Healthcare Assistance for Single Mothers in Vermont
Vermont Healthcare Assistance for Single Mothers [2025]: Medicaid, Dr. Dynasaur (CHIP) & More
Last updated: September 2025
This is a practical, Vermont‑specific guide for single moms who need healthcare now. Every fact below links to an official state, federal, or established nonprofit source. Where income limits use “% of the Federal Poverty Level (FPL),” we’ve converted them into actual dollar amounts using the official 2025 HHS poverty guidelines.
Quick help (read this first)
- Apply or check eligibility online now at Vermont Health Connect. If you’re likely eligible, you can enroll in Medicaid/Dr. Dynasaur any time; marketplace plans enroll during Open Enrollment or after qualifying life events. Call 855‑899‑9600 if you prefer phone help. Vermont Health Connect — How to apply/eligibility tools and Plan Comparison Tool. (info.healthconnect.vermont.gov)
- Pregnant or within 12 months after pregnancy? Dr. Dynasaur covers you with $0 premiums and Vermont Medicaid guarantees a full 12 months postpartum coverage. Medicaid SPA approvals and Vermont’s Dr. Dynasaur overview. (info.healthconnect.vermont.gov, medicaid.gov)
- No car to get to appointments? Medicaid will set up rides. Call the statewide broker at 833‑387‑7200 (Vermont Public Transportation Association). Schedule at least 2 business days ahead. VPTA Medicaid NEMT page. (vpta.net)
- Struggling with medical bills from a hospital? Vermont law requires large hospitals to give free care at ≤250% FPL, at least 40% discounts up to 400% FPL, and catastrophic help up to 600% FPL. Ask the hospital’s financial assistance office. 18 V.S.A. § 9482. (legislature.vermont.gov)
- Need free/low‑cost care today? Try a nearby free or community clinic:
• Good Neighbor Health Clinic (Upper Valley): 802‑295‑1868 (medical) / 802‑295‑7573 (dental)
• People’s Health & Wellness (Barre): 802‑479‑1229
• Open Door Clinic (Addison County): 802‑388‑0137
These clinics can also help with Medicaid/VHC enrollments. (goodneighborhealthclinic.org, phwcvt.org, opendoormidd.org, vtfreeclinics.org)
Why this guide is different (and what other pages miss)
Most top search results are generic benefits lists or outdated blog posts. We closed the gaps by:
- Using Vermont’s current 2025 income limits, FPL numbers, and postpartum coverage rules, with direct links and exact dollar amounts. (aspe.hhs.gov, info.healthconnect.vermont.gov, medicaid.gov)
- Flagging the current status of Dr. Dynasaur premiums (suspended) and linking to Vermont’s own pages. (info.healthconnect.vermont.gov)
- Including statewide non‑emergency medical transportation (NEMT) phone and scheduling rules. (vpta.net)
- Explaining Vermont’s hospital financial‑assistance law (free/discounted care mandates). (legislature.vermont.gov)
Quick Reference Cheat Sheet (Vermont, 2025)
| Program | Who it helps | 2025 income limit (examples) | Cost to you | How to apply | Key link |
|---|---|---|---|---|---|
| Medicaid for Adults (MCA) | Single moms age 19–64 | Effective adult limit ~138% FPL. Monthly examples: HH1 1,799.75∗∗,HH2∗∗1,799.75**, HH2 **2,432.25, HH3 3,064.75∗∗,HH4∗∗3,064.75**, HH4 **3,697.25 | Usually $0 premium; small copays | Apply anytime via VHC or call 855‑899‑9600 | Medicaid & Dr. Dynasaur at VHC. Income table: VTLawHelp. (info.healthconnect.vermont.gov, vtlawhelp.org) |
| Dr. Dynasaur (pregnancy) | Pregnant Vermonters | Effective limit ~213% FPL. Monthly examples: HH1 2,777.88∗∗,HH2∗∗2,777.88**, HH2 **3,754.13, HH3 4,730.38∗∗,HH4∗∗4,730.38**, HH4 **5,706.63 | $0 premiums; 12‑month postpartum | Apply anytime via VHC 855‑899‑9600 | VHC overview. Income table: VTLawHelp. (info.healthconnect.vermont.gov, vtlawhelp.org) |
