Residents of the Green Mountain State are spoiled when it comes to health care. According to a study by US News, Vermont has the sixth best health care in the nation! The study accounts for health care access, quality, and overall public health.
According to Vermont’s Insurance Division, residents have several options for health care:
Where do most Vermont residents get their health insurance coverage?
|Individual or family||5%|
|Other Public Care||3%|
|Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population|
Only five percent of VT residents are uninsured, less than the national average. That’s good news for policyholders, as the more uninsured people there are, the higher prices are for insured people.
VT residents spend an average of $10,190 on health care every year, more than the national average. What influences your prices in the Green Mountain State? Costs vary person to person, but are based primarily on these factors:
According to the CDC, a high body mass can lead to serious health conditions. Because of this, insurance companies analyze your BMI to determine your risk-level. A high BMI means higher premiums.
In 2016, VT had a 27.6 percent obesity rate, the 40th highest in the country. Of the many state residents who used QuoteWizard to compare health insurance plans, 23 percent had a BMI in the obese range.
Tobacco users spend more on health insurance because of the high risks from smoking. About 17 percent of VT residents are smokers, the 23rd lowest rate in the country.
Health insurance plans cost up to three times more for older people compared to younger people. State residents who used QuoteWizard to shop for health insurance are, on average, 40 years old.
Marketplace plans come in metal tiers: bronze, silver, gold, and platinum. The more coverage you want, the more you’ll pay.
So, how much should you expect to spend on health care every month? These are the average monthly prices for each plan type for a middle-aged VT resident in 2019:
|Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier|
Premiums for a gold plan cost about 35 percent more than for a bronze plan. That’s because gold plans cover 80 percent of medical costs, whereas bronze plans cover 60 percent of costs.
VT residents may also qualify for a catastrophic plan, the lowest level of coverage available in the marketplace. Catastrophic plans have low monthly premiums but a yearly deductible of $7,150. Because of that deductible, it may save you money to invest in a bronze or silver plan if you need preventative care.
Where you live plays an important role in your rates. Every state has different health insurance laws, regulations, and providers. Options can even vary between counties.
Insurance companies use a community-rating to determine your premiums. That means your rates are partly based on the combined claims that everyone files. So, if your state files an abnormally high number of claims, your prices could skyrocket.
So, your state’s overall health is a part of how much you pay for insurance. According to America’s Health Rankings, VT is the third healthiest state in the country! That’s a great sign for policyholders and insurance shoppers.
VT residents have a few options for health insurance companies in their state. These providers offer both individual and family plans in your state:
The Affordable Care Act restricts health insurance companies from using certain factors when pricing your policy.
There’s a limit to how much you’ll pay out-of-pocket for a marketplace plan. In 2018, the out-of-pocket maximum is $7,350 for an individual plan and $14,700 for a family plan.
Vermont state law requires health insurance companies to offer at least some coverage for the following services:
There are additional services that providers need to offer coverage for. Find the entire list on cms.gov.
Medicare and Medicaid are both government-funded health care programs. Medicare helps seniors, whereas Medicaid aids low-income families and children.
VT residents 65 and over qualify for Medicare. There are several coverage options within the program, including parts A, B, C, D, and supplemental coverage plans. You may also qualify for a Medicare Savings Program:
Medicaid aids low-income families and children. These are the state’s Medicaid financial requirements:
|Household Size||Maximum Yearly Income|
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