Paying for Coverage
Many Vermonters will receive assistance in paying for coverage through tax credits and/or public assistance, depending on income. You may be eligible for a federal tax credit if your income is less than 400 percent of the federal poverty level — $44,680 per year for an individual (or $94,200 for a family of four).
See if you're eligible
To see if you qualify for these federal subsidies, visit this link for a subsidy calculator.
*Please note that premium tax credits (to subsidize premium costs) are calculated on monthly modified adjusted gross income as determined by the exchange and are subject to IRS rules. Please consult your tax accountant for precise information regarding your eligibility.
Graph provided by: Kaiser Health Reform Subsidy Calculator
Your income determines your savings
Depending on your income, you may be eligible for a cost-share reduction plan through the exchange. These plans offer lower costs for deductibles, co-payments and co-insurance – the costs you pay when you get care. If you household income is below the following amounts, there’s a possibility you may qualify:
- Up to $34,470 for individuals
- Up to $46,530 for a family of two
- Up to $70,650 for a family of four
When you apply for coverage through Vermont’s health benefit exchange, Vermont Health Connect, you’ll find out if you’re eligible for these out-of-pocket savings.
Cost-share reduction savings only apply to Silver plans
There are four levels of coverage called “metallic levels,” – bronze, silver, gold and platinum. These levels are based on how much of your medical costs you pay and how much is paid by the plan when you receive medical care. They do not reflect a plan’s quality level.
If you qualify for a cost-share reduction (out-of-pocket savings) plan, you must choose a silver plan to get the savings. You have the option to choose any level of coverage (metallic level) but you’ll only get the out-of-pocket savings if you enroll in a silver plan.