If you live in Vermont, the following health insurance contact information may be helpful to you:
Vermont Insurance Division
The Vermont Insurance Division is responsible for regulating all types of insurance sold in the state of Vermont -- including health insurance policies.
If you are looking for health insurance coverage, the Insurance Division keeps a list of insurance companies licensed to sell policies in Vermont. You can also search for both companies and agents.
If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Insurance Division. Call the Consumer Help Line listed below for more information on the best way to proceed. Find a complaint form here.
Vermont Insurance Division
89 Main Street
Montpelier, VT 05620-3101
Phone: 800-964-1784
U.S. Department of Labor
If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees -- for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.
If you have concerns about your employer's practices in administering your job-based health coverage -- for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan -- contact your regional EBSA office.
U.S. Department of Labor Employee Benefits Security Administration
Boston Regional Office
J.F.K. Building, Room 575
Boston, MA 02203
James Benages - Director
Phone: 617-565-9600
Fax: 617-565-9666
Buying Individual Policies in Vermont
Insurers in Vermont must offer you health coverage regardless of your health status. However, state law does not limit the monthly premium you can be charged for your insurance policy. Also, insurers may impose a pre-existing condition exclusion period upon those individuals who do not have prior continuous coverage.
"HIPAA-eligible" individuals are exempt from these pre-existing condition exclusion periods. You may be HIPAA-eligible if you:
- had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
- you have exhausted all COBRA continuation coverage which was available to you.
If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Vermont Insurance Division can help you find out.
Vermont Green Mountain Care
Green Mountain Care is a state government program that administers Dr. Dynasaur (children's health insurance), the Vermont Health Access Plan, and Catamount Health. Eligibility for these programs varies based on your age and household income.
Dr. Dynasaur provides health insurance coverage for children whose family income meets certain guidelines. Premiums currently range from $0-$40/month and are based on income. There are no co-pays associated with care under the Dr. Dynasaur plan.
The Vermont Health Access Plan offers inexpensive coverage for lower-income Vermonters. Eligibility is based on income level -- singles must earn less than $1306/month, while families can earn more depending on the number of children. Premiums currently range from $7-$49/month and vary according to income.
Catamount Health is a relatively new program that offers reasonably priced health insurance to residents of all income levels who are unable to obtain insurance through their jobs or another state program. Premiums are based on income and provide coverage for emergency care, doctor's visits, chronic disease care, prescriptions, and more.
To learn more about any of these programs, contact Green Mountain Care or the Vermont Office of Health Care Reform.
Green Mountain Care
Phone: Phone: 1-800-250-8427
Vermont Office of Health Care Reform
Vermont Agency of Administration
109 State Street
Montpelier, VT 05609
Phone: 802-828-1354
Vermont State Health Insurance Assistance Program (SHIP)
SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit, or Medigap coverage.
SHIP
Phone: 800-642-5119
Vermont Medicaid
Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals.
Interested in learning more about Medicaid? Contact Green Mountain Care.
Green Mountain Care
Phone: Phone: 1-800-250-8427
