Vermont Affordable Care Act




Vermont Affordable Care Act Guide

In this informative article, you will learn about the Affordable Care Act health care reform laws in Vermont.  You will learn how the new health care reform law, Affordable Care Act, also known as Obamacare or ACA, impacts you as a citizen of the state.  Learn how to sign-up for Vermont Affordable Care Act, the Affordable Care Act penalty, and subsidies.

What is Vermont’s Affordable Care Act?

Affordable Care Act, also know as ObamaCare or Health Care Reform was signed into law in March 2010.  There are four main goals of the Affordable Care Act:

  1. Expanding Health Care Insurance Coverage
  2. Providing New Consumer Insurance Protections
  3. Offering New Insurance Choices via Marketplace Exchanges
  4. Making Health Insurance more affordable

When can I apply for the Affordable Care Act in Vermont?

You can only apply for Vermont Affordable Care Act during Open Enrollment.  The open enrollment for Vermont Affordable Care Act is usually from November 1 to December 15.

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

If there are life-changing events, then you can apply for the Affordable Care Act Special Enrollment Period.

When is the Vermont Affordable Care Act deadline?

The VT Affordable Care Act Open Enrollment is only open for 6 weeks around November and December.  There are two important dates for the Vermont Affordable Care Act:

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

How do I apply for the Affordable Care Act Vermont (VT ACA)?

Vermont Affordable Care Act Health Insurance Marketplace is run by the state of Vermont. Click on Vermont Health Connect 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.

How much is the Affordable Care Act Vermont?

The cost of Vermont’s Affordable Care Act health insurance depends on the metal plan you choose and the number of people in the household.

There are four different health insurance plans within the Vermont Obamacare Marketplace.  All of the plans cover the Essential Health Benefits.  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

Platinum plans have the highest insurance premiums (monthly cost) and Bronze plans have the lowest insurance premiums.

How much is Vermont Affordable Care Act Penalty?

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

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’s Affordable Care Act Subsidies? What are the requirements?

If your gross income is between 133% to 400% of the Federal Poverty Level, you can qualify for Affordable Care Act Subsidies if you purchased the health insurance from the Federal/State Marketplace.  Affordable Care Act Subsidies are also called, “Premium Tax Credits or PTC.”  If your income is above 400% of the Federal Poverty Level, you do not qualify for any Affordable Care Act Premium Subsidy.

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.

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Do I need to get the Affordable Care Act in Vermont?

Yes, every individual in Vermont needs to have health insurance.  One of the hallmarks of the Affordable Care Act health care reform law is the Individual Mandate.  The Individual Mandate of Affordable Care Act health care law requires US Citizens and legal residents to enroll in a health insurance plan or pay a penalty.

You can choose not to have health insurance, but you will have to pay the penalty in addition to the hospital/doctors medical fee if you do get sick.

You might be able to qualify for health coverage exemptions and be waived from paying the Affordable Care Act penalty.

What is the Requirement for Affordable Care Act Vermont?

To qualify for 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

Medicaid Expansion Relating to Affordable Care Act Vermont

Vermont expanded the Medicaid program.

Vermont Affordable Care Act Frequently Asked Questions:

  1. Who runs the Affordable Care Act Vermont Marketplace? Vermont
  2. Where can I sign up for the Affordable Care Act in Vermont? Click here
  3. How much is the health insurance premium for Vermont Affordable Care Act? It depends on your income and the number of households/family.
  4. Which insurance companies are offering Affordable Care Act Plans in the state of Vermont? Click here to see the insurance companies

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

For additional Information on Vermont Affordable Care Act / Obamacare:

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

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

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

Vermont’s five largest cities in terms of population: Burlington, Essex, South Burlington, Colchester, and Rutland.