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Medical Insurance in Vermont: An Overview

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Medical Insurance in Vermont

Medical Insurance in Vermont

Introduction: In accordance to a survey conducted by The Center for Disease Control, about 10% of the total Vermont population did not get any coverage under Vermont medical insurance per year, between 2001 and 2003.

Here, in this article, we have talked about some important Vermont medical insurance regulations as well as Vermont state medical insurance alternative options.

Regulations for Vermont Medical Insurance

  • All Vermont individuals having Vermont medical insurance policy under an employer or group can not be refused or restricted coverage under that employer or group Vermont medical insurance policy.
  • Vermont is a guaranteed issue state.
  • Vermont individuals asking for coverage under individual Vermont medical insurance plan can not be refused or restricted, according to the Vermont health insurance laws, on the basis of age, health or any other criteria.
  • Almost all Vermont medical insurance policies have guaranteed provision for renewal. This guaranteed renewability provision lets a Vermont individual renew his or her existing Vermont medical insurance plan. However, he or she should have disbursed all the premiums in time and provided no fake information during the term of the plan; to avail the facility.
  • Every Vermont medical insurance policy should offer at least one option to every interested Vermont individual to provide coverage to the spouses, families and dependants. They can not be refused on the basis of health age or other criteria.
  • Vermont medical insurance policies can have elimination riders, through which the policies can refuse providing coverage for particular health conditions, body systems or body parts, even permanently for the entire term of the policy.
  • Vermont medical insurance companies can impose pre-existing condition waiting period for maximum of one year. Vermont health insurers are allowed to investigate an applicant's health record dating back 6 months before providing coverage to see whether there was any condition for which the applicant has been or should have been treated, received medical advice or diagnosed, previously. And, if so, the Vermont medical insurance companies can refuse coverage for that health condition for up to one year.
  • regnancy is considered as a pre-existing medical condition by most of the Vermont medical insurance companies and therefore, subject to an exclusion period.
  • Vermont medical insurance rates get controlled. They can not differ based on health. However, they can differ on the basis of family size and age. The rates can go up at each renewal done after every one year. Nevertheless, the rates can not go up over 20%.
  • All newborns and adopted children should get coverage under their parent's individual Vermont medical insurance for the initial 31 days from the day of birth or adoption, provided the policy should offer coverage for the dependants.
  • In some cases, disabled and handicapped children can remain under parent's medical insurance policy, even beyond upper age limit.

Vermont Medical Insurance Alternative Options

To provide coverage to the uninsurable as well as financially weak Vermont individuals, there are some state-aided medical insurance alternative programs available within the state.

  • Dr. Dynasaur is the state's Children's Health Insurance Program: The program is available to the children and teens from the families, which are not qualified for Vermont Medicaid or unable to pay for Vermont medical insurance.
  • Vermont Medicaid: This program is accessible to the Vermont individuals who meet all the qualifying as well as income criteria.
  • Vermont Office of Health Care Ombudsman: Vermont individuals, who are having difficulties obtaining state-operated health insurance policies or need assistance in solving health-related issues or otherwise require filing grievances, are able to access the program.
  • Vermont Health Access Plan or VHAP: The program helps providing medical insurance to the Vermont adult individuals. It also helps them getting prescription drugs and spectacles.

Vermont Health Care Administration

Vermont individuals wanting more information on Vermont medical insurance can contact at the following address:

89 Main St. Drawer 20
Montpelier, VT 05620-3101


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