×

ADVERTISEMENT

Vermont Obamacare (Affordable Care Act) Facts 2021

What Vermont Residents Need to Know About Obamacare for 2021

Essential facts about the Affordable Care Act (ACA or Obamacare) in Vermont, including whether you must get health insurance, how much it will cost, and how you can save money.

ADVERTISEMENT

Updated: 2021-02-16 by

It's not too late! Affordable Care Act (Obamacare) enrollment will be OPEN in Connecticut from February 16 to May 14.

Vermont has announced a special enrollment period (SEP) for health plan signups under the Affordable Care Act (Obamacare). This COVID-related enrollment period will run from February 16 to May 14. It mirrors the federal special enrollment period announced by the Biden administration, but Vermont's SEP applies only to those who are currently uninsured.

This website provides information about getting health insurance under the Affordable Care Act (ACA), including:

To begin, keep in mind these key points about health insurance in Vermont:

1. You can use the COVID special enrollment period to get covered under the Affordable Care Act, even though open enrollment is over.

Because of the COVID-19 pandemic, Vermont Health Connect will be open for new Obamacare signups from February 16 to May 14, 2021. If you are currently uninsured, you can use this special enrollment period to get covered for 2021. To learn more about enrollment, see How To Sign Up for Obamacare in Vermont.

If you already have health insurance. If you're already insured, you can change plans only if you have a "qualifying life event." Otherwise, you must wait until open enrollment for 2022 plans begins in the fall of 2021. To learn whether you qualify for a special enrollment period that will allow you to switch plans, see What Happens If I Missed the Vermont Obamacare Enrollment Deadline?

2. Vermont passed a law requiring state residents to have health insurance but lawmakers never agreed on a penalty.

The federal tax penalty for going without health insurance went away in 2019. In response, a handful of states, including Vermont, passed their own health insurance requirements. Technically, Vermont's law requires you have health insurance beginning January 1, 2020. But because state lawmakers never agreed on a penalty, the law has no teeth. 

That said, even if the law doesn't force you to do it, think carefully about whether it makes sense to forego health insurance. A medical crisis could knock the financial wind from your sails and do more damage than any penalty would. (A study published in 2019 showed that a lapse in health insurance coverage can double a person's chances of ending up in bankruptcy.) And if you miss open enrollment and find yourself needing coverage mid-year, you’ll have to wait until 2022 to get it.

3. Your health insurance marketplace is located at Vermont Health Connect.

During open enrollment, or whenever you qualify for a special enrollment period, you can use Vermont Health Connect to choose your health insurance plan, apply for cost-saving tax credits, and get other help you need.

To learn more about enrollment, see How Do I Sign Up for Obamacare in Vermont?

4. For 2021, insurers are sticking with the marketplace and average premium costs are going up -- but way less than last year.

Two insurance companies sell plans through Vermont Health Connect: Blue Cross Blue Shield of Vermont and MVP. Average premium increases for Blue Shield plans will be 4.2%. For MVP, average increases are 2.7%. (This is an improvement over last year's increases of more than 10%.) Both companies had initially proposed rate increases about twice as high, but the Green Mountain Care Board kept them down.

5. Vermont offers additional premium subsidies to save you money.

In addition to the existing federal premium subsidies provided under the Affordable Care Act, Vermont offers state-based financial assistance to help those with low incomes get covered.

Federal tax credits. The federal government provides help with premium payments for those whose incomes fall between 100% and 400% of the federal poverty level. For example, for 2021 health plans, a family of four in Vermont earning as much as $104,800 can qualify for subsidies, as can an individual who earns up to $51,040. Though the subsidies are tax credits, they are automatically deducted from the cost of your premiums each month, as long as you purchase your plan through Vermont Health Connect.

Vermont cost-sharing reductions and premium subsidies. In addition to the federal subsidies provided under the Affordable Care Act, Vermont offers help with premiums and out-of-pocket costs to those earning up to 300% of the federal poverty level. At Vermont Health Connect, you can find a detailed chart to help you figure out if you are eligible for these benefits in 2021. To qualify for some types of assistance, you must purchase a silver plan through Vermont Health Connect.

Medicaid. If your income is very low, you may qualify for free or low-cost coverage through Green Mountain Care in Vermont.

For more information, see Ways to Save Money on Obamacare in Vermont.

6. Vermont limits "short-term insurance plans" to fewer than three months.

In 2018, the Trump administration made it easier to purchase short-term insurance plans. These plans don't have to cover preexisting conditions or the essential health benefits provided by Obamacare plans. The new federal rules say that short-term plans can last for as long as three years. In Vermont, however, short-term plans must last fewer than three months and they cannot be automatically renewed. Vermont plans must also cover pre-existing conditions. (Vermont's Department of Financial Regulation publishes these rules.)

If you’re genuinely caught without health insurance and need it for a few months to cover a new health condition, you might want to consider a short-term plan to get you through to the next open enrollment period. Otherwise, be careful of plans that don’t meet the requirements of the Affordable Care Act. Shop around to look for coverage that truly meets your needs.

Remember, if your income is very low, you may qualify for free or low-cost coverage through Medicaid in Vermont.

7. You can get help signing up if you need it.

A couple of years back, the Trump administration drastically cut funding for programs that provide help with health insurance enrollment. But that doesn't mean you have to fend for yourself when finding and signing up for health insurance. To connect with local support resources, see How To Sign Up for Obamacare in Vermont.

 

You may also be interested in:

ADVERTISEMENT

ADVERTISEMENT

Vermont: Law