Dr. Dynasaur

Dr. Dynasaur is low-cost or free health coverage for children, teenagers under age 19 and pregnant women.

To find out if you are eligible and apply for coverage, go to Vermont Health Connect.

Covered Services

More Information and Limitations

Chiropractic

  • Chiropractic services are limited to treatment by means of manual manipulation of the spine for the correction of a misalignment of the spine.
  • Coverage is limited to ten (10) treatments per calendar year per beneficiary.
  • Treatments beyond ten per year require prior authorization.
  • Treatments for children under 12 years of age require prior authorization.

Dental

  • Prior authorization is required for most special dental procedures.
  • Dental coverage under Dr. Dynasaur includes the dental services necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions.
  • Services covered under Dr. Dynasaur are:
    • Prevention, evaluation and diagnosis, including radiographs when indicated;
    • Periodic prophylaxis, including topical fluoride applied in a dentist’s office;
    • Periodontal therapy;
    • Treatment of injuries;
    • Treatment of disease of bone and soft tissue;
    • Oral surgery for tooth removal and abscess drainage;
    • Treatment of anomalies;
    • Root canal therapy (endodontics);
    • Restoration of decayed teeth;
    • Orthodontics; and
    • Replacement of missing teeth, including fixed and removable prosthetics (i.e. crowns, bridges, partial dentures and complete dentures).
Conditions of Coverage
  • Coverage of periodic oral evaluation is limited to once every six months, except more frequent treatments can be authorized by the department's dental consultant.
  • Prior authorization by the department's dental consultant is required for most special dental procedures.
  •  Non-surgical treatment of TMJ (jaw) disorders is limited to the fabrication of a TMJ splint.

Diapers

Durable Medical Equipment

Eye Exams

  • Provides either
    • One comprehensive eye exam and one intermediate eye exam within a two year period,
    • Two intermediate eye exams within a two year period

Eyeglasses

  • For beneficiaries under the age of six (6):
    • One pair of eyeglass frames per year
    • One new lens per eye per year
    • One fitting per year
  • For beneficiaries age six (6) and older and under age 21:
    • One pair of eyeglass frames per two years
    • One new lens per eye per two years
    • One fitting per two years

Hearing Aids

  • Hearing aids are limited to one hearing aid per ear every three years for specified degrees of hearing loss.

Lab Tests and X-rays or Imaging

  • The following outpatient high-tech imaging services require prior authorization:
    • Computed tomography (CT) (previously referred to as CAT scan);
    • Computed tomographic angiography (CTA);
    • Magnetic resonance imaging (MRI);
    • Magnetic resonance angiography (MRA);
    • Positron emission tomography (PET); and
    • Positron emission tomography-computed tomography (PET/CT).
    • Laboratory services for urine drug testing is limited to eight (8) tests per calendar month.
  • This limitation applies to tests provided by professionals, independent labs and hospital labs for outpatients. Exceptions to this limitation require prior authorization.

Naturopaths

  • Services are limited to those specified in protocols for licensure and reviewed and accepted by the State of Vermont, Director of the Office of Professional Regulation, and are services covered by Medicaid.

Nursing Facility

  • Short-term Skilled Nursing Facility (SNF) stay that is limited to not more than 30 days per episode and 60 days per calendar year.

Outpatient Hospital

  • Administratively necessary or court ordered tests are not covered, unless they are medically necessary.

Podiatry

  • Podiatrists’ services are limited to non-routine foot care.

Physical Therapy, Occupational Therapy and Speech or Language Therapy (Adult)

  • Services are limited to thirty (30) therapy visits per calendar year, and include any combination of physical therapy, occupational therapy and speech/language therapy.
  • Prior authorization beyond 30 therapy visits in a calendar year will only be granted to beneficiaries with the following diagnoses
    • Spinal Cord Injury
    • Traumatic Brain Injury
    • Stroke
    • Amputation
    • Severe Burn

Physical Therapy, Occupational Therapy and Speech or Language Therapy (Children under 21)

  • Eight (8) therapy visits from the start of care date per diagnosis or condition for each type (physical therapy, occupational therapy, and speech/language therapy) are covered based on a physician’s order.
  • Provision of therapy services beyond the initial 8 visits is subject to prior authorization.

Substance Abuse

Team Care

  • Team Care is designed to:
    • Decrease over-utilization, misuse and/or abuse of covered health services and/or benefits.
    • Improve coordination and quality of care.
    • Establish a method of monitoring non-emergency health care services for members.
  • To contact the Team Care line, call 1-802-238-6039.

Transportation

Addison County

ACTR (Addison County Transit Resources)
(802) 388-2287
PO Box 532
297 Creek Road
 Middlebury, VT
05753

Northern Windsor County

STSI (Stagecoach Transportation Services, Inc)
(802) 728-3773
1 L St.
Randolph, VT   05060

Southern Windsor and Windham Counties

CRTI (Connecticut River Transit, Inc.)
706 Rockingham Rd.
Rockingham, VT 05101
(802) 460-7433
(802) 460-7433

Bennington County

GMCN (Green Mountain Community Network)
215 Pleasant St.
Bennington, VT 05201
(802) 447-0477

Franklin, Grand Isle and Washington Counties

GMTA (Green Mountain Transit Agency)
375 Lake Rd 3B
St. Albans, VT 05478
(802) 527-2181

GMTA (Green Mountain Transit Agency)
6088 VT Rte 12
Berlin, VT 05602
(802) 223-7287

Rutland County

MVRTD (Marble Valley Regional Transit District)
158 Spruce St
Rutland, VT 05701

Caledonia, Essex and Orleans Counties

RCT (Rural Community Transportation, Inc.)
1161 Portland St.
St. Johnsbury, VT 05819
(802) 748-8170

Lamoille and  Orange Counties

RCT (Rural Community Transportation, Inc.)
29 Sunset Dr., B1
Morrisville, VT 05661
(802) 888-6200

Chittenden County

SSTA (Special Services Transportation Agency)
2091 Main St
Colchester, VT 05446
(802) 878-1527

Contact Information

Green Mountain Care
Health Access Member Services
Department of Vermont Health Access
312 Hurricane Lane
Williston, VT 05495
Phone: 1-800-250-8427
Relay services for the Deaf and hard of hearing: 711