- Vermont runs its own state-based marketplace, Vermont Health Connect, and all individual and small-group plans in the state must be bought through it — not Healthcare.gov.
- The main carriers are Blue Cross Blue Shield of Vermont and MVP Health Care, offering standard ACA metal tiers (Bronze, Silver, Gold, Platinum).
- Medicaid (under the Green Mountain Care umbrella) covers adults to 138% of the federal poverty level, and Dr. Dynasaur covers children and pregnant Vermonters at much higher income levels — verify the current thresholds.
- The enhanced ACA premium tax credits were scheduled to expire after 2025; if they lapse, 2026 marketplace premiums rise substantially, so confirm the current subsidy rules before you enroll.
- Vermont also offers state-funded Vermont Premium Assistance and cost-sharing help that stack on top of federal subsidies for some enrollees.
- Free, certified enrollment help is available by phone and in person; this article is general education, not insurance advice — confirm every figure against Vermont Health Connect.
Vermont has long been at the forefront of healthcare reform in the United States. The Green Mountain State was one of the first to expand Medicaid, once pursued a single-payer system, and operates its own state-based marketplace called Vermont Health Connect. With an uninsured rate of roughly 4% — among the lowest in the nation, according to U.S. Census Bureau data — most residents have coverage. But choosing the right health insurance Vermont plan still requires understanding costs, options, and how the system works.
Whether you are picking a marketplace plan, checking Medicaid eligibility, or evaluating employer coverage, Vermont’s healthcare landscape has features that set it apart from nearly every other state. Here is what you need to know for 2026 — and where the rules are in flux, so you can verify the current details before you enroll.
Vermont Health Connect: The State Marketplace
Vermont operates its own health insurance marketplace called Vermont Health Connect. Unlike most states that rely on Healthcare.gov, Vermont built and manages its own enrollment platform. This lets the state control the shopping experience, set its own enrollment timelines, and tailor outreach to residents.
A distinctive feature of Vermont’s marketplace is that all individual and small-group plans must be sold through Vermont Health Connect. In many states, insurers can sell ACA-compliant plans both on and off the exchange; Vermont channels all individual-market enrollment through its exchange. This concentrates the risk pool and is intended to help stabilize premiums.
Plans follow the standard ACA metal tiers: Bronze (roughly 60% actuarial value), Silver (70%), Gold (80%), and Platinum (90%). Catastrophic plans are available to people under 30 or who qualify for a hardship exemption. The main insurers on Vermont Health Connect are Blue Cross Blue Shield of Vermont — a Vermont-based nonprofit that has pursued affiliation with a larger Blue Cross organization (confirm the current corporate structure) — and MVP Health Care. Because Vermont is a small market with few carriers, plan choice is more limited than in large states, which makes comparing the available options carefully all the more important.
Average Premiums and Costs
Vermont’s marketplace premiums are among the higher ones in the country, and they moved up meaningfully for 2026 after the Green Mountain Care Board reviewed carrier rate requests. Rather than rely on a single benchmark figure that goes stale quickly, run your own numbers in the plan-comparison tool on Vermont Health Connect, which shows current-year premiums for your age and county. Vermont uses a community-rating system: insurers cannot vary premiums based on health status, gender, or occupation — only by age, geographic area, tobacco use, and family size.
Premium tax credits significantly reduce costs for eligible enrollees. Under the ACA, subsidies traditionally applied to households between 100% and 400% of the federal poverty level. Beginning in 2021, temporary “enhanced” premium tax credits made subsidies larger and extended them above 400% of the poverty level, and the Inflation Reduction Act extended those enhancements through plan year 2025. Those enhanced credits were scheduled to expire after 2025. According to KFF, if they lapse, subsidized enrollees nationwide could see their premium payments roughly double on average in 2026. Whether Congress extended the enhanced credits is exactly the kind of detail to confirm before you enroll — check Vermont Health Connect or a certified assister for the rules in force this year.
