Frequently Asked QuestionsFrequently Asked Questions
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
Catamount Health
Dr. Dynasaur
Vermont Health Access Plan (VHAP)
Medicaid
Prescription Assistance
Disability and Long-Term Care
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. Plan eligibility and cost is based on household income and family size. There may be a program for you no matter how much you earn.
2. How do I apply for Green Mountain Care?
There are three ways to apply!
- Online: Use the Screening Tool to find out which Green Mountain Care program may be available to you. Download an application and mail or fax it to the address listed on the application.
- Telephone: Call 1-800-250-8427 to find out what you should apply for or to request an application.
- Mail: 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 plan you qualify for. Green Mountain Care programs include deductibles, premiums and co-payments.. Some programs also offer premium assistance. Family size and income affects how much the health coverage plan will cost.
4. What health services are covered?
Green Mountain Care programs cover comprehensive 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 for children, teenagers and pregnant women and covers important health services including immunizations, checkups, dental care and skin care.
6. How long does the application process take?
It usually takes 30 days to enroll in a program. However applying for some programs is a multi-step process so enrollment can take longer. You can apply up to 60 days prior to needing coverage to begin.
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 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 who is considered a resident?
Yes, you do have to be a Vermont resident, defined as an individual who lives in Vermont with the intent to remain in the state for an indefinite period of time or permanently.
9. I am a student. Is there anything available for me?
Student criteria are complex. You can find out if you qualify by sending in a completed application. To determine which application is right for you, go through the Screening Tool or call 1-800-250-8427 to learn more.
10. My children are insured, but I am not. 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 use the Screening Tool to find out if you're eligible.
11. Can I qualify for Green Mountain Care if I am enrolled in Medicare?
Yes, depending upon your income, 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. Complete a Pharmacy Programs Application from the Applications Forms page.
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. Generally, you can apply for health coverage through Green Mountain Care if you meet the income guidelines, have access to your employer’s plan but are not enrolled, and you have been uninsured for 12 months or more - although there are exceptions to these rules. You may even get assistance to pay for your employer's premiums, depending on the benefits of your employer’s plan and other factors.
14. Can I choose the doctor I want to go to?
Most doctors in Vermont participate in the 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.
15. Will I get an insurance card if I enroll in Green Mountain Care?
Yes. All Green Mountain Care Programs have insurance cards. However if you qualify for Catamount, you will receive your insurance card directly from the carrier you choose for your Catamount Plan. You will want to keep this with you at all times and will need to present it when accessing health services.
16. How do I apply and what things do I need to provide the state in order to apply for Green Mountain Care?
To determine which application is right for you, go through the Green Mountain Care Screening Tool. You can print, fill out and mail in your application. A Green Mountain Care representative will let you know if they need any additional information.
17. Where can I find more information about Green Mountain Care?
Information about Green Mountain Care programs can be found in the sections below and in the Green Mountain Care Programs section of this Web site. You can also call 1-800-250-8427.
Catamount Health
1. What is Catamount Health?
Catamount Health is a health insurance plan within Green Mountain Care for uninsured Vermonters. It offers comprehensive, quality benefits. Catamount Health is offered, in cooperation with the state of Vermont, by Blue Cross Blue Shield of Vermont and MVP Health Care.
2. Who can qualify for Catamount Health?
Generally, Vermont residents who have been uninsured for 12 or more months and who do not have access to employer-sponsored insurance that is comprehensive, meaning that it covers both hospital care and doctor visits. However, there are exceptions.
- You do not need to have been without health insurance for 12 months to be eligible for Catamount Health if you lost your insurance due to a life change such as divorce or loss of job (Read further information on Catamount Health Qualifications) or,
- You have been enrolled for at least six months in an individual insurance plan (i.e., a policy that is not sponsored by an employer or association) with an annual deductible of 7,500 or more for single coverage or $15,000 or more for two-person or family coverage. (Please note that you will not be eligible for Premium Assistance until you have been on Catamount Health for 12 months).
