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Living with Diabetes
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Vermont
The following information details health insurance and assistance programs available to uninsured people in Vermont.
Vermont Department of Banking, Insurance, Securities, and Health Care Administration (BISHCA) - (800) 631-7788
Residents of Vermont cannot be turned down from purchasing an individual health insurance policy regardless of any health conditions they may have. This is called guaranteed issue. In addition, residents cannot be charged a higher rate for their policy because of their health status. This is called community rating. The BISHCA may be able to help you locate names and phone numbers of possible insurers who will sell you this type of policy.
If you are self-employed with no employees, you can choose to purchase a small group policy on your own. However, you can also purchase an individual policy, as mentioned above. You must be able to show proof of residency in the state of Vermont.
Vermont Office of Health Care Ombudsman - (800) 917-7787
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Division of Health Care Administration. They may be able to provide you with assistance in reaching a conclusion.
Vermont Medicaid - (800) 250-8427
Medicaid is available to anyone who meets income and eligibility criteria. Even if your income meets the criteria, you must fall into one of the eligibility categories in order to qualify. Contact your state Medicaid program for more information.
Dr. Dynasaur - State Children’s Health Insurance Program - (800) 250-8427
Dr. Dynasaur is the health insurance program designed to provide health insurance to children and teens under age 19 as well as pregnant women whose families may have too great an income to qualify for Medicaid, but who may not be able to afford health insurance. Visit the Web site to find out more about the income guidelines.
Vermont Health Access Plan (VHAP) - Health insurance program, prescription drug program, etc. - (800) 250-8427
The Vermont Health Access Plan provides health insurance coverage to adults. It includes a variety of services. The VHAP plan also includes a pharmacy and eyeglass-only benefit for adults who qualify (VHAP Pharmacy). In addition, programs that provide maintenance drugs for elderly or disabled individuals who do not qualify for Medicaid are available through the VScript and VScript-expansion programs. Contact VHAP for more information on all of these programs.
Pre-Existing Condition Insurance Plan (PCIP)
Through the Affordable Care Act, uninsured people with diabetes who have been continually uninsured for six months or more will be able to access insurance through a new program called the Pre-Existing Condition Insurance Plan (PCIP). PCIP, which is administered by either your state or the U.S. Department of Health and Human Services, will be available until the provisions banning discrimination based on pre-existing conditions are fully implemented in 2014.
PCIP will be available in every state, but the program may vary depending on the state. Currently, many states run programs, often called “high risk pools,” to offer insurance for those with pre-existing conditions. To build on what states are already doing, states can either run a new program with resources from the Affordable Care Act or rely on the U.S. Department of Health and Human Services to provide coverage. Please check out the State Plans page to learn more about how PCIP works in your state. http://www.pcip.gov/StatePlans.html
Local Community Health Clinics
If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.