| Dr. Dynasaur (children <19) | Your kids | Effective limit ~317% FPL. Monthly examples: HH1 4,134.21∗∗,HH2∗∗4,134.21**, HH2 **5,587.13, HH3 7,040.04∗∗,HH4∗∗7,040.04**, HH4 **8,492.96 | Child premiums currently suspended | Apply anytime via VHC 855‑899‑9600 | VHC Dr. Dynasaur page. Premiums suspended note. (info.healthconnect.vermont.gov) |
| Marketplace Plans (VHC) | Over‑income for Medicaid | Open Enrollment: Nov 1–Jan 15. 2025 example: 40,000∗∗single=Goldplanfor“<∗∗40,000** single = Gold plan for “<**1/mo”; family of 4 at 100,000∗∗≈∗∗100,000** ≈ **155.37/mo | Big premium and cost‑sharing help in 2025 | Apply at VHC; phone 855‑899‑9600 | DVHA Open Enrollment news and VHC site. (dvha.vermont.gov) |
| VPharm | Moms on Medicare Part D | ≤225% FPL (e.g., HH1 35,213/yr∗∗,HH2∗∗35,213/yr**, HH2 **47,588/yr) | Small monthly premium; helps pay Part D | Mail app or use DVHA doc uploader | Statute §2074 and DVHA pharmacy resources. (legislature.vermont.gov, dvha.vermont.gov) |
| Healthy Vermonters | Discounts on Rx | ≤350% FPL (all), or ≤400% FPL if 65+ or disabled | Discounts (no premium) | DVHA prescription assistance page | Statute §2003; DVHA page. (legislature.vermont.gov, dvha.vermont.gov) |
| WIC | Pregnant/postpartum, infants, kids <5 | ≤185% FPL (USDA 2025–26) | Food benefits; nutrition supports | Text “Apply” to 844‑839‑8942 or call 800‑464‑4343 | VT Dept. of Health & USDA FNS. (healthvermont.gov, fns.usda.gov) |
| NEMT rides (Medicaid) | Medicaid members | Must lack other transport | $0; schedule ≥2 business days ahead | Call 833‑387‑7200 | VPTA Medicaid page. (vpta.net) |
Notes: Adult/pregnancy/child limits shown as “effective” use the standard 5% MAGI disregard many agencies apply. Vermont’s program rules list base thresholds of 133% (adults), 208% (pregnant), and 312% (children); with the 5% disregard these functionally equal 138%, 213%, 317%. See VHC program descriptions and VTLawHelp’s 2025 monthly chart. (info.healthconnect.vermont.gov, vtlawhelp.org)
Start here: the fastest path to coverage
- Use the 2025 Plan Comparison Tool to see, in minutes, if you or your kids likely qualify for Medicaid/Dr. Dynasaur or for subsidized marketplace plans. Then apply online or call 855‑899‑9600 for help. If you prefer in‑person support, VHC’s Assister Directory can book you with a certified navigator at a local hospital/clinic or nonprofit. (info.healthconnect.vermont.gov)
- Open Enrollment to buy a marketplace plan is every year Nov 1 – Jan 15. Enroll by Dec 15 for coverage starting Jan 1; enroll by Jan 15 for Feb 1 start. Medicaid/Dr. Dynasaur are year‑round. (dvha.vermont.gov, info.healthconnect.vermont.gov)
- In 2025, subsidies are unusually strong. The state reports 95% of enrollees get financial help, and many saw “Gold for less than $1/month” at common income levels. Don’t assume it’s unaffordable—check. (dvha.vermont.gov)
What to do if this doesn’t work: call the Vermont Health Connect line at 855‑899‑9600, use the Assister Directory for free in‑person help, or ask the Office of the Health Care Advocate at 800‑917‑7787 to troubleshoot denials and appeals. (info.healthconnect.vermont.gov, vtlawhelp.org)
Vermont Medicaid and Dr. Dynasaur (CHIP)
Most important action
- Apply through Vermont Health Connect now (online or call 855‑899‑9600). If you qualify, coverage can be active the first of the month after approval, sometimes earlier for urgent needs. Vermont must process most applications within 45 days (disability‑based up to 90 days) under federal timeliness rules. (info.healthconnect.vermont.gov, law.cornell.edu)
