Vermont Health Insurance

Independent agents in Vermont shop multiple companies to get you the best price on health insurance.

Written by Meg Stefanac
Written by Meg Stefanac

Financial blogger and business owner, Meg Stefanac, has more than 15 years experience working in the financial services industry and enjoys helping individuals make solid financial decisions. Meg has extensive experience writing about insurance and finances and is a key contributor to TrustedChoice.com.

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Health insurance is quickly becoming a buzzword in today's society. Every major news outlet seems to be showing news and updates regarding the latest developments in the Affordable Care Act. If you live in Vermont, It's more important than ever to get your family covered by health insurance. In fact, neglecting to get health insurance could lead to fines in the future. Read the information below before you go out to look for medical insurance quotes.

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Health Insurance Statistics in Vermont

  • Ninety-two percent of VT residents carried health insurance in 2011.
  • For a family of four living in Vermont, without employer-sponsored healthcare, the average healthcare premiums for an entire family may cost around $13,326 per year.
  • Vermont's unemployment rate was 4.5 percent in October 2013.

Health insurance is more important than ever, as even a simple trip to the E.R. may cost, on average, $1,233, which is 40 percent more than an average monthly rent payment.

When considering purchasing health insurance, it's important to know what plans are available, what discounts you can take advantage of and what supplemental plans you may want to enroll in to cover gaps in your current policy.

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What Health Insurance Plans Are Available in Vermont?

There are many types of health insurance available in Vermont, and, when deciding which policy to purchase, be sure to familiarize yourself with all the options available to make sure you get the best fit for your family:

  • Health Maintenance Organization: This option is typically more affordable than other options; however, your choice of providers is limited. The plan assigns you a specific provider, and, if you go out of network, it will not cover your costs. Additionally, you will typically need referrals to see a specialist.
  • Preferred Provider Organization: A PPO plan works similarly to an HMO. However, their list of in-network providers is larger, and you can choose to see any of the providers on the list. Additionally, you may also see specialists without a referral. If you see a doctor or specialist out of the network, the plan usually reimburses you at a reduced rate.
  • Point of Service plan: A POS plan will assign you to a primary physician. If you need to see a specialist, your primary physician will refer you. You may see a specialist outside of the network, and a percentage of your bill will be due at the time of service.
  • High Deductible Health Plan: These plans, termed "catastrophe insurance," tend to be more affordable than other types. The coverage has a high deductible. You must pay for any care that you receive before you meet the deductible.
  • Indemnity: An indemnity plan is good for individuals who may have no problems affording their care out of pocket. There are no limits; however, you must pay most costs out of pocket. Following review by the insurance company, they may reimburse you up to 80 percent.

Each of these plans has pros and cons, and it's crucial to decide which plan will work best for your family before purchasing.

What Do Health Insurance Plans Cover?

The majority of the plans will cover a percentage of the following:

  • Doctors visits
  • Routine care
  • Prescriptions
  • Labs/X-rays
  • Emergency room visits
  • Specialists
  • Hospital inpatient and outpatient visits
  • Surgeries
  • Therapy
  • Maternity care

The percentages, deductibles and co-pays will vary depending on which plan you choose. Make sure you get a clarification from your agent or the health insurance company on any services you are especially concerned about.

Are There Supplemental Plans Available?

For many families in Vermont, these insurance plans don't offer enough coverage in certain areas. Insurance companies typically offer plans known as "supplemental plans" which offer additional insurance coverage for certain conditions and situations:

  • Medigap: Insurance companies sell this insurance to individuals and families enrolled in Medicare. While Medicare covers a majority of medical costs, bills and co-pays can be very expensive. Medigap insurance offers Medicare participants extra hospital benefits, nursing home services, preventive care and even some procedures performed outside the U.S.
  • Supplemental hospital insurance: Supplemental hospital insurance is a great way to cover medical disasters. This insurance takes care of everything related to a hospital stay, including childcare and transportation. The plan may reimburse you in one lump sum or in installments. Be advised, however, that a waiting period may apply.
  • Supplemental cancer insurance: Cancer is an epidemic in the United States. Chances are you know someone with cancer. Unfortunately, the typical health insurance may not over the cancer costs that are non-medical (up to 67 percent). A cancer insurance policy can help pay for treatments such as chemo, radiation, drugs and travel.
  • Accidental death: If you suffer death or dismemberment in an accident, an accidental death policy can help your family recover. If you have a high-risk job, your employer may offer this coverage. You can buy this policy privately as well. If you die due to an illness, suicide or natural causes however, your family will not receive benefits.
  • International policies: If you are a frequent international traveler, this insurance is crucial, as it provides coverage outside of the U.S.
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How Much Is Medical Insurance in Vermont?

Before purchasing medical insurance, it's a wise idea to get a few different quotes. One policy may suit your situation, but a combination of policies, such as an indemnity policy plus and international policy, may be better. Either way, getting different quotes is important. When getting quotes, it's important to have the following information available:

  • The age and sex of those who need coverage
  • Pre-existing conditions
  • Driving records
  • Previous births
  • Any drug/tobacco/alcohol use
  • Any previous surgeries
  • Previous prescriptions/doctors visits/vaccinations
  • Employer/line of work
  • Type(s) of coverage preferred
  • Deductible preferred

Insurers will consider all of these factors, plus more, before giving you health insurance policy quotes. There may be discounts available as well, including educator discounts, new customer discounts, multi-policy discounts, military discounts and many more.

How Do You Purchase Health Insurance in Vermont?

Health insurance can be confusing. When determining which types of policies may be a good fit for your family, it's important to have some help along the way. A Trusted Choice® agent is always available to help recommend coverage, suggest policies and even help you file claims.

Contact a local Trusted Choice agent in your neighborhood for more information.

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