Vermont Health Insurance Guide

From scenic mountains and rolling landscapes to vibrant small towns, Vermont offers a high quality of life and abundant outdoor activities. Understanding your health insurance options in Vermont is essential to securing your health and financial well-being.

As of 2025, Vermont’s uninsured rate reflects steady access to coverage and increased enrollment in health programs. If you’re currently without health insurance, here’s what you need to know about getting insured in Vermont.

Health Insurance Options in Vermont

Vermont provides a variety of health insurance options tailored to meet the needs of its residents, depending on factors like income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many Vermonters receive health insurance through their employer. If your workplace offers coverage, it’s often the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through the Health Insurance Marketplace. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA Marketplace plans come in four tiers: Bronze, Silver, Gold, and Platinum. Each plan type has different costs and coverage levels. The plans also vary by provider networks and out-of-pocket expenses, so be sure to compare them carefully to find the best fit for your needs.

Marketplace Plans:

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum: Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown:

• Bronze: Insurance company pays 60%, you pay 40%
• Silver: Insurance company pays 70%, you pay 30%
• Gold: Insurance company pays 80%, you pay 20%
• Platinum: Insurance company pays 90%, you pay 10%

Medicaid

Vermont’s Medicaid program, known as Green Mountain Care, provides free or low-cost coverage for eligible low-income residents. Medicaid typically covers preventive care, hospital visits, mental health services, prescriptions, and more.

Short-Term Plans

Vermont currently does not offer short-term medical (STM) plans. Unlike ACA-compliant plans, STM plans are designed for temporary coverage during gaps in insurance. While some states allow STM plans, Vermont has stricter regulations and offers other comprehensive options for those needing temporary health insurance.

Children’s Health Insurance Program (CHIP)

Vermont’s CHIP program, known as Dr. Dynasaur, helps children and pregnant women in families that earn too much for Medicaid but need affordable insurance.

Student Health Insurance

College students in Vermont have several health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic plans, making Vermont student health insurance accessible and flexible.

Medicare

Medicare is available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage Plans (Part C): These plans are offered by private insurers and provide additional benefits beyond Original Medicare, often including prescription drug coverage. Learn more about Medicare Advantage.
• Prescription Drug Plans (Part D): Medicare Part D provides coverage for prescription drugs and vaccines, offered by private insurers.
• Medicare Supplement (Medigap): Medicare Supplement plans help cover the out-of-pocket costs that Original Medicare does not pay, such as deductibles, copayments, and coinsurance.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to continue your employer’s coverage temporarily—typically at full cost.

Enrollment Periods in Vermont

Open Enrollment for 2026 Coverage:

November 1, 2025 – January 15, 2026
During this window, all eligible residents can apply for, renew, or change their marketplace health plans.

Special Enrollment Period:

Available year-round for those experiencing qualifying life events, such as:

• Loss of coverage
• Marriage or divorce
• Birth or adoption of a child
• Relocation
• Major change in income

You typically have 60 days from the event to enroll.

Health Insurance Providers in Vermont

As of 2025, these insurers offer individual and family plans through Vermont Health Connect:

• Blue Cross and Blue Shield of Vermont – Visit Blue Cross and Blue Shield of Vermont website
• MVP Health Care – Visit MVP Health Care website

Plan availability may vary by county or zip code. Some carriers may also offer standardized plans if Vermont provides a public option.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common cost terms:

• Premium: Monthly payment to maintain your plan.
• Deductible: Amount you pay before insurance covers services.
• Copayment (Copay): Fixed amount per visit/service.
• Coinsurance: Shared costs with your insurer after the deductible.
• Out-of-Pocket Maximum: Your yearly cost cap for covered services.
• In-Network vs. Out-of-Network: Staying in-network helps you avoid higher charges. Learn more about health insurance terms here.

Bottom Line

Health insurance in Vermont offers many choices—whether through your employer, the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure affordable and reliable coverage that supports your health and budget.

Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for financial aid, or speak with a licensed insurance agent about all your options.