Vermont Health Insurance Plans
Compare comprehensive health insurance options in Vermont. Find marketplace plans, PPO coverage, HMO plans, and Medicaid options. Licensed agents help you navigate Vermont’s 2025 health insurance marketplace.
What Health Insurance Plans Are Available in Vermont?
Vermont residents have access to multiple types of health insurance coverage through Vermont Health Connect (the state’s health insurance marketplace), private insurance carriers, and Medicaid. Whether you’re looking for comprehensive coverage or budget-friendly options, Vermont offers plans to fit various needs and budgets.
Vermont Health Connect (Marketplace Plans)
Vermont’s state-based health insurance marketplace offers ACA-compliant plans with standardized metal tiers (Bronze, Silver, Gold, Platinum). Most residents qualify for subsidies that reduce monthly premiums.
PPO Health Insurance
PPO plans offer flexibility to see any doctor without referrals, with both in-network and out-of-network coverage options. Ideal for those who want provider choice and travel frequently.
EPO & HMO Plans
More affordable options with network restrictions. HMOs require primary care physician selection and referrals for specialists. EPOs offer no out-of-network coverage except emergencies.
Vermont Medicaid & Dr. Dynasaur
Free or low-cost coverage for eligible low-income residents. Vermont Medicaid covers adults up to 138% of Federal Poverty Level ($21,597 for individuals in 2026). Dr. Dynasaur covers children and pregnant individuals.
Vermont Health Insurance Costs by Age (2026 Estimates)
Vermont’s Unique Pricing: Community Rating
Unlike most states, Vermont uses community rating—one of only three jurisdictions in the U.S. (along with New York and D.C.) where health insurance premiums don’t vary by age. A 25-year-old pays the same premium as a 60-year-old for the same plan. This spreads costs evenly across all enrollees.
Because Vermont prohibits age-based pricing, your premium depends on two main factors: the metal tier you choose and the carrier you select. Here’s what to expect for 2026:
2026 Monthly Premiums by Plan Level
| Metal Tier | MVP Health Care | Blue Cross Blue Shield VT | What You Get |
|---|---|---|---|
| Bronze | $850 – $920 | $940 – $1,020 | Lowest premium, highest deductible (~$9,100) |
| Silver | $1,080 – $1,150 | $1,270 – $1,340 | Mid-range costs, CSR eligible if income qualifies |
| Gold | $1,320 – $1,400 | $1,520 – $1,620 | Higher premium, lower deductible (~$1,500) |
| Platinum | $1,520 – $1,620 | $1,750 – $1,860 | Highest premium, lowest out-of-pocket costs |
Why the price difference? The Green Mountain Care Board approved different rate increases for 2026: MVP received a 1.3% increase, while BCBSVT received a 9.6% increase. This makes MVP plans significantly more affordable for the same coverage level.
Note: These are pre-subsidy prices. Most Vermont residents qualify for premium tax credits that dramatically reduce these costs—often by $500-$900 per month. Your actual cost depends on household income.
What This Means for You
Good News for Older Adults
In most states, a 60-year-old pays 3x more than a 21-year-old. In Vermont, you pay the same. If you’re over 50, Vermont’s community rating works in your favor.
Consideration for Younger Adults
Younger Vermonters pay more than their peers in other states. However, subsidies can offset this—and you get the same comprehensive coverage as everyone else.
Carrier Choice Matters
With only two carriers, comparing MVP and BCBSVT is straightforward. MVP typically offers lower premiums; BCBSVT may have broader provider networks in some areas.
Subsidies Are Key
With Vermont’s higher baseline premiums, subsidies provide even greater savings for eligible households. Many pay under $200/month for Silver coverage.
Major Health Insurance Carriers in Vermont
Vermont has a concentrated health insurance market with two primary carriers offering individual and family marketplace plans. Both carriers participate in Vermont Health Connect and offer various plan types including PPO-style options.
Blue Cross Blue Shield of Vermont (BCBSVT)
The largest health insurer in Vermont, BCBSVT offers comprehensive marketplace plans with extensive in-state provider networks. They provide Bronze, Silver, Gold, and Platinum tiers through Vermont Health Connect.
- Network Size: Extensive Vermont provider network including major hospitals
- Plan Types: HMO and EPO plans available
- 2026 Rate Change: 9.6% increase (reduced from 23.3% requested)
- Strengths: Established Vermont presence, broad acceptance
MVP Health Care
A regional carrier serving Vermont and surrounding states, MVP offers competitive marketplace plans with strong coverage in both urban and rural Vermont communities.
- Network Size: Regional network covering Vermont, New York, and New Hampshire
- Plan Types: HMO plans with multiple design options
- 2026 Rate Change: 1.3% increase (reduced from 6.2% requested)
- Strengths: Lower premiums, regional expertise, cross-border coverage
Real Vermont Savings: A Burlington Example
Sarah’s Story: Self-Employed Graphic Designer in Burlington
Sarah, a 42-year-old freelance designer, earned $48,000 in 2025. Without help, she’d face Vermont’s full Silver plan premium of around $1,200/month.
Here’s what she actually pays for 2026:
- Full Silver premium (MVP): $1,113/month
- Her premium tax credit: approximately $780/month
- Her actual cost: $333/month
- Annual savings: $9,360 in federal subsidies
Because her income falls under 250% of the Federal Poverty Level ($39,125 for an individual), she also qualifies for cost-sharing reductions on her Silver plan—reducing her deductible from $3,050 to under $750.
Note: 2026 subsidies may be smaller than 2025 due to enhanced credits expiring. We can help you calculate your exact eligibility.