Vermont also offers state-funded help called Vermont Premium Assistance, along with state cost-sharing assistance, that can stack on top of federal subsidies. These programs help certain residents whose incomes put them just above Medicaid eligibility but who still struggle with marketplace premiums, functioning as a bridge between Medicaid and standard marketplace subsidies.
As with any plan, review the full cost picture: premium, deductible, copays, coinsurance, and the out-of-pocket maximum. Silver plans are often the best value for lower-income enrollees because they qualify for cost-sharing reductions that lower deductibles and copays.
Medicaid (Green Mountain Care) and Dr. Dynasaur
Vermont expanded Medicaid well before the ACA required it, and the state’s program — often referred to under the Green Mountain Care umbrella — covers adults with incomes up to 138% of the federal poverty level. Benefits are comprehensive, including medical, dental, vision, mental health, substance use disorder treatment, and preventive services.
Children in Vermont are covered through the Dr. Dynasaur program, which combines Medicaid and CHIP. Dr. Dynasaur covers children and pregnant individuals at much higher income thresholds than adult Medicaid — children in families earning well over 300% of the federal poverty level, and pregnant Vermonters at generous levels as well. Exact percentages are adjusted over time, so verify the current thresholds with Vermont Health Connect. The program provides full medical, dental, and vision coverage with minimal or no cost-sharing.
Vermont’s approach to public coverage is notably expansive. The state invests heavily in keeping its population insured, and the combination of Medicaid, Dr. Dynasaur, and premium assistance creates fewer gaps than in most other states. You can apply for Medicaid and Dr. Dynasaur at any time through Vermont Health Connect — there is no enrollment window for these public programs.
How to Enroll in Health Insurance in Vermont
Vermont Health Connect’s Open Enrollment Period typically runs from November 1 through January 15, though the state has adjusted the dates in some years, so confirm the current window. Plans selected by mid-December generally take effect January 1; those chosen later in the window usually start the following month.
Special Enrollment Periods let you sign up outside Open Enrollment if you have a qualifying life event such as losing other coverage, moving to Vermont, getting married, having a baby, or a significant income change. You typically have 60 days after the event to enroll. Medicaid and Dr. Dynasaur, again, have no enrollment window at all.
You can apply online through the Vermont Health Connect portal, by phone at 1-855-899-9600, or in person with the help of certified navigators and assisters. Vermont has a robust network of community organizations that provide free enrollment help, which can be valuable for comparing plans and understanding your subsidy options — especially in a year when the subsidy rules may be changing.
If you are self-employed or run a small business, Vermont Health Connect is where you shop. Small employers can find group plans through the exchange as well; Vermont requires small-group coverage to be purchased through it.
Vermont’s Healthcare Reform History
Vermont made national headlines in 2011 when it passed Act 48, a law intended to create a single-payer healthcare system called Green Mountain Care. The plan would have provided universal coverage to all state residents, funded through payroll and income taxes, and largely eliminated private insurance for primary and preventive care.
Governor Peter Shumlin ultimately shelved the plan in 2014, citing the tax increases required — an 11.5% payroll tax and additional income taxes were projected — as too burdensome. While single-payer did not come to fruition, the effort reflected Vermont’s approach to healthcare policy and left behind infrastructure, including the Vermont Health Connect exchange.
This history shapes the current landscape. Health insurance in Vermont is sold within a regulatory environment that prioritizes coverage, rate review, and consumer protection, and the state’s commitment to near-universal coverage shows in its consistently low uninsured rate. For more on how state-level policy decisions affect insurance markets nationwide, visit our healthcare policy guide.
Provider Networks and Access
Vermont’s healthcare system revolves around the University of Vermont Medical Center in Burlington, the state’s largest hospital and only academic medical center. Dartmouth Health (Dartmouth Hitchcock Medical Center), just across the border in New Hampshire, also serves many Vermont residents, particularly in the Upper Valley region.
Smaller hospitals and community health centers are distributed across the state, but like other rural New England states, Vermont faces provider shortages in some areas. Primary care access is generally good, but specialist wait times can be longer than in metropolitan areas.
