offers insurance and your monthly income. If your employer does not offer insurance, you can apply for Catamount Health regardless of your income. If your employer does offer health insurance, you can apply for Catamount Health if your monthly income is $2,613 or less (higher for larger households).*
6. If I make more than $2,613* a month, but I have access to my employer’s insurance, can I enroll in Catamount Health?
No. If you have access to your employer’s health insurance and make more than $2,613* a month, you cannot enroll in Catamount Health.
7. What is Catamount Health's policy on pre-existing conditions?
Coverage under Catamount Health is subject to a pre-existing condition waiting period. If you have been diagnosed with, treated for, or advised to seek treatment by a healthcare professional in the last twelve months, carriers may deny coverage for treatment of that condition for up to one year. However, waiting periods will be waived if you have not had a break in coverage that is longer than 63 days. Also, waiting periods for certain pre-existing conditions will be waived if you participate in a chronic care management program. Pregnancy is not considered a pre-existing condition and is not a reason for denial of coverage. If you have any questions about pre-existing conditions, waiting periods or chronic care programs, contact Catamount Blue at 1-888-445-5805 or MVP Catamount Choice at 1-888-687-6277. Individuals already covered under Catamount Health also may refer to their Certificate of Coverage for information on pre-existing conditions.
* You may still qualify if your monthly income is up to $200 per month higher if you have earned income and/or child care expenses (higher for larger households).
Dr. Dynasaur
1. What is Dr. Dynasaur?
Dr. Dynasaur is a program that provides low-cost or free health coverage for children, teenagers under age 18 and pregnant women.
2. Who can qualify for Dr. Dynasaur?
Pregnant women and children under 18 years of age.
3. How much does Dr. Dynasaur cost?
Good news! Premiums for Dr. Dynasaur recently decreased by 50 percent! There are no co-payments and monthly family premiums range from $0-$40 depending on your family’s income.
4. What services are covered through Dr. Dynasaur?
Services include doctor visits, prescription medicines, dental care, home/community services, skin care, hospital visits, immunizations, lab tests, vision care, mental health care, substance abuse treatment, chiropractor services (for children only), eye exams, eyeglasses (for children only) and special services for pregnant women.
5. How much can I earn and have my child qualify for Dr. Dynasaur?
Income guidelines are based on your family size. A family of two can earn up to and including $3,542 a month, $4,412 a month for a family of three, and $6,312 a month for a family of four. Pregnant women can earn up to and including $2,341 a month (higher if expecting twins, etc.) (Certain exceptions apply and figures change in January 2008. Read the Talking About Income Eligibility section for more information).*
* You may still qualify if your monthly income is up to $200 per month higher if you have earned income and/or child care expenses (higher for larger households).
Vermont Health Access Plan (VHAP)
1. What is VHAP?
VHAP is a health insurance program for low-income uninsured adults, regardless of marital or employment status.
2. Who can apply for VHAP?
Adults 18 years or older who are not eligible for Medicaid.
3. What services are covered through VHAP?
VHAP helps cover costs of doctor visits, prescriptions, hospital care, emergency care, tests, x-rays, family planning, mental health services, substance abuse services, home health care and more.
4. How much does VHAP cost?
Good news! VHAP recently reduced the cost of premiums by 35 percent! Premiums for VHAP now range from $0-$49, depending on your income, and there is only one co-payment ($25 for emergency room visits).
5. How much can I make and still qualify for VHAP?
If you do not qualify for Catamount Health, Medicaid or Medicare, adults without children can earn up to and including $1,306 a month, and parents can make up to and including $2,166 a month in a family of two, $2,721 in a family of three, and $3,276 in a family of four (certain exceptions apply and figures change in January 2008).*
* You may still qualify if your monthly income is up to $200 per month higher if you have earned income and/or child care expenses (higher for larger households).
Medicaid
1. What is Medicaid?
Medicaid is a comprehensive health insurance program for low-income families and individuals. Eligibility is based on your income and resources (e.g., cash, bank accounts, etc.).
2. Who can apply for Medicaid?
Medicaid is a health insurance program for low-income children, young adults under age 21, parents, pregnant women, caretaker relatives, people who are blind or disabled, and those age 65 or older. In some cases, those enrolled in Medicare may also be eligible to receive Medicaid benefits.
3. What services are covered through Medicaid?
Medicaid helps cover costs of doctor visits, prescriptions, hospital care, emergency care, tests, x-rays, family planning, mental health services, substance abuse services, home health care, dental care, eye care, occupational therapy, physical therapy, speech therapy, long-term care and more.
4. How much does Medicaid cost?
Medicaid is a low-cost program, and costs may include co-payments of $3 for outpatient visits, prescription medicines and dentist visits. However, children, pregnant women and people in nursing facilities never have to pay co-payments.
5. How much can I earn and still qualify for Medicaid?
Income eligibility varies by age and other factors. Call 1-800-250-8427 to find out more.
Vermont Prescription Assistance Programs
1. What are the Prescription Assistance Programs?
Vermont has several Prescription Assistance programs to help uninsured Vermonters and those enrolled in Medicare pay for prescription medicines based on your income, disability status and age. These programs include VScript, VHAP-Pharmacy, VPharm and Healthy Vermonters.
2. What do the programs help pay for?
The programs help you pay for prescription medicines and other related services depending on which program you are eligible for.
3. Who can apply for these programs?
VPharm, VHAP-Pharmacy and VScript are available to people over age 65, depending on the type of health care coverage they receive. You may even be eligible if you're receiving Medicare benefits. Healthy Vermonters is available to Vermonters of all ages and you qualify based on your family income.
4. How much can I make and still qualify for Prescription Assistance?
Income eligibility guidelines vary by program. Call 1-800-250-8427 to find out more.
