A Guide to Health Insurance in Vermont (VT)

If you are currently in the process of seeking out or understanding Vermont Health Insurance, then this article will help to shed some light on how medical insurance works in The Green Mountain State.

Health Insurance can be confusing because there are a number of different options that are available, ranging from getting insurance through a workplace group policy, individual insurance, or through government programs like Medicare and Medicaid. And then within each of these are different styles of policy, such as HMOs, PPOs, indemnity plans, POS Plans and all manner of other confusing sounding health plans.

The first thing to realize is that it is often really easier to simply think about the endgame that is the reason you are getting the cover, and then worry about the schemes that can get you there.

When we talk about health insurance in Vermont, what we are really talking about is Comprehensive Vermont Health Insurance, or as some people like to call it, Major Medical Vermont Health Insurance.

This essentially protects you when you become sick by paying out for the cost of most of your healthcare, and will pay for such items as:

- Hospital Care and Hospital Treatments
- Prescription Medication
- Visits to your Doctor
- Tests
- Certain Therapies

Certain things are not included in most policies such as:

- Dental Care
- Vision
- Disability Cover
- Accident Cover
- Long Term Care

But for most of these, if you want them, then you can either purchase separate insurance, or for the payment of an additional premium add it to your existing cover.

One thread that you will find running through ALL discussions of health insurance in Vermont or anywhere else, is that of having to pay for it! And in reality that can be difficult, because health insurance premiums have been rising every year by amounts that are well above inflation, and in the last ten years have more than doubled.

To help to pay these rising costs there are some Government initiatives that have been introduced, including the Affordable Care Act, which try to bring down the cost of insurance to ‘average levels’ for those who might otherwise either be rejected for health insurance because of pre-existing conditions, or else forced to otherwise pay sky-high premiums in order to get covered.

In addition there have been various savings schemes introduced that have tax-advantages built into them such as Health Savings Accounts (HSA) which were first brought in in 2004, and which offer people the opportunity to pay for their health care from dollars that they haven’t had to pay tax on, and also to save any surplus money that hasn’t been paid out (within set limits) on the same basis.

How to Get Vermont Health Insurance

Once you cut through all the complicated jargon there are really only two ways that you can privately get health insurance in Vermont.

These are either through a workplace group policy, or else by arranging your own cover by buying an Individual Vermont Health Insurance Plan.

The advantage of getting covered through your work is that often this is offered in the same way that you might get 20 days paid holiday every year, or a company car. Namely that it is a benefit of doing the job and is often subsidized heavily by your employer.

Getting covered this way also means that you generally will not have to undergo medical underwriting by having a medical, and that you are guaranteed to be accepted if the scheme is open to other employees.

If this option is not available then getting an Individual Vermont Health Insurance Plan will also see you covered, but you may have to jump through more hoops, sit a medical, and possibly pay more for your cover, or even be rejected if you have any pre-existing medical conditions.

Take some time to review your options when it comes to Vermont Health Insurance and read the policy documents carefully of any policies that you are considering buying, as deciding what policy to go for is an important decision to make that can have long-term repercussions.


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