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Green Mountain Health Care Frequently Asked Questions Green Mountain Care is a family of low-cost and free health coverage programs for uninsured Vermonters. Offered by the state of Vermont and its partners, Green Mountain Care programs provide quality, comprehensive health coverage at a reasonable cost. How do I apply for Green Mountain Care? Go to www.GreenMountainCare.org and access the Screening Tool to find out what Green Mountain Care program may be available to you. Download an application and mail or fax it to the address listed on the application. You can also call 1-800-250-8427 to find out what you should apply for or request an application. Additionally, you can request an application by mailing in the pre-paid postcard attached to a Green Mountain Care brochure. How much does Green Mountain Care cost? It depends on which health coverage program you enroll in. Green Mountain Care programs include reasonable deductibles, premiums and co-payments to keep out-of- pocket costs low. Some programs also offer premium assistance. How much you earn may also affect how much the health coverage program will cost. What health services are covered? Green Mountain Care programs cover basic health services such as doctor visits, hospitalization, emergency care, check ups, screenings, prescription medication, immunizations and more. Depending on which program you are eligible for, the services covered may vary. Is there anything available for uninsured children? Dr. Dynasaur is a health insurance program designed exclusively for children and teenagers and covers important health services for children including immunizations, check ups, dental care and skin care. Dr. Dynasaur also covers pregnant women. How long does the application process take? It usually takes no more than 30 days to process an application. Is there anything available for young adults who don’t have children? You may qualify for one of the Green Mountain Care programs depending on your past and current insurance status and how much you earn. Do I have to be a resident of Vermont to apply for a Green Mountain Care program and what is considered a resident? Yes, you do have to be a resident of Vermont. You are a Vermont resident if you live in Vermont (and plan to continue living here). There is no minimum amount of time you need to live in Vermont to be a resident. I am a student. Is there anything available for me? You may be eligible for one of the Green Mountain Care programs. Call 1-800-250-8427 or go to www.GreenMountainCare.org to find out. I am an uninsured parent but my children are insured. Is there anything available to me through Green Mountain Care? Yes. Green Mountain Care includes several health coverage programs for adults depending on your insurance status and how much you earn. Can I apply for Green Mountain Care if I am enrolled in Medicare? Yes. You can apply for Medicaid, VPharm or Healthy Vermonters. What if I only need help paying for my prescription medicines? Vermont has several prescription assistance programs to help Vermonters pay for prescription medicines based on their income, disability status and age. These programs include VScript, VHAP-Pharmacy, VPharm and Healthy Vermonters. If I have access to my employer’s insurance but it’s too expensive, is there anything I can apply for? Yes. If you have been uninsured for 12 months or more (or meet one of the exceptions) you can apply for Catamount Health or VHAP. You may even get assistance to pay for your employer's premiums, depending on the benefits of your employer’s plan and the cost to the state. I work. Can I qualify for any of the Green Mountain Care programs? Catamount Health or VHAP may be good health coverage programs for you. Based on how much you earn, you may be able to get assistance with paying your premiums. In addition, if you have access to your employer’s coverage but can’t afford it, you may get help paying your employer’s premium. Can I choose the doctor I want to go to? Most doctors in Vermont participate in the family of plans offered through Green Mountain Care, and you can choose which doctor to go to within the plan’s network. In the Catamount Health Plans, you can also go to doctors not in the network, but you may have higher out-of-pocket costs. Will I get an insurance card if I enroll in Green Mountain Care? Yes. You will want to keep this with you at all times and will need to present it when accessing health services. Do I have to go into an office to apply and what things do I need to provide the state in order to apply for Green Mountain Care? No you do not need to go into an office. You can mail in your application and a Green Mountain Care representative will let you know if they need proof of anything or any additional information. Where can I find out more information about Green Mountain Care? Go to www.GreenMountainCare.org or call 1-800-250-8427 to learn more.