Who qualifies in 2025 (with real numbers)
Vermont posts base thresholds (adults 133% FPL; pregnant 208% FPL; children 312% FPL). With the standard 5% disregard many households effectively qualify up to 138%/213%/317%. For quick decisions, use the “effective” monthly limits mothers actually see at enrollment (from VTLawHelp’s 2025 chart): (info.healthconnect.vermont.gov, vtlawhelp.org)
Income limits — monthly (effective with 5% disregard), 2025
| Household size | Adults (138% FPL) | Pregnant (213% FPL) | Children <19 (317% FPL) |
|---|---|---|---|
| 1 | $1,799.75 | $2,777.88 | $4,134.21 |
| 2 | $2,432.25 | $3,754.13 | $5,587.13 |
| 3 | $3,064.75 | $4,730.38 | $7,040.04 |
| 4 | $3,697.25 | $5,706.63 | $8,492.96 |
| 5 | $4,329.75 | $6,682.88 | $9,945.88 |
| 6 | $4,962.25 | $7,659.13 | $11,398.79 |
| 7 | $5,594.75 | $8,635.38 | $12,851.71 |
| 8 | $6,227.25 | $9,611.63 | $14,304.63 |
Source: Vermont Legal Aid/VTLawHelp 2025 chart. Vermont Health Connect displays base thresholds (133/208/312 FPL). (vtlawhelp.org, info.healthconnect.vermont.gov)
- Cost: Adult Medicaid typically has 0premium.Somesmallcopaysapply(seebelow).Dr.Dynasauris∗∗freeforpregnantpeople∗∗;andVermonthassuspendedchildpremiums“indefinitely,”somostfamiliespay∗∗0 premium. Some small copays apply (see below). Dr. Dynasaur is **free for pregnant people**; and Vermont has suspended child premiums “indefinitely,” so most families pay **0** monthly in 2025. (info.healthconnect.vermont.gov)
- Postpartum coverage: A full 12 months of continuous coverage after pregnancy; Vermont also exempts postpartum members from cost sharing. (medicaid.gov)
What’s covered and key costs (Medicaid/Dr. Dynasaur)
| Benefit | What it means for you | Typical member cost |
|---|---|---|
| Primary & specialty care, hospital, maternity/newborn, mental health & substance use, Rx, labs, preventive care | Full essential health benefits | Many services $0; small copays on some services |
| Prescriptions | Tiered small copays tied to price | **1∗∗(<1** (<30), 2∗∗(2** (30–49.99),∗∗49.99), **3 (≥$50) |
| Dental (Adults 21+) | Cleanings & exams twice per year don’t count against the cap; emergency services covered | 3∗∗pervisit;adultannualcap∗∗3** per visit; adult annual cap **1,500 (pregnant & postpartum are exempt from cap) |
| Outpatient hospital visit fee | Facility‑side charge | $3 per day per hospital |
| Transportation to Medicaid appointments | Bus/van/volunteer driver | $0; schedule rides ≥2 business days ahead via 833‑387‑7200 (VPTA) |
Sources: DVHA member page for covered services and copays; Adult dental cap and exemptions codified in statute and SPA. NEMT details via DVHA/VPTA. (dvha.vermont.gov, legislature.vermont.gov, vpta.net)
Real‑world example:
- You’re a mom with 2 kids (HH3) earning 2,900/month∗∗.That’sundertheadult1382,900/month**. That’s under the adult 138% limit (**3,064.75), so you get adult Medicaid; your kids qualify for Dr. Dynasaur. Expect 0premiumsandonlysmall0 premiums and only small 1–$3 Rx copays. If you don’t have a ride to the pediatrician, call 833‑387‑7200 2 business days ahead. (vtlawhelp.org, vpta.net)
How to apply (fastest path):
- Online or phone: apply with Vermont Health Connect (portal or call 855‑899‑9600). Use the Document Uploader if they ask for proof. Mail address for paper forms is on that page. (info.healthconnect.vermont.gov, dvha.vermont.gov)
Required documents (you won’t need all of these every time):
- Proof of identity and Vermont residency (ID, lease, mail).
- Proof of income (recent paystubs, award letters).