3. Who is eligible for Premium Assistance to help pay for Catamount Health?
Remember, no matter how much you earn, you may qualify for Catamount Health at full-pay (based on being uninsured for 12 months or more, or having a qualifying episode). However, depending upon your income you may be eligible to receive Catamount Health with Premium Assistance (CHAP). Premiums are based on household income and family size. Read further about Income and Premiums for Catamount Health. For questions about eligibility for Premium Assistance, call Green Mountain Care at 1-800-250-8427, TDD: 1-888-834-7898.
4. 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.
5. How much does Catamount Health cost?
The monthly premium for Catamount Health full-pay or Catamount Health with Premium Assistance (CHAP) varies based on household income and family size. Premiums are locked in for 12 months and are subject to change on your one-year anniversary. Catamount Health, like most insurance policies, is subject to cost-sharing requirements, including copayments and deductibles. Contact MVP or Blue Cross Blue Shield of Vermont for specific questions about cost-sharing requirements. Read further about Income and Premiums for Catamount Health.
6. Can I qualify for Catamount Health if I work?
Yes. However we will first screen you for the health care program for which you are eligible based on your household income and family size. You may qualify for another program with a lower premium.
- If your employer offers comprehensive insurance that covers both hospital and doctor services, we will screen you for premium assistance to help pay for your insurance at work.
- If your employer’s insurance is not comprehensive, you may qualify for Catamount Health with Premium Assistance (CHAP).
- If you are over income for CHAP, you may still qualify for Catamount Health at full-pay.
7. If 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 you cannot enroll in Catamount Health. There is an exception to this rule if your employer's insurance does not cover both hospital and doctor services.
8. What is Catamount Health's policy on preexisting conditions?
A preexisting condition is a physical or mental condition for which medical advice, diagnosis, care or treatment was recommended by or received from a provider. Generally, coverage under Catamount Health is subject to a preexisting condition waiting period of up to one year however, this is waived if you have not had a break in coverage longer than 63 days.
There are important exceptions to preexisting waiting periods under Catamount Health:
- Pregnancy is not considered a preexisting condition.
- Waiting periods for certain preexisting conditions will be waived if you enroll and participate in a chronic care management program. Co-pays will also be waived if you enroll and participate in management programs for certain chronic conditions.
If you have any questions about preexisting conditions, waiting periods or chronic care programs, contact Catamount Blue at 1-888-445-5805 or MVP Catamount Choice at 1-888-687-6277.
9. Is pregnancy a preexisting condition?
Pregnancy is not a preexisting condition. In other words, if someone is pregnant at the time of application, Catamount Health plans will cover expenses related to the pregnancy.
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?
Children under 18 years of age and pregnant women.
3. How much does Dr. Dynasaur cost?
There are no co-payments. Monthly premiums are based on household income and family size. Read further about Income and Premiums for Dr. Dynasaur.
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?
Eligibility is based on household income and family size. The number in the household can be any configuration of adults and children. For example a 3-person household could include two parents and a child or one parent and two children. Read further about Income and Premiums for Dr. Dynasaur.
Vermont Health Access Plan (VHAP)
1. What is VHAP?
VHAP is a health insurance program for uninsured adults, regardless of marital or employment status.
2. Who can apply for VHAP?
Adults age 18 years or older who meet income guidelines.
3. What services are covered through VHAP?
VHAP helps cover the 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?
Premiums for VHAP are based on household income and family size. There are no pharmacy co-payments for lower income levels. There may be a co-payment for emergency room visits. Read further on Income and Premiums for VHAP.
5. How much can I make and still qualify for VHAP?
Eligibility is based on household income and family size. Adults, with or without children can qualify for VHAP. If you have access to Employer-Sponsored Insurance (ESI) you may be eligible for both VHAP and ESI with premium assistance.
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 and people who are blind or disabled. 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 for outpatient visits, prescription medicines and dentist visits. However, children, pregnant women and people in nursing facilities never have to pay co-payments. Read further on Income and Premiums for Medicaid.
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 who are disabled or over age 65, depending on the type of health care coverage they receive. You may be eligible even 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.
Disability and Long-Term Care
1. What type of assistance is available for long-term care for the disabled or elderly?
The Department of Disabilities, Aging and Independent Living (DAIL) offers long-term services to qualified Vermonters at their home or nursing facility. Visit the DAIL Web site to see if you meet both the clinical and financial requirements.
