Health Insurance in Vermont (2025 Guide)
Finding affordable, reliable health insurance in Vermont can feel overwhelming, but it doesn’t have to be. Whether you’re self-employed, between jobs, or just exploring your options outside of employer-sponsored coverage, Vermont offers a range of health plans tailored to your needs. From subsidized options through Vermont Health Connect to PPO plans that offer more provider freedom, this guide walks you through everything you need to know to make a smart decision in 2025.
What Health Insurance Plans Are Available in Vermont?
Vermont residents can choose from several plan types, depending on their needs and eligibility:
- Marketplace Plans (via Vermont Health Connect)
- Private PPO & EPO Plans
- Medicaid & Dr. Dynasaur
Marketplace Plan Tiers
- Bronze: Lower premiums, higher deductibles (good for younger/healthy individuals)
- Silver: Balanced option; eligible for cost-sharing reductions (CSR)
- Gold: Higher premiums, lower out-of-pocket costs
- Platinum: Highest premiums, best coverage, often unnecessary for most
Private PPO & EPO Plans
While Vermont’s individual market is heavily based on marketplace enrollment, some private PPO plans are still available, especially for freelancers and the self-employed. PPO plans typically allow more provider flexibility and out-of-network care. These plans often appeal to:
- Small business owners who want broader provider access for themselves or employees
- High-income earners who can afford higher monthly premiums in exchange for national networks
- Early retirees not yet eligible for Medicare
- Professionals seeking treatment at specific hospitals or specialists not covered by HMO networks
Example: A self-employed consultant in Montpelier earning $90,000 per year may prefer a PPO plan that includes out-of-state provider access, even if it costs $200/month more than a standard HMO.
Major Carriers in Vermont
Two main insurers currently offer ACA-compliant individual and family plans in Vermont:
- Blue Cross Blue Shield of Vermont (BCBSVT)
- MVP Health Care
Both are non-profit and participate in Vermont Health Connect. Plan availability may vary by county. For PPO-style coverage or national provider access, speak to a licensed broker who can help explore private plan options that may not appear on the public exchange.
Health Insurance Costs in Vermont by Age (2025 Estimates)
Here are sample monthly premiums for a Bronze plan before subsidies:
| Age | Monthly Premium (Estimated) |
|---|---|
| 25 | $345 |
| 40 | $398 |
| 60 | $738 |
Want more provider access? PPOs may run 20–35% higher but offer national coverage and fewer referral barriers.
PPO vs HMO vs EPO: What’s the Difference?
| Feature | PPO | HMO | EPO |
|---|---|---|---|
| Referrals Required? | No | Yes | No |
| Out-of-Network Care | Yes (Partial) | No | No |
| Primary Care Gatekeeper | No | Yes | No |
| Flexibility | High | Low | Moderate |
| Premiums | Higher | Lower | Moderate |
PPO plans are ideal for:
- People managing chronic conditions
- Those with preferred doctors outside of a local network
- Frequent travelers or those who split time in multiple states
Real-World Examples from Vermont
- Early Retirees in Bennington: A couple in their early 60s without access to employer coverage may use a PPO to maintain specialist care at Boston hospitals.
- Remote Freelancer in Rutland: A digital marketer who splits time between Vermont and New Hampshire can benefit from a PPO’s national network.
- Family in Burlington: A family earning $95,000 with two young kids may qualify for cost-sharing reductions while also considering a PPO for broader pediatric care access.
Health Plans by County in Vermont
While plan options are fairly consistent across Vermont, availability and network size may vary slightly by region. Chittenden, Rutland, and Washington counties typically offer the broadest networks.
Need help finding a plan in your county?
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Subsidies and Financial Assistance in Vermont
Over 70% of Vermonters enrolling through the marketplace qualify for premium subsidies or cost-sharing reductions (if eligible through a Silver plan).
| Household Size | Max Income for Subsidy (2025 est.) |
|---|---|
| 1 | $58,320 |
| 2 | $78,880 |
| 3 | $99,440 |
| 4 | $120,000 |
Programs like Dr. Dynasaur also expand access to low-cost or free care for children and pregnant individuals.
Even if you earn too much for subsidies, higher-tier PPO plans may offer better total value if you want wide access and direct specialist visits.
How to Enroll in a Vermont Health Plan
Open Enrollment runs from November 1 to January 15.
You may also qualify for a Special Enrollment Period (SEP) if you:
- Lost employer coverage
- Moved to Vermont
- Got married or had a baby
Step-by-step:
- Compare plans through Vermont Health Connect or via a broker.
- Gather income documents and dependent information.
- Check for subsidies and cost-sharing reductions.
- Enroll online, by phone, or with help from a licensed expert.
Fast-track tip: PPO plans often allow enrollment year-round, depending on your situation. Call a licensed agent to see if you qualify today.
Vermont Health Insurance FAQs
Do I qualify for Medicaid in Vermont?
If your household income is under 138% of the federal poverty level, you’re likely eligible. Use Vermont Health Connect to apply and check.
What is Dr. Dynasaur?
A Vermont-specific program that provides free or low-cost coverage for children under 19 and pregnant people up to 317% of the FPL.
What’s the cheapest health insurance plan in Vermont?
Bronze-tier plans typically offer the lowest monthly premiums, but be sure to consider deductibles and cost-sharing reductions if you’re eligible.
Can I buy health insurance outside the marketplace?
Yes, though most Vermont residents qualify for subsidies through Vermont Health Connect. Private PPO plans may offer more provider freedom for those not eligible for financial help.
What’s the best health insurance in Vermont for the self-employed?
Self-employed Vermonters who value choice and nationwide access often benefit most from PPO plans — especially if they can write off premiums as a business expense.
Who should choose a PPO over an HMO in Vermont?
People who travel frequently, live in rural areas, or need direct access to out-of-state providers benefit most from PPO flexibility.
Speak With a Vermont PPO Health Plan Expert
We specialize in helping self-employed professionals, freelancers, and early retirees find flexible PPO coverage in Vermont. Don’t settle for a one-size-fits-all plan.
Call today to compare your options and get a free quote. Our service is free, fast, and backed by years of experience.