- Pregnancy verification (if applying for pregnancy coverage).
- SSNs for applicants who have one (non‑citizens have options—see the non‑citizen section below).
Use DVHA’s secure Document Uploader to send proofs from your phone. (dvha.vermont.gov)
Timelines and what to expect:
- Most Medicaid decisions must be made within 45 days of application (or 90 days if based on disability). If your info is complete and can be verified electronically, it often moves faster; delays usually happen when proof is missing or mismatched. (law.cornell.edu)
Common problems we see:
- Missing proof of income or residency → upload clear photos of full documents (front/back if needed).
- Not reporting changes (new job, move) → update within 30 days to avoid closures or debt.
- Scheduling NEMT rides late → call ≥2 business days in advance, cancel rides you can’t make (3 no‑shows triggers confirm‑by‑noon policy). (vpta.net)
What to do if this doesn’t work:
- Ask a certified Assister to submit/expedite your case; or call the Office of the Health Care Advocate at 800‑917‑7787 for free help with denials, billing issues, or appeals. (info.healthconnect.vermont.gov, vtlawhelp.org)
Marketplace coverage (Vermont Health Connect) when you’re over Medicaid limits
Most important action
- Use the Plan Comparison Tool for a custom 2025 estimate and then enroll through VHC (that’s how you get subsidies). Call 855‑899‑9600 if you prefer human help. (info.healthconnect.vermont.gov)
What you need to know for 2025:
- Open Enrollment ran Nov 1, 2024 – Jan 15, 2025. If you missed it, certain life events (loss of Medicaid, move, new baby, etc.) trigger a 60‑day Special Enrollment Period. For 2026 coverage, OE will again run Nov 1 – Jan 15. (info.healthconnect.vermont.gov)
- Vermont reports record enrollment and unusually high subsidies in 2025: a single adult at 40,000/year∗∗couldgetalowest‑costGoldplanforlessthan∗∗40,000/year** could get a lowest‑cost Gold plan for less than **1/month; a family of four at 100,000/year∗∗about∗∗100,000/year** about **155.37/month. (dvha.vermont.gov)
Reality check:
- Even with a low premium, look closely at deductibles and out‑of‑pocket caps. Gold plans usually mean lower costs when you actually use care. If you expect regular visits, mental health care, or medications, compare total yearly cost, not just the monthly premium. (info.healthconnect.vermont.gov)
What to do if this doesn’t work:
- If marketplace premiums are still too high, ask the hospital about financial assistance (see below) and get sliding‑fee primary care at a community health center or free clinic while you try again at the next SEP/Open Enrollment. (legislature.vermont.gov, phwcvt.org)
Prescription cost help (VPharm and Healthy Vermonters)
Most important action
- If you (or a parent you care for) are on Medicare, apply for VPharm. If you don’t have Rx coverage or hit a cap, look at Healthy Vermonters for discounts. Start at DVHA’s Prescription Assistance page. (dvha.vermont.gov)
Key rules and 2025 income limits:
- VPharm income limit is ≤225% FPL (state statute). That’s about 35,213/year∗∗(HH1)or∗∗35,213/year** (HH1) or **47,588/year (HH2). It wraps around your Part D: helps with premiums and cost‑sharing for many drugs. Expect a small monthly premium (varies by tier). (legislature.vermont.gov)
- Healthy Vermonters gives Rx discounts with no premium. Income ≤350% FPL for most; ≤400% FPL if 65+ or disabled. (Examples, HH1: 54,775/yr∗∗at35054,775/yr** at 350% and **62,600/yr at 400%.) (legislature.vermont.gov)
How to apply:
- Use the DVHA Document Uploader or mail the application listed on the Prescription Assistance page. For questions, call the DVHA Customer Support Center (855‑899‑9600) or Green Mountain Care Member Services (800‑250‑8427). (dvha.vermont.gov)
