Vermont Health Insurance Plans Catamount Health
The official State of Vermont website for Catamount Health.
Catamount Health is a health insurance plan, offered in cooperation with the state of Vermont, by Blue Cross Blue Shield of Vermont . Catamount Health provides comprehensive, quality health coverage. There is no upper income limit for Catamount Health, however, depending on your income, you may even qualify for assistance in paying your Catamount premium. See below for information on Catamount Health with Premium Assistance.
Catamount Health (Full-Pay)
Who can enroll?
Catamount Health is designed for Vermonters age 18 or older and families who:
- Are not eligible for other Green Mountain Care plans such as the Vermont Health Access Plan (VHAP), or the premium assistance programs;
- Have been uninsured for 12 months or more – with exceptions for Vermonters who recently lost their insurance because of a life change such as a divorce or loss of a job. (Read further information on Catamount Health Qualifications) or have been enrolled for at least six months in an individual plan with deductibles of $7,500 or more for an individual or $15,000 or more for a family. Please note that you will not be eligible for premium assistance until you have been on Catamount Health for 12 months;
- Unlike our other programs, some college students also may qualify for Catamount Health.
What services are covered?
Benefits include doctor visits, checkups and screenings, hospital visits, emergency care, chronic disease care, prescription medicines and more.
How much does it cost?
If you do not qualify for premium assistance, you pay the full monthly premium directly to the insurance carrier of your choice. See Income & Premium Chart for Catamount Health.
How do I apply?
If you are not applying for premium assistance, please complete the Catamount Health Application Form.
Catamount Health with Premium Assistance (CHAP)
Catamount Health with Premium Assistance (CHAP) provides the same comprehensive, quality health coverage as Catamount Health at full-pay; however, premiums are based on household income and family size. (Read further information on Catamount Health Premium Assistance Qualifications).
Who can enroll?
Catamount Health with Premium Assistance (CHAP) is for Vermonters with income at lower levels than those on Catamount Health at full-pay. The program is for Vermonters age 18 or older who:
- Are not eligible for other Green Mountain Care programs such as Premium Assistance for Employer-Sponsored Insurance or the Vermont Health Access Plan (VHAP);
- Have been uninsured for 12 months or more – with exceptions for Vermonters who recently lost their insurance because of a life change such as a divorce or loss of a job. (Read further information on Catamount Health Qualifications) or have been enrolled for at least six months in an individual plan with deductibles of $7,500 or more for an individual or $15,000 or more for a family. Please note that you will not be eligible for premium assistance until you have been on Catamount Health for 12 months;
- Do not have access to comprehensive insurance through an employer; and
- Meet program and income guidelines. See chart below.
- Unlike our other programs, some college students may qualify for Catamount Health with Premium Assistance.
What services are covered?
Benefits include doctor visits, checkups and screenings, hospital visits, emergency care, chronic disease care, prescription medicines and more.
How much does it cost?
See the Income & Premium Chart for Catamount Health below to determine what your monthly premiums may be. Your eligibility for a particular plan and your share of the cost will be determined based on the application you submit.
How do I apply?
Click here to apply online. (This link takes you to mybenefits.vt.gov.)
Income & Premiums for Catamount Health
|
# in Household |
1 |
2 |
3 |
4 |
Individual Monthly Premium Using BCBS |
|
|---|---|---|---|---|---|---|
|
If your total monthly/yearly household income is less than: |
$1,915/ $22,980 | $2,585/ $31,020 | $3,255/ $39,060 | $3,925/ $47,100 | $60/mo | |
| $2,155/ $25,860 | $2,909/ $34,908 | $3,662/ $43,944 | $4,416/ $52,992 | $124/mo | ||
| $2,394/ $28,728 | $3,232/ $38,784 | $4,069/ $48,828 | $4,907/ $58,884 | $152/mo | ||
| $2,634/ $31,608 | $3,555/ $42,660 | $4,476/ $53,712 | $5,397/ $64,764 | $180/mo | ||
| $2,873/ $34,476 | $3,878/ $46,536 | $4,883/ $58,596 | $5,888/ $70,656 | $208/mo | ||
- Premiums are updated annually for July 1.
- Income levels are updated annually for January 1.
- The amount you pay is based on monthly household income. Report changes in household size or income within 10 days.
- A household is defined as the number of related people living in the same house.
- You may still qualify if your monthly income is higher than the amounts in the chart if you have earned income and/or child care expenses.
- Catamount Health copayments for office visits are $10, prescription copayments range from $10-$55. Deductibles are $500 for individuals / $1,000 for families (in-network).
- Unlike other programs, some college students also may qualify for Catamount Health.
- Dependents who are no longer eligible for coverage under a parent's plan at age 26, may be eligible for Catamount.
- For further information on the guidelines and exceptions, please contact Green Mountain Care Member Services at 1-800-250-8427 on business days between 7:45 a.m. and 4:30 p.m.