Telehealth has expanded significantly in Vermont, with state law requiring insurers to cover telehealth services. This has improved access for residents in the Northeast Kingdom and other remote areas. Always confirm that a plan’s network includes the providers and facilities you rely on before you finalize enrollment.
Frequently Asked Questions
What is Vermont Health Connect?
Vermont Health Connect is the state’s official health insurance marketplace, where individuals, families, and small businesses shop for, compare, and enroll in health plans. It also handles Medicaid and Dr. Dynasaur applications. All individual-market plans in Vermont must be sold through this exchange.
Did Vermont create a single-payer healthcare system?
No. Vermont passed legislation in 2011 to create a single-payer system but abandoned the effort in 2014 because of the projected tax burden. The state kept its state-based marketplace and continues to pursue near-universal coverage through existing ACA structures.
How much does health insurance cost in Vermont?
Vermont has some of the higher marketplace premiums in the country, and 2026 rates rose after state rate review. Because figures change every year, check the current premium for your age and county in the Vermont Health Connect plan-comparison tool. Federal premium tax credits and state premium assistance reduce costs for eligible enrollees, but note that the enhanced federal subsidies were scheduled to expire after 2025 — verify the current rules.
What is Dr. Dynasaur?
Dr. Dynasaur is Vermont’s program covering children and pregnant individuals through a combination of Medicaid and CHIP. It provides comprehensive health, dental, and vision coverage at little to no cost, with income thresholds well above adult Medicaid. Confirm the current percentage limits with Vermont Health Connect.
Which insurance companies sell plans on Vermont Health Connect?
Blue Cross Blue Shield of Vermont and MVP Health Care are the primary insurers on Vermont Health Connect. Both offer plans across multiple metal tiers, and all individual-market plans in the state are sold exclusively through the exchange.
Where can I get free help enrolling?
Vermont Health Connect offers free help by phone at 1-855-899-9600 and through certified navigators and assisters at community organizations statewide. They can walk you through plan comparisons, subsidy eligibility, and Medicaid or Dr. Dynasaur applications at no charge.
The Bottom Line
Vermonters buy coverage in one of the most consumer-friendly regulatory environments in the country. Between the Vermont Health Connect marketplace, expansive Medicaid, the Dr. Dynasaur program for children, and state premium assistance, the Green Mountain State provides more pathways to affordable coverage than most. The wrinkle for 2026 is cost: premiums rose, and the enhanced federal subsidies that many enrollees rely on were scheduled to expire after 2025. Use Open Enrollment (or a Special Enrollment Period if you qualify) to compare plans, apply for every subsidy you may be eligible for, confirm the current subsidy rules, and check that your provider network meets your needs.
Vermont runs its own marketplace, Vermont Health Connect, where all individual and small-group plans must be bought (Blue Cross Blue Shield of Vermont and MVP are the carriers). Medicaid covers adults to 138% of the federal poverty level and Dr. Dynasaur covers children and pregnant Vermonters well above that. Vermont has relatively high premiums, and the enhanced federal ACA subsidies were scheduled to expire after 2025 — so verify the current subsidy rules and 2026 rates before enrolling, and use the free certified help (1-855-899-9600) if you need it. This is general education, not insurance advice; confirm every figure with Vermont Health Connect.
Sources
- Vermont Health Connect (portal.healthconnect.vermont.gov) — state marketplace, plan-comparison and eligibility tools, and official help line 1-855-899-9600
- KFF — Inflation Reduction Act enhanced premium tax credits scheduled to end after 2025 and the projected 2026 premium increase if they expire
- Vermont Department of Financial Regulation and the Green Mountain Care Board — rate review and 2026 approved marketplace rates (verify current figures)
- U.S. Census Bureau — Vermont’s uninsured rate
- HealthCare.gov / Centers for Medicare & Medicaid Services (CMS) — ACA metal tiers, cost-sharing reductions, and the open enrollment framework