Get personalized Vermont health insurance quotes in minutes. We compare all available plans and help you maximize subsidies to find the most affordable coverage.
Compare Vermont Plans Now Speak to a Specialist: 1-888-215-4045PPO vs HMO vs EPO: Understanding Your Options
Vermont offers different plan types with varying levels of flexibility and cost. Understanding these differences helps you choose coverage that matches your healthcare needs and budget.
| Feature | PPO Plans | HMO Plans | EPO Plans |
|---|---|---|---|
| Primary Care Physician | Not required | Required | Not required |
| Specialist Referrals | Not required | Required | Not required |
| Out-of-Network Coverage | Yes (higher cost) | Emergency only | Emergency only |
| Monthly Premium | Higher | Lower | Moderate |
| Provider Flexibility | Maximum | Network only | Moderate |
| Best For | Travelers, provider choice | Coordinated local care | Balanced cost and access |
Which Plan Type Is Right for You?
Choose PPO If…
- You want maximum provider choice
- You travel frequently outside Vermont
- You see specialists without referrals
- You prefer out-of-network coverage options
Choose HMO If…
- You prefer coordinated care through one doctor
- You have an established primary care physician
- You don’t mind referrals for specialists
- You want MVP’s lower premiums
Choose EPO If…
- You want direct specialist access
- You prefer BCBSVT’s provider network
- You’re comfortable staying in-network
- You want balance of cost and flexibility
Vermont Health Insurance Subsidies & Financial Assistance
Most Vermont residents qualify for financial assistance that reduces monthly premiums and out-of-pocket costs. Premium tax credits are available to individuals and families earning up to 400% of the Federal Poverty Level.
Important 2026 Change: Enhanced premium tax credits that were in place since 2021 are set to expire at the end of 2025. This means subsidy amounts for 2026 may be smaller than in previous years, and households earning above 400% FPL ($62,600 for individuals, $128,600 for a family of four) will no longer qualify for marketplace subsidies. Contact us for the latest information on your eligibility.
Premium Tax Credits (APTC)
These subsidies reduce your monthly premium based on household income and size. The subsidy calculation ensures you don’t pay more than a certain percentage of your income for health insurance.
How It Works
Premium tax credits are applied directly to your monthly premium when you enroll through Vermont Health Connect. You can choose to receive the full credit monthly or claim it on your tax return.
2026 Eligibility
Available to Vermont residents with incomes between 100% FPL ($15,650) and 400% FPL ($62,600 for individuals) who don’t have access to affordable employer coverage.
Cost-Sharing Reductions (CSR)
If you earn under 250% FPL ($39,125 for individuals) and enroll in a Silver plan, you qualify for reduced deductibles, copays, and out-of-pocket maximums.
Medicaid Eligibility
Vermont Medicaid covers adults earning up to 138% FPL ($21,597) and children/pregnant individuals through Dr. Dynasaur up to 317% FPL with comprehensive benefits.
Example Subsidy Savings for 2026
A Vermont resident making $40,000/year (about 255% FPL) would pay approximately:
- Full Silver premium: $1,100-$1,300/month (depending on carrier)
- With premium tax credit: $280-$350/month for the same plan
- Annual savings: $9,000-$11,400 in premium assistance
Remember: In Vermont, these savings apply regardless of your age thanks to community rating.
Frequently Asked Questions
When can I enroll in Vermont health insurance?
Open Enrollment for Vermont Health Connect runs from November 1 through January 15 annually. Enroll by December 15 for coverage starting January 1, or by January 15 for February 1 coverage. You can enroll outside this period if you experience a Qualifying Life Event such as losing job-based coverage, marriage, birth of a child, or moving to Vermont.
Why are Vermont premiums so high compared to other states?
Vermont’s community rating spreads costs evenly across all ages, resulting in higher premiums for younger people but lower premiums for older adults compared to age-rated states. Vermont also has a small population and limited carrier competition. However, subsidies offset these higher sticker prices for most residents.
Do I need to use Vermont Health Connect?
If you want to receive premium tax credits or cost-sharing reductions, you must enroll through Vermont Health Connect. The same plans are available directly from carriers, but without financial assistance.
What if I’m self-employed in Vermont?
Self-employed Vermont residents can purchase marketplace plans through Vermont Health Connect and often qualify for substantial subsidies. You can also deduct health insurance premiums as a business expense on your tax return, reducing your overall tax burden. Learn more in our self-employed health insurance guide.
Can I keep my current doctor?
Check each plan’s provider network before enrolling. With only two carriers in Vermont, your choice is between MVP and BCBSVT networks. We can help you verify if your doctors participate before you enroll.
What happens if I don’t have health insurance?
Vermont does not have a state penalty for being uninsured (the federal penalty was eliminated in 2019). However, going without coverage exposes you to significant financial risk and you won’t receive preventive care benefits.
How do I apply for Vermont Medicaid?
Apply through Vermont Health Connect online, by phone, or with free assistance from our team. If you qualify based on income, you’ll be automatically enrolled in Medicaid rather than a marketplace plan.
Explore More Vermont Health Insurance Resources
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Compare plan types to find the right fit for your healthcare needs
Ready to Compare Plans?
Ready to find the right Vermont health insurance plan? We compare all available options, help you maximize subsidies, and guide you through enrollment. Most customers save hundreds per month with the right plan selection.
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ForHealthInsurance.com is an independent health insurance agency serving Vermont residents. We are not affiliated with any carrier or government agency. We help you compare plans and enroll in coverage that meets your needs at no extra cost to you.