Catamount Health is a new health insurance plan within Green Mountain Care that became available October 1, 2007 for uninsured Vermonters. It offers comprehensive, quality benefits with low co-payments and premiums to keep out-of-pocket costs reasonable. The plan is offered, in cooperation with the state of Vermont, by Blue Cross Blue Shield of Vermont and MVP Health Care. Coverage begins November 1, 2007. Who can qualify for Catamount Health? Adults (18 and older) who (1) have incomes of more than $1,777 a month (higher for larger households) or parents with incomes of more than $1,575 a month (higher for larger households); (2) are not eligible for Medicaid, Medicare or VHAP; (3) have been uninsured for 12 or more months (certain exceptions apply); and (4) do not have access to employer-sponsored coverage (unless their monthly income is $2,553 or less*). What services are covered through Catamount Health? Catamount Health provides comprehensive coverage including doctor visits, check ups, screenings, hospital visits, emergency care, care for chronic diseases, prescription medicines and more. How much does Catamount Health cost? Costs include $10 office visit co-payment; Prescriptions range from $10-50; Monthly premiums range from $60-$395 (based on income); Deductibles of $250 for individuals/$500 for families (in-network). Can I qualify for Catamount Health if I work? Yes. However, it depends on whether your employer offers insurance and your monthly income. If your employer does not offer insurance, you can apply for Catamount Health regardless of our income. If your employer does offer health insurance, you can apply for Catamount Health if your monthly income is $2,553 or less.* * Applicants may still qualify if their monthly income is up to $200 per month higher than the FPL if they have earned income and/or child care expenses. Dr. Dynasaur is a program that provides low-cost or free health coverage for children, teenagers under age 18 and pregnant women. Who can qualify for Dr. Dynasaur? Pregnant women and children under 18 years of age. How much does Dr. Dynasaur cost? Good news! Premiums for Dr. Dynasaur recently decreased by 50 percent! There are no co-payments and monthly family premiums range from $0-$40 depending on your family’s income. What services are covered through Dr. Dynasaur? Services include doctor visits, prescription medicines, dental care, home/community services, skin care, hospital visits, immunizations, lab tests, vision care, mental health care, substance abuse treatment, chiropractor services (for children only), eye exams, eyeglasses (for children only) and special services for pregnant women. How much can I earn and have my child qualify for Dr. Dynasaur? Income guidelines are based on your family size. A family of two can earn up to $3,422 a month, $4,292 a month for a family of three, and $5,162 a month for a family of four* * Applicants may still qualify if their monthly income is up to $200 per month higher than the FPL if they have earned income and/or child care expenses.
VHAP is a health insurance program for low-income uninsured adults, regardless of marital or employment status. Adults without children 18 years or older who are not eligible for Medicaid. What services are covered through VHAP? VHAP helps cover costs of doctor visits, prescriptions, hospital care, emergency care, tests, x-rays, family planning, mental health services, substance abuse services, home health care and more. Good news! VHAP recently reduced the cost of premiums by 35 percent! Premiums for VHAP now range from $0-$49, depending on your income, and there is only one co-payment ($25 for emergency room visits). How much can I make and still qualify for VHAP? If you do not qualify for Catamount Health, Medicaid or Medicare, adults without children can earn up to $1,276 a month, and parents can make up to $2,110 a month in a family of two, $2,647 in a family of three, and $3,182 in a family of four.* * Applicants may still qualify if their monthly income is up to $200 per month higher than the FPL if they have earned income and/or child care expenses.
Medicaid is a comprehensive health insurance program for low-income families and individuals. Eligibility is based on your income and resources (e.g., cash, bank accounts, etc.). Medicaid is a health insurance program for children, parents, people age 65 or older, caretakers and people with disabilities who meet income eligibility and resources requirements. What services are covered through Medicaid? Medicaid helps cover costs of doctor visits, prescriptions, hospital care, emergency care, tests, x-rays, family planning, mental health services, substance abuse services, home health care, dental care, eye care, occupational therapy, physical therapy, speech therapy, long-term care and more. Medicaid is a low-cost program, and costs may include co-payments of $3 for outpatient visits, prescription medicines and dentist visits. However, children, pregnant women and people in nursing facilities never have to pay co-payments. How much can I earn and still qualify for Medicaid? Income eligibility varies by age and other factors. Call 1-800-250-8427 or go to www.GreenMountainCare.org to find out more.
What are the Prescription Assistance Programs? Vermont has several prescription assistance programs to help Vermonters pay for prescription medicines based on your income, disability status and age. These programs include VScript, VHAP-Pharmacy, VPharm and Healthy Vermonters. What do the programs help pay for? The programs help you pay for prescription medicines and other related services depending on which program you are eligible for. Who can apply for these programs? VPharm, VHAP-Pharmacy and VScript are available to people over age 65, depending on the type of health care coverage they receive. Healthy Vermonters is available to Vermonters of all ages and you qualify based on your family income.* How much can I make and still qualify for Prescription Assistance? Income eligibility guidelines vary by program. Call 1-800-250-8427 or go to www.GreenMountainCare.org to find out more. * Applicants may still qualify if their monthly income is up to $200 per month higher than the FPL if they have earned income and/or child care expenses. |
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| Call us with your questions at 1-866-482-4723 |
| 2007 Vermont Campaign for Health Care Security Education Fund | website design by imaginecreativity.com |