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Vermont Affordable Care Act

Vermont Affordable Care Act Comprehensive Guide

In this article, you will learn about the Affordable Care Act health care reform laws in Vermont.  You will get an understanding of how the health care law impacts you as a citizen of the state.  Learn how to sign-up for the Affordable Care Act, learn about the Affordable Care Act penalty and subsidies, and much more.

What is Vermont’s Affordable Care Act?

Affordable Care Act, also known as Obama Care, was signed into law in March 2010.  The goal of the Affordable Care Act is to provide US citizens with affordable health insurance and to reduce the cost of health care spending for families and in America.

The Key Points of the Affordable Care Act / Vermont Obamacare:

How to Apply for Vermont Affordable Care Act?

Vermont’s Affordable Care Act marketplace is run by the state of Vermont.  Click on Health Connect Vermont to access Vermont Affordable Care Act Marketplace.  You can preview the different insurance plans and see participating doctors before selecting the final health insurance plan.

State Federal or State Marketplace  Website Medicaid Expansion?
Vermont State healthconnect.vermont.gov Yes

When can I apply for Vermont Affordable Care Act (Vermont ACA)?

Vermont Affordable Care Act’s Open Enrollment starts on November 1 and ends on December 15.  To have health insurance coverage beginning in the following year, you must apply before the December 15 deadline.

In order to qualify for Tax Credit or Premium Tax Subsidies, you must purchase health insurance from the Affordable Care Act Marketplace during the Open Enrollment period.

If you qualify for Vermont Medicaid health insurance, then you can sign-up for Medicaid any time of the year.

When is the deadline for Vermont Affordable Care Act (VT ACA)?

Important dates for Vermont Affordable Care Act deadlines:  The absolute last day to purchase health insurance from the Marketplace is December 15.

  • November 1: First day to enroll in or change plans for new insurance
  • December 15: Last day to enroll in or change plans for new coverage to start the new year

How much is Vermont Affordable Care Act?

There are four different plans within the Vermont Affordable Care Act.  The metal plans represent the various levels of coverage you receive and what the plan pays on average.  The plan levels DO NOT represent the quality of the health coverage/doctors you receive.

  • Bronze Plan: The plan pays 60% of the cost, you pay 40% of the cost
  • Silver Plan: The plan pays 70% of the cost, you pay 30% of the cost
  • Gold Plan: The plan pays 80% of the cost, you pay 20% of the cost
  • Platinum Plan: The plan pays 90% of the cost, you pay 10% of the cost

The cost of the Affordable Care Act in Vermont depends on the metal plan you choose and the number of people in the household.   Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

State Year Avg. Monthly Silver Plan (before Tax Credits) US Average
Vermont 2015 $436 $268

What are the Vermont Affordable Care Act Eligibility Requirements?

In order to get Vermont Affordable Care Act, you must meet the following requirements:

  • Must live in Vermont
  • Must be a US citizen, national, or lawfully present, immigrant
  • Cannot be currently incarcerated (be in jailed)
  • Have a valid Social Security Number
  • and few other requirements

Do I need to get Vermont Affordable Care Act?

Yes, every individual in Vermont needs to have health insurance.  The Individual Mandate of Affordable Care Act health care law requires US citizens to enroll in a health insurance plan or pay a penalty.  If you have Medicaid or company-sponsored health insurance, you have met the insurance coverage requirement.

You can choose not to have health insurance, but you have to pay the penalty in addition to the hospitals/doctor’s medical fee if you do get sick.

How much is the Affordable Care Act Penalty in Vermont?

The penalty (or also called individual shared responsibility payment) is calculated in two ways.

Starting in the 2019 tax year, there is no longer a penalty for not having health insurance.

From 2016-2018, the ACA penalty is as follows:

  1. By percentage of income (2.5% of household income or a maximum of National Average Bronze plan premium)
  2. By number of people in the household ($695 per adult, $347.50 per child, or maximum $2085)

You’ll pay whichever penalty is higher. 

How much are Vermont ACA Subsidies? What are the requirements?

Affordable Care Act Subsidies are also called, “Premium Tax Credits.”

ACA subsidy lowers your premium – the amount you pay each month to your insurance plan. The amount of your ACA Subsidy depends on the estimated household income that you put on your ACA Marketplace application.

In order to qualify for the Affordable Care Act Subsidy, your income must be between 100% to 400% of the Federal Poverty Level.

Affordable Care Act - Federal Poverty Level
Federal Poverty Level Insurance Premium After PTC Subsidy
Up to 133% FPL 2% of income
133-150% FPL 3%-4% of income
150-2000% FPL 4%-6.3% of income
200-250% FPL 6.3%-8.05% of income
250-300% FPL 8.05%-9.5% of income
300-400% FPL 9.5 of income
Over 400% FPL No Government Subsidy

Medicaid Expansion under the Affordable Care Act

With the new health care reform, the Federal government offered incentives for states to expand the Medicaid program.  30 states out of the 50 states plus Washington DC expanded Medicaid program while 20 states decided not to expand Medicaid due to expected future cut back funding from the Federal government.

Vermont expanded the Medicaid program under the Affordable Care Act Health Care Reform.

State Medicaid Expansion
Vermont Yes

Insurance Companies that offer Affordable Care Act Health Insurance Plans in Vermont:

The following insurance companies are offering Affordable Care Act Plans in the Marketplace.

  • Blue Cross Blue Shield
  • MVP

Frequently Asked Questions (FAQ) on Vermont Affordable Care Act:

  1. Who runs the Vermont Affordable Care Act? Vermont
  2. Where can I sign up for Vermont Affordable Care Act? Click here
  3. Do I need to get health insurance or the Affordable Care Act? Yes, if not, you have to pay a penalty.
  4. How much is Vermont Affordable Care Act? Click here for the average ACA premium
  5. Did Vermont expand Medicaid under the Affordable Care Act? Yes

Click here for more Frequently Asked Questions on Obamacare / Affordable Care Act.

For more information on Vermont Obamacare / Affordable Care Act:

Federal HealthCare.Gov Marketplace
Toll-Free: 1-800-318-2596
Website: HealthCare.gov

Vermont Division of Financial Regulation
89 Main Street
Montpelier, VT 05620-3101
(802) 828-3301
Vermont Health Insurance | Vermont Health Connect

Vermont Affordable Care Act Marketplace

If you have a hard time affording health coverage and you have questions about eligibility for Medicaid or about current Medicaid benefits, go to: 
Vermont Department of Human Services
103 South Main Street
Waterbury, VT 05676-1500
http://dcf.vermont.gov/esd/health_insurance

Vermont’s five largest cities in terms of population: Burlington, Essex, South Burlington, Colchester, and Rutland.  You can apply for Affordable Care Act Health Insurance in any city in Vermont.