What to do if this doesn’t work:
- Ask your prescribing clinic if they participate in 340B pharmacy programs (discounts) and look into the UVM Health Network’s Health Assistance Program (can waive pharmacy copays for eligible families; phone 802‑847‑6984 or 888‑739‑5183). (uvmhealth.org)
You First (free breast & cervical cancer screenings + heart health)
Most important action
- If you’re 21+ and need breast/cervical screening, apply to You First. You may qualify up to 250% FPL (e.g., HH1 39,125/yr∗∗,HH3∗∗39,125/yr**, HH3 **66,625/yr). If cancer is found through screening pathways, Medicaid can cover treatment (“Breast and Cervical Cancer Treatment Program”). (healthvermont.gov)
How to apply:
- Start on the VT Department of Health’s You First page and contact the program for intake support. (healthvermont.gov)
What to do if this doesn’t work:
- Ask a free clinic (Barre, WRJ, Addison—numbers above) to help you get the screening elsewhere, or use the hospital’s financial assistance while you re‑apply. (phwcvt.org, goodneighborhealthclinic.org)
WIC — food, formula, breastfeeding and nutrition support (pregnant and kids under 5)
Most important action
- Apply three easy ways: text Apply to 844‑839‑8942, call 800‑464‑4343, or start online. WIC uses 2025–26 income rules up to 185% FPL and accepts families who are on Medicaid/SNAP/TANF. (healthvermont.gov, fns.usda.gov)
What you get:
- Monthly food benefits on a WIC card, breastfeeding support, nutrition counseling, and referrals. Many appointments are remote by phone/video. (healthvermont.gov)
What to do if this doesn’t work:
- Ask your local Health Department district office (see Quick Contacts table below) or call Vermont 2‑1‑1 to locate food shelves and emergency help while WIC is processing. (women.vermont.gov)
Mental health, substance use, and crisis support (24/7)
- Call or text 988 for the Suicide & Crisis Lifeline (free, confidential). Vermont also offers mobile crisis response statewide—find your local mobile crisis agency at gethelpvt.org. (mentalhealth.vermont.gov, gethelpvt.org)
- Local Designated Agency crisis lines operate 24/7 in every county (Howard Center First Call in Chittenden: 802‑488‑7777; others listed by the Vermont Psychological Association). If you’re not sure who to call, dial 988. (vermontpsych.org)
- Peer support/warm line: (833) 888‑2557 (VT Support Line). (mentalhealth.vermont.gov)
What to do if this doesn’t work:
- Go to the nearest ER, or call 911 for immediate safety. You won’t be turned away for inability to pay; hospital financial assistance rules apply (see below). (legislature.vermont.gov)
Transportation to care (Medicaid NEMT)
Most important action
- If you have Medicaid and no reliable ride, call 833‑387‑7200 to schedule transportation. Call at least 2 business days in advance. Three no‑shows triggers a confirm‑by‑noon requirement. Pharmacy trips may be covered when delivery isn’t available. For long trips (>100 miles) or out‑of‑state visits, your provider must submit referral forms for approval. (vpta.net)
What to do if this doesn’t work:
- Ask your clinic’s social worker for gas card mileage reimbursement forms, or call VPTA back and request a volunteer driver option. If repeatedly denied, request the written Notice of Decision and appeal (ask the Health Care Advocate: 800‑917‑7787). (vpta.net)
Hospital bills and financial assistance: Vermont’s strong protections
Vermont law requires “large health care facilities” to offer robust patient financial assistance:
- Uninsured with income ≤250% FPL → at least 100% discount (free care).
- Uninsured with 250–400% FPL → at least 40% discount.
- Insured patients with out‑of‑pocket costs and income ≤250% FPL → out‑of‑pocket waived.
- Insured 250–400% FPL → at least 40% discount on your out‑of‑pocket.
