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Obamacare Marketplace Profile: Vermont’s Health Insurance Exchange

Obamacare Marketplace Profile: Vermont’s Health Insurance Exchange

Posted Nov 25, 2013 by Jenifer Dorsey

Exchange name: Vermont Health Connect
Website: healthconnect.vermont.gov
State-based or federally run: Vermont is among the 17 declared state-based health insurance exchanges, which include Washington, D.C. Two states that initially opted for state-based exchanges, Idaho and New Mexico, are temporarily partnering with the federal exchange.

Plans: Vermont Health Connect offers Vermont residents individual major medical health insurance plans that fall into the four metal levels —bronze, silver, gold and platinum—as well as catastrophic coverage for those who qualify due to age or income. Health insurance sold through Vermont Health Connect includes preventive care and services within the 10 essential health benefits categories. Dental plans for adults and children are also available through the state exchange; dental coverage that is part of the pediatric dental and vision essential health benefit is available both embedded into health plans and as stand-alone coverage.

Vermont Health Connect’s standard plans “all cover the same basic benefits package of ten essential health benefits, although there is some variation in cost-sharing and provider networks between the plans.” Non-standard plans, according to the website, “are unique to each health insurance carrier. They still cover the same basic benefits package, but they may also include a focus on primary/preventive care, innovative wellness programs, and mental health/substance abuse treatment.” Vermont’s exchange FAQ reminds consumers to look at each plan’s summery of benefits coverage to determine what meets their needs and preferences.

Additional information is available at healthconnect.vermont.gov. Vermont residents may create an account to determine what options are available to them and their families. Comparison brochures are available at info.healthconnect.vermont.gov/healthplans

Rates: General rate information may be obtained at info.healthconnect.vermont.gov/healthplans. Specific monthly premium information is available once consumers create an account at Vermont Health Connect. Rates are based on factors such as geographic location and applicant age. In 2014 and beyond, Obamacare mandates that insurers cannot deny coverage or charge more due to health history or preexisting conditions. These provisions apply whether plans are purchased via the marketplace or not.

The healthedeals.com Health Care Reform Calculator, which was listed among The Financial Times “Best Online Tools for the Toughest Health Questions,” can help those planning to buy from an exchange calculate their Obamacare health insurance cost and tax credit.

All Americans can enroll in exchange-based coverage whether or not they qualify for tax and cost-sharing subsidies. It is important to note that only coverage purchased through an exchange is eligible for subsidies.

In the news: Vermont Health Connect made headlines over the weekend after the state confirmed a security breach of the website. The incident occurred in October. One user gained “improper access to another user’s Social Security number and other date,” according to an Associated Press article published in the Bennington Banner. An official said it was the only incident of its kind and that technical changes have been made.

Consumer assistance: Those shopping Vermont Health Connect can call 855-899-9600 for help (TTY/TDD 888-834-7898). In-person assistors, which include navigators, brokers and certified application counselors, may be located via the website’s Help Center.

The chat feature Alex, which Vermont Health Connector dubs “our interactive advisor,” is also available to assist site visitors. The feature is currently located in a colorfully illustrated tan box at the lower-right corner of the individual and employee portals.

Additional coverage options: Obtaining additional protection can be a wise move for many consumers. For instance, a bundled gap plan that includes coverages such as accident medical expense insurance and accident disability income insurance pays lump-sum cash benefits when a qualifying event occurs and can help create more comprehensive benefits like those offered through an employer. A critical illness insurance plan pays out lump-sum cash benefits upon diagnosis of certain illnesses that can be used for everything from medical bills to childcare.

Supplemental insurance is not available through state-based or federally operated health insurance exchanges and does not qualify for Obamacare premium tax credits and cost-sharing subsidies. However, they are easy to obtain directly from the plan’s carrier or a licensed agent or broker. Supplemental insurance plans come in several designs to fit your individual household budget and needs.

Need coverage now? A short-term medical insurance plan is an option for those who need health insurance until their new coverage kicks in Jan. 1, 2014, or later. Temporary insurance plans can provide coverage for as few as 30 days. Start shopping on healthedeals.com or contact a healthedeals.com sales consultant at 866-745-6630 for more information on short-term health insurance and supplemental plans.

Jenifer Dorsey is a freelance writer whose specialties include health and fitness, wellness, sports and recreation. She is a competitive amateur track cyclist who also enjoys mountain biking, hiking, camping and other outdoor adventure. Jenifer received a B.A. in journalism from Columbia College Chicago and is an MFA candidate at Naropa University. She lives in Colorado.