Editor’s note: This oped is by Susan W. Besio, Ph.D., the director of the Office of Vermont Health Access.
On March 23, 2010, federal health care reform known as the Patient Protection and Affordable Care Act was signed into law. The law will be phased in over the next five years, with some changes retroactive to January, 2010. This article is the first in a series on how federal reforms will dovetail with existing programs in Vermont.
Vermonters can be proud of the fact that numerous consumer protections found in the new law have been in place in our state for several years. Many states are scrambling to develop plans like those we offer under Green Mountain Care (See below).
Many Vermonters – both insured and uninsured – are unclear about how the new health reform law changes will affect them. There is much good news in this law. The first real impact is changes to how private insurance works for young adults.
So what does this new law mean to you if you just graduated, are no longer a full-time student in high school or college, or you became 19 years of age? Starting Sept. 23, the new federal law will require that health plans begin the process of allowing young adults up to age 26 to continue to be covered on their parents’ plans if they so choose.
The start date varies depending upon when your family plan renews after Sept. 23, 2010. For many people the renewal date will occur Jan. 1, 2011. For others it could take up to a year. Even before the law takes effect, some plans are allowing dependents under age 26, who are currently on their parents’ plan, to remain on their parents’ plans. Check with you or your parent’s health plan to learn how this provision affects you and go to www.GreenMountainCare.org/updates for more information.
And this website also has important information for all Vermonters who are uninsured. Over 47,000 Vermonters lack health insurance and half of these individuals are eligible for health insurance under Green Mountain Care, but are not enrolled.
Green Mountain Care is a family of low-cost and free health coverage programs for uninsured Vermonters offered by the state of Vermont and its partners. Green Mountain Care includes plans such as Catamount Health, Vermont Health Access Plan, Dr. Dynasaur, Medicaid, and a number of pharmacy assistance and premium assistance programs. Plan eligibility and cost is based on household size and income. Typically there is a 12-month waiting period for these plans, but there are exceptions.
Green Mountain Care Plans
1. Catamount Health Plan – There is no upper income limit for Catamount but Vermonters earning roughly $20,000 to $32,000 may be eligible for premium assistance. Catamount Health is offered through BlueCross BlueShield or MVP Health Care. However, premium assistance to help pay for Catamount is available through Green Mountain Care making premiums as low as $60 per month. If you think you may be eligible for premium assistance start by applying through Green Mountain Care.
2. Premium Assistance for Employer-Sponsored Insurance Premium Assistance is also for Vermonters earning around $20,000 to $32,000 per year. If you have access to insurance at work, but are not yet enrolled you may be eligible for assistance to help you pay for insurance at work, making your premium as low as $60 per month. If you think you may be eligible for premium assistance, start by applying through Green Mountain Care.
3. Vermont Health Access Plan is for Vermonters earning around $20,000 or less per year, and the cost is $50 or less per month.
4. If you are age 21 and older, the state does not consider your parents’ income when determining your eligibility for these plans even if you live at home. If you are under 21, and need information about how your income is calculated, call 1-800-250-8427 or visit www.GreenMountainCare.org. A helpful screening tool is available to point you to the application that is right for you.
5. Green Mountain Care also has several prescription assistance programs as well as plans for children, teenagers, pregnant women and people with disabilities.
As we continue to learn more about how federal health care reform will impact Vermonters we will bring this information to you and your communities. With over 47,000 of our friends and neighbors living without health insurance, there is more work to be done because the state of Vermont believes every Vermonter should have access to the coverage they need to stay healthy.
