www.catamounthealth.org
Vermont Medicaid

The information below refers to Medicaid for adults ages 19 to 65 who are not blind or disabled.

Individuals who want to apply for Medicaid based on being age 65 or older, blind or disabled must meet additional eligibility criteria. Click here for an application

Medicaid for children up to age 19 and pregnant women is called Dr. Dynasaur.

Eligibility
Financial Eligibility
Benefits
Cost
Enrolling


Eligibility

To be eligible for Medicaid, individuals must meet the following criteria:

  • You must be a Vermont resident and a U.S. citizen or be able to meet the citizenship requirements. You can still apply for Medicaid even if you are not a U.S. citizen. Click here for more information.

  • Individuals do not have to be uninsured to be eligible; many beneficiaries have other insurance. For example, many children also have insurance through their parents.

  • A person can be eligible for Medicaid for up to 90 days prior to the date they applied for coverage, as long as the person would have been actually eligible in that 90 day period before applying. This is called retroactive coverage.

  • Beneficiaries must ask for retroactive coverage. It is not automatically determined. If beneficiaries have to pay premiums, they would have to pay them for the retroactive months of coverage.

Financial Eligibility

As of January 1, 2014, Vermonters between the ages of 19 and 65 can be eligible for Medicaid as long as their household income is within the Medicaid income guidelines. 

Income is defined as household Modified Adjusted Gross Income (MAGI).  MAGI is approximately the Adjusted Gross Income amount from your tax return (line 37 of a 1040 form), plus any Social Security benefits that are not taxed, tax exempt interest (line 8b), and foreign earned income and housing expenses for Americans living abroad.

Assets are not counted as income, and assets are not considered in determining eligibility for Medicaid.

Income Limits:
Household of 1     $1322 mo/ $15,864 year
Household of 2     $1784 mo/$21,408 year
Household of 3     $2246 mo/$26,952 year
Household of 4     $2709 mo/$32,508 year


Benefits

Medicaid provides comprehensive coverage.  For adults, Medicaid covers doctors, hospitals, mental health and substance abuse care, naturopathic care, prescription drugs, chiropractic care, and a limited amount towards dental care.


Cost

There are no premiums for Medicaid.

Out of pocket costs are:
$1/$2/$3 for prescription drugs depending on cost
$3/dental visit
$3 day/hospital out patient services

For more information on Medicaid, click here


Enrolling

Apply for Medicaid through the Vermont Health Connect web site

Or, call or email us for help enrolling or for a paper application. 866-482-4723


 



email us or call us with your questions at 1-866-482-4723
2 Spring Street, Montpelier VT, 05602
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