Accessing Health Care
Is your health insurance meeting your family’s needs? We can help you with accessing health care, by:
- Answering questions about health care financing
- Assisting with applications
- Helping with the appeals process
- Brainstorming solutions to gaps in your health care coverage
Medicaid is a low cost or free health coverage program for Vermonters. Eligibility is based on household income, family size, disability, and other criteria.
- Dr. Dynasaur is Vermont’s Medicaid for children under the age of 19 and pregnant woman. Eligibility and cost (premium) is based on household income and family size.
- Children with special health needs may qualify for Medicaid through Disabled Children’s Home Care (DCHC). This program is also known as Katie Beckett Medicaid. Eligibility is based on your child’s disability and their income and resources. Parent’s income and resources are not counted.
- Children (birth through age 18) may receive Medicaid if they are eligible for Supplemental Security Income (SSI). Eligibility is determined by the child’s disability and household income. Children over the age of 18 with a disability may qualify for SSI based on their own income and resources.
- Our Six Ways to Access Medicaid guide explains additional ways to access Medicaid. It is a great resource covering topics including: managing health care for children with special needs, available public programs, the benefits of Medicaid and EPSDT (Early and Periodic Screening, Diagnosis, and Treatment), grievance and appeals, and more.
- Visit the Vermont Medicaid Portal – Healthcare Provider Look up to see if your family doctor is a Medicaid participating provider.
Applying for Health Care
- To apply for Medicaid based on your child’s disability, contact Green Mountain Care and request the Disabled Children’s Home Care (Katie Beckett) application packet.
- To apply for income-based Medicaid, including Dr. Dynasaur, visit Vermont Health Connect or contact a health care navigator.
- Vermonters without access to employer-sponsored insurance may qualify for a subsidy to help cover the cost of the premium. To apply for a health plan or to view your health plan options, visit Vermont Health Connect or contact a health care navigator.
- Health Insurance: Why It’s Important and What You Need to Know is a useful guide published by Vermont Health Connect. It can help you learn how insurance works and understand insurance terms.
- The Affordable Care Act requires that all plans cover 10 Essential Health Benefits. When choosing a plan outside of Vermont Health Connect you will want to be sure it provides this coverage.
- From Coverage to Care is a Vermont Health Connect guide to help you understand your health plan and how to get the most from it.
Vermont’s Early Childhood Developmental Disorders Insurance
Vermont law requires health insurance carriers to provide coverage for evidence-based therapies for children with early childhood developmental disorders. The law indicates the treatments, including Applied Behavior Analysis (ABA), be a covered service for children birth to age 21, and who have an early childhood developmental disorder, such as Autism Spectrum Disorder (ASD), Down Syndrome, Fragile X, Williams Syndrome, and others. For information on how to obtain coverage, see our Early Childhood Developmental Disorders Insurance fact sheet.
For more information related to accessing health care, visit our health resources page.