Vermont Health Insurance Plans Employer-Sponsored Insurance (ESI) Premium Assistance
If you’re an uninsured Vermonter and have access to employer-sponsored health insurance, you can get help paying the health insurance premiums.
The following criteria are met:
- You are eligible to enroll in Catamount Health or the Vermont Health Access Plan (VHAP);
- You are not yet enrolled in your employer’s plan;
- Your employer’s plan has comprehensive benefits, which means it covers both hospital and physician visits;
- It is more cost-effective for the state to provide premium assistance to enroll in your employer’s plan than to provide premium assistance to enroll in Catamount Health or VHAP; and
- You meet the income guidelines. See the chart below to determine what your premium cost may be. Your eligibility for a particular plan and your share of the cost will be determined based on the application you submit.
Income & Premiums for
Catamount Health & Employer-Sponsored Insurance
|
# in Household |
1 |
2 |
3 |
4 |
Your likely Individual Monthly Premium is |
|---|---|---|---|---|---|
|
If your total monthly/yearly household income is less than: |
$1,812/ |
$2,439/ |
$3,065/ |
$3,692/ |
$60/mo |
|
$2,039/ |
$2,744/ |
$3,449/ |
$4,154/ |
$122/mo |
|
|
$2,265/ |
$3,048/ |
$3,832/ |
$4,615/ |
$149/mo |
|
|
$2,492/ |
$3,353/ |
$4,215/ |
$5,077/ |
$177/mo |
|
|
$2,718/ |
$3,658/ |
$4,598/ |
$5,538/ |
$205/mo |
|
| If your total monthly/yearly household income is over: |
Over |
Over |
Over |
Over |
$452.08/mo |
- Your premiums are locked in for 12 months. Your premiums are subject to change on your one-year anniversary.
- 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.
- A household is defined as the number of related people living in the same house.
- Catamount Health copayments for office visits are $10, prescription copayments range from $10-$50. Deductibles are $250 for individuals / $500 for families (in-network).
- Unlike other programs, some college students also may qualify for Catamount Health.
- For further information on the guidelines and exceptions, please contact Health Access Member Services for Green Mountain Care at 1-800-250-8427 on business days between 7:45 a.m. and 4:30 p.m.
- This chart is updated each January.
