Losing Medicaid? We’re Here to Help.

Medicaid renewals have restarted for Vermonters. In an effort to help everyone continue to have health care coverage, we’re ready to help Vermonters who are no longer Medicaid eligible make the transition to another health plan. 

If you’re losing Medicaid coverage, we can help you find out if you can get money from the government to lower your monthly health insurance bill. With a premium subsidy, you may be able to get coverage for free or at a greatly reduced cost. We’ll also help you select one of our health plans that best meets your needs.

Why Is This Happening?

During the pandemic, the federal government required Vermont and other states to let most people receiving Medicaid benefits stay on the program, even if they may no longer be eligible. That federal requirement has ended and Vermont is again checking eligibility through a renewal process.
It’s estimated that 60 percent of Vermonters currently on Medicaid will need to submit information to the state so that it can be determined if their Medicaid benefits can continue.

What to Expect

Over the next year, Vermont Health Connect will mail renewal notices to many current Medicaid enrollees. They will be asked to: 

• Verify that the information Medicaid has about them is correct.
• Change any wrong information and provide missing information.
• Explain the reasons why their income has changed (such as getting a new job).
• Disclose if they have a job that offers health insurance benefits.

Signed renewal forms will need to be returned to Vermont Health Connect by the due date printed on the form. If it’s not returned in time, the person may lose their Medicaid benefits.

The state Medicaid program will review the renewal form and determine if the person is still eligible for benefits. In some cases, additional information will be requested, such as copies of pay stubs. A letter will be sent to notify the person of the decision. If a person is losing Medicaid benefits, they are encouraged to purchase a new health plan as soon as possible to avoid a gap in coverage.

If you or a family member is on Medicaid, it is important to make sure that Vermont Health Connect has the correct mailing address, email address, and phone number so that the renewal notice and reminders will arrive without delay.

Simple Steps to Subsidies

If you lose Medicaid coverage, and can’t get affordable, job-based health coverage from your employer, you may qualify for financial help (a subsidy) through Vermont Health Connect to buy insurance from us or another company. Here’s what to do:

1. Estimate available financial help. You can easily get a good idea how much financial help, if any, you can qualify for. You can do this by calling Vermont Health Connect at (855) 899-9600 or using the plan finder tool on our website. If you prefer, we’ll be glad to help you with this. Call us at (800) 255-4550 (TTY: 711) or email us at consumersupport@bcbsvt.com. We’re available from 8 a.m. to 4:30 p.m. weekdays, except holidays.
2. Shop for a health plan. Once you know how much financial help you can get each month, you can shop for a health plan that meets your budget and medical needs. You can do this through Vermont Health Connect, or we’ll be glad to go over plan options and help you select the most appropriate plan that we offer. We can make sure you’ll still have access to your primary care provider and other doctors, and your pharmacy benefits.
3. Enroll through Vermont Health Connect. Sign up for your preferred health plan online or by calling Vermont Health Connect at (855) 899-9600. You can also find a local assister to help you in-person. (We’re unable to help with this step, as all subsidy enrollments must be done through Vermont Health Connect.)
4. Pay your first invoice. After Vermont Health Connect completes your enrollment, if you’ve chosen one of our plans, you’ll receive an invoice from us. On the bill, you’ll see the regular monthly premium, your subsidy amount, and the amount remaining that you must pay. Your coverage will not be active until we receive full payment of the amount due.

We know that changing health insurance plans can be stressful and confusing, so we want to do everything we can to make it easier for you. Our Vermont-based team is here to give you local support. Please contact us if you’d like us to help or answer any questions that you have.