Types of Plans

To help you compare costs and coverage, Vermont Health Connect (VHC) plans are divided into four “metal levels”:

Platinum
Gold
Silver
Bronze

Platinum plans have the highest premiums and lowest cost-sharing. Bronze plans have lower premiums and higher out-of-pocket costs. Cost-sharing describes your out-of-pocket costs for things like deductibles, copays, coinsurance and out-of-pocket maximums. We explain what these words mean on our Understanding Health Care Costs page.

You can pick the metal level that best meets your medical needs and your budget. You should look at more than just the monthly premium. Picking the plan with the lowest monthly premium may not be best for you if you have a lot of medical visits and costs. This is because you may have to pay more out-of-pocket when you get health care services.

You may be able to get help paying your monthly premiums (Premium Tax Credits) or help with your cost-sharing. If you qualify for Premium Tax Credits, you can use them to lower the monthly premium for your platinum, gold, silver or bronze plan. If you qualify for cost-sharing assistance to reduce your out-of-pocket costs, you can only use it if you choose a silver plan.

It is a good idea for everyone to look at the Plan Comparison Tool and make sure that they are on the best plan for their household.

Read the plan brochures and use a Plan Comparison Tool on the Vermont Health Connect website.

Essential Health Benefits (Minimum Essential Coverage)

All metal level plans must cover these health benefits:

Children’s health services, including eye and dental care
Emergency care
Being admitted to a hospital
Lab services
Maternity and newborn care
Mental health and substance abuse services
Outpatient services
Prescription drugs
Preventive and wellness services and chronic disease management
Services and devices to rehabilitate (regain skills) and habilitate (improve skills that may not be developing normally)

Catastrophic Plans

Catastrophic plans may be an affordable way to protect yourself from worst-case events, like getting seriously sick or injured. The premiums are lower, but you cannot get Premium Tax Credits to help pay for a catastrophic plan. The deductible is also higher with a catastrophic plan which means you will pay most routine medical costs yourself.

You can buy these plans if you are under age 30.

Catastrophic plans cover:

Free preventative health services
Three primary care doctor visits
Essential health benefits after you meet your deductible

Find more information about Vermont Health Connect catastrophic plans.

Dental Plans

None of the VHC medical plans include adult dental care, but you can buy an adult dental care plan separately through Vermont Health Connect.

You can also buy an adult dental care plan directly through Northeast Delta Dental. They offer many different plans and you can sign up anytime (you do not need a special enrollment period).