Monthly premium
Your monthly payment for your health plan coverage.
$2,419.26
per monthGood news! You may qualify for financial help through Vermont Health Connect.
The estimate below is based on the information entered for your annual household income and household members needing insurance. You may qualify for an estimated subsidy of:
Based on the information entered for your annual household income and household members needing insurance, you may qualify for Medicaid. You can learn more about Medicaid through the Vermont Health Connect website.
Based on the information entered for your annual household income and household members needing insurance, you may not qualify for financial help through Vermont Health Connect. Please check your current situation and eligibility with Vermont Health Connect.
Your monthly payment for your health plan coverage.
$2,419.26
per monthThe dollar amount you pay for services and/or medications before your plan begins to pay a larger portion of your costs.
$2,500
per yearThere are two deductible types, stacked and aggregate. Members enrolled in an individual-only plan are not impacted, but if a family member is added onto the plan at a later date, it will change how the plan pays benefits.
On a stacked plan, once an individual meets their deductible or out-of-pocket limit, the plan pays accordingly, even on a two-person or family plan. With an aggregate plan, the full deductible or out-of-pocket limit must be met collectively by members on the plan before benefits are paid.
Aggregate
The maximum amount you will pay for covered services (medical or prescriptions) during a plan year. Once you meet this limit, your plans pays 100% of covered health care costs for the rest of the plan year.
$10,300
per yearA Health Savings Account (HSA) is a tax-free savings account that can be used to pay for IRS-approved medical expenses that are not covered by a member’s health plan. HSAs work in conjunction with an HSA-eligible health plan that meets IRS guidelines.
Not Compatible
Health Reimbursement Arrangements (HRA) are administered and funded by employers to help employees pay for out-of-pocket health care expenses like deductibles, office visits, hospital stays, and prescription drug costs.
Not Compatible
A network type determines the network of providers and facilities available in a health plan. For example, all of our Qualified Health plans have an Exclusive Provider Organization (EPO) network which allows access to the preferred BlueCard® network of providers & facilities in Vermont and nationwide.
EPO
The amount you pay toward the cost of medications before your plan will begin to pay costs.
Combined with medical
A limit on the amount you will pay for covered prescriptions in a calendar year. Once you meet this limit, we will pay for 100% of covered costs for the rest of the calendar year. Some plans may have a separate prescription out-of-pocket maximum, or it may be combined with the overall out-of-pocket maximum.
$3,300
A generic drug is a medication created to be the same as an existing approved brand-name drug.
Full price
$5
co-payBrand-name drugs that are listed on our formulary drug list (drugs covered by your plan).
Full price
40%
co-insuranceA medication that has been determined to have an alternate drug available that is clinically equivalent such as a generic equivalent.
Full price
60%
co-insuranceGeneric medication for select conditions such as asthma, antidepressants, cardiovascular/heart disease, diabetes, smoking deterrents, and more.
$5
co-pay$5
co-payPreferred brand medications for select conditions such as asthma, antidepressants, cardiovascular/heart disease, diabetes, smoking deterrents, and more.
$50
co-pay$50
co-payPreferred brand medications for select conditions such as asthma, antidepressants, cardiovascular/heart disease, diabetes, smoking deterrents, and more.
60%
co-insurance60%
co-insuranceThe prescription deductible is waived for wellness drugs.
Services used to find or reduce your risks when you do not have symptoms, signs, or specific increased risk for the condition being targeted. They may include immunizations, screenings, counseling, or medications that can prevent or find a condition.
$0
A test that helps find diseases and conditions early, such as diabetic screenings, colonoscopies, mammograms, and more,. Routine health screenings are recommended for people throughout life as part of preventive care.
$0
Vaccinations for adults and children.
$0
If you are diagnosed with diabetes or heart disease, you will receive an additional 4 visits at no cost before the deductible to see a specialist to help manage your health. Eligible specialists are cardiologist, endocrinologist, nephrologist, ophthalmologist, or podiatrist.
Included
Primary Care: A visit to a healthcare provider who provides primary, routine care services.
Mental Health: A visit to a healthcare provider for routine, office-based mental health and/or substance use disorder treatment.
Combined 8 visits at $0
$20
co-payA visit to a healthcare provider that is considered a medical specialist, such as an orthopedic surgeon or cardiologist.
4 Chronic Care Specialist visits per member at $0
$40
co-payA visit to a licensed chiropractic provider to treat and prevent neuromusculoskeletal disorders.
Full price
$30
co-payA visit to a healthcare provider for therapy that relieves pain of an acute condition, restores function, and prevents disability following disease, injury, or loss of body part.
Full price
$30
co-payA visit to a healthcare provider that helps you assess your dietary habits and create an individual action plan for ongoing self-care.
Full price
$40
co-paySpeech therapy services provide treatment of swallowing, speech-language and cognitive-communication disorders. Occupational therapy services promote the restoration of a physically disabled person’s ability to accomplish the ordinary tasks of daily living or the requirements of their particular occupation.
Full price
$40
co-payHealth care services that are necessary to treat a condition or illness of an individual that if not treated within 24 hours would cause risk.
$60
co-pay$60
co-payCare for illness or injuries that need immediate attention and care.
Full price
$250
co-payTransportation provided to the nearest facility or hospital, such as by an ambulance service.
Full price
$40
co-payTests ordered by your provider to learn or determine more about a specific condition or disease. These services can include labs, x-rays, testing, and other procedures. These tests can be performed in an office and in an outpatient hospital.
Full price
$40
co-payOutpatient care in a General Hospital or ambulatory surgical center that does not require an overnight stay. Services may include surgery, diagnostic services, advanced imaging (MRI, CT, or PET scan), treatments (such as chemotherapy), or other types of procedures.
Full price
$750
co-payMedical care when you get admitted to a health care facility, like a hospital or other type of inpatient facility and spend at least one night.
Full price
$750
co-payReady to enroll? Based on whether you qualify for financial help or not, we have outlined the enrollment options below.
If you do qualify for financial help (subsidies), you must enroll through Vermont Health Connect.
You can enroll directly with Blue Cross VT by using our Online Enrollment Form or by downloading the PDF form to complete and send to us.
By choosing to direct enroll with Blue Cross VT, you are acknowledging that you will not receive any financial help through Vermont Health Connect, and as a result may end up paying more for your health plan coverage. To verify your eligibility for financial help and help reduce your monthly premium, visit Vermont Health Connect using the button above.
We'll help you find the right plan for yourself or your whole family.
Connect with UsMonday–Friday
8:00 a.m. to 4:30 p.m.