Vermont Health Insurance Plans
Compare comprehensive health insurance options in Vermont. Find marketplace plans, PPO coverage, HMO plans, and Medicaid options. Licensed brokers 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. Dr. Dynasaur covers children and pregnant individuals.
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 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 PPO-style plans available
- Coverage: All metal tiers on the marketplace
- 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: Multiple plan designs including flexibility options
- Coverage: Bronze through Platinum plans
- Strengths: Regional expertise, cross-border coverage options
Note: Carrier availability and plan offerings may vary by county. We represent multiple carriers and can help you compare options specific to your location and needs.
Vermont Health Insurance Costs by Age (2025 Estimates)
Health insurance premiums in Vermont vary significantly by age, plan level, and subsidy eligibility. The table below shows approximate monthly costs before subsidies for non-tobacco users.
| Age | Bronze Plan | Silver Plan | Gold Plan | Platinum Plan |
|---|---|---|---|---|
| 21-29 | $280 – $350 | $345 – $425 | $420 – $520 | $490 – $600 |
| 30-39 | $315 – $395 | $390 – $480 | $475 – $585 | $550 – $675 |
| 40-49 | $385 – $475 | $475 – $585 | $580 – $715 | $675 – $825 |
| 50-59 | $575 – $710 | $710 – $875 | $865 – $1,065 | $1,005 – $1,235 |
| 60-64 | $820 – $1,010 | $1,010 – $1,245 | $1,230 – $1,515 | $1,430 – $1,760 |
Important: Most Vermont residents qualify for premium tax credits that significantly reduce these costs. A 30-year-old making $35,000/year might pay only $100-150/month for a Silver plan instead of the full $390-480.
Get personalized Vermont health insurance quotes in minutes. Our licensed brokers 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 Required | No | Yes | No |
| Referrals for Specialists | Not required | Required | Not required |
| Out-of-Network Coverage | Yes (higher cost-sharing) | Emergency only | Emergency only |
| Monthly Premium | Higher | Lower | Moderate |
| Provider Flexibility | Maximum | Limited to network | Moderate |
| Best For | Frequent travelers, specific provider preferences | Budget-conscious with established PCP | Balance of cost and flexibility |
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 want the lowest premiums
- You have an established primary care doctor
- You don’t mind referrals
- You stay within Vermont’s provider network
Choose EPO If…
- You want moderate premiums
- You like specialist access without referrals
- 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.
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.
Eligibility
Available to Vermont residents with incomes between 100% and 400% of FPL who don’t have access to affordable employer coverage or other qualifying coverage.
Cost-Sharing Reductions (CSR)
If you earn under 250% FPL and enroll in a Silver plan, you qualify for reduced deductibles, copays, and out-of-pocket maximums in addition to premium credits.
Medicaid Eligibility
Vermont Medicaid covers adults earning up to 138% FPL and children/pregnant individuals through Dr. Dynasaur up to 317% FPL with comprehensive benefits and minimal cost-sharing.
Example Subsidy Savings
A single 35-year-old Vermont resident making $35,000/year would pay approximately:
- Without subsidy: $390-480/month for a Silver plan
- With premium tax credit: $100-150/month for the same plan
- Annual savings: $3,480-3,960 in premium assistance
- Plus CSR benefits: Reduced deductible from $3,000+ to under $500
Frequently Asked Questions
When can I enroll in Vermont health insurance?
Open Enrollment for Vermont Health Connect typically runs from November 1 through January 15 annually. 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.
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. Private insurance purchased directly from carriers outside the marketplace does not qualify for subsidies.
What if I’m self-employed in Vermont?
Self-employed Vermont residents can purchase marketplace plans through Vermont Health Connect and may qualify for subsidies. You can also deduct health insurance premiums as a business expense on your tax return, reducing your overall tax burden.
Can I keep my current doctor?
Check each plan’s provider network before enrolling. PPO plans typically offer the broadest networks with out-of-network coverage options, while HMO and EPO plans have more restricted networks but lower premiums.
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 assistance from a licensed broker. 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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Explore PPO plan benefits and how they provide access to broader provider networks.
National overview of PPO coverage options tailored for self-employed professionals.
Ready to find the right Vermont health insurance plan? Our licensed agents 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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