- Catastrophic help ≤600% FPL if bills exceed 20% of your income. (legislature.vermont.gov)
Examples and contacts:
- UVM Health Network Health Assistance Program can waive pharmacy costs and help with glasses/equipment for eligible families. Call 802‑847‑6984 or 888‑739‑5183. (uvmhealth.org)
- Southwestern Vermont Medical Center (Bennington) provides financial help up to 400% FPL and catastrophic aid up to 600% FPL (billing 802‑447‑4500). (svmc.org, svhealthcare.org)
What to do if this doesn’t work:
- Ask for the hospital’s “Plain Language Summary,” apply again with full paperwork (recent paystubs, tax return, proof of Vermont address), and set up a $0 or low‑payment plan while they review. If denied, appeal and request the hospital’s “amounts generally billed” calculation; call the Health Care Advocate (800‑917‑7787). (cvmc.org)
Community clinics and enrollment help (free/low‑cost)
- Good Neighbor Health Clinic & Red Logan Dental (Upper Valley): medical 802‑295‑1868; dental 802‑295‑7573. (goodneighborhealthclinic.org)
- People’s Health & Wellness Clinic (Barre): 802‑479‑1229. (phwcvt.org)
- Open Door Clinic (Addison County): 802‑388‑0137; health insurance assister 802‑989‑6872. (opendoormidd.org)
These clinics can also help you apply for Medicaid/Dr. Dynasaur or marketplace coverage and navigate hospital financial assistance. (vtfreeclinics.org)
Diverse communities: targeted tips and resources
- LGBTQ+ single mothers: You First welcomes LGBTQ+ Vermonters and connects you to inclusive breast/cervical screenings and heart‑health supports. Pair with Medicaid/Dr. Dynasaur for full coverage. (healthvermont.gov)
- Single mothers with disabilities or disabled children: Medicaid covers many services with EPSDT for kids under 21 (medically necessary services beyond standard limits). For Medicare + low income, add a Medicare Savings Program (QMB/SLMB/QI/QDWI)—2025 monthly examples for QMB: single ≤**1,305∗∗,couple≤∗∗1,305**, couple ≤**1,763**. Apply through DVHA. (dvha.vermont.gov)
- Veteran single moms: If you served, apply for VA health care (may include maternity/newborn care policies and community‑care referrals). Use VA plus Vermont programs as needed. (Check va.gov for eligibility specifics.)
- Immigrant/refugee single moms: “Public charge” does NOT penalize applying for Medicaid (except for long‑term institutional care). Vermont’s Immigrant Health Insurance Plan (IHIP) covers pregnant people and children <19 who can’t get Medicaid due to immigration status—apply with form 205IHIP or 205ALLMED. (info.healthconnect.vermont.gov, dvha.vermont.gov)
- Tribal citizens: If you’re Abenaki or another federally recognized tribe member living in VT, you still qualify for VHC/Medicaid like other residents. Ask about Indian Health Service/Tribal program coordination if you use those services.
- Rural moms with limited access: Use NEMT for long‑distance specialty visits (>100 miles require prior approval). Ask about lodging/meal reimbursement when medically necessary. (vpta.net)
- Single fathers raising children: The same programs apply—Dr. Dynasaur for kids, Medicaid for adults, WIC for kids under five, and You First for eligible breast/cervical screening if medically appropriate.
- Language access: DVHA and VHC offer interpreter services; request at application or when calling 855‑899‑9600. Many pages include translated materials. (info.healthconnect.vermont.gov)
What to do if this doesn’t work:
- Call Vermont 2‑1‑1 for an interpreter‑assisted referral to local clinics, legal aid, and social services, or the Health Care Advocate (800‑917‑7787) if your application is stuck. (women.vermont.gov)
Application checklist (print or screenshot)
- Photo ID and proof you live in Vermont (license, lease, mail)
- Proof of income (last 4 weeks of paystubs, unemployment, child support if counted, award letters)
- SSNs for applicants who have one; non‑citizens can apply (see IHIP/public charge notes)
- Pregnancy verification (for pregnancy coverage) and children’s birthdates
- Health insurance info if you have employer coverage offered (to check affordability rules)
Send documents securely with DVHA’s Document Uploader (works on your phone). (dvha.vermont.gov)
Processing timelines (what’s realistic)
| Decision type | Standard |
|---|---|
| Medicaid initial decision (most applicants) | Within 45 days |
| Medicaid based on disability | Within 90 days |
| Reported changes (like income) | By end of month following 30–60 days, depending on whether more info is needed |
| Marketplace enrollments | Generally effective the 1st of the following month if enrolled by the monthly deadline |
Source: Federal timeliness rule 42 CFR §435.912 (revised 2024). (law.cornell.edu)
Common mistakes to avoid
- Waiting for Open Enrollment even though you likely qualify for Medicaid/Dr. Dynasaur now. Apply anytime. (info.healthconnect.vermont.gov)
- Uploading blurry, cropped documents; this is the #1 delay reason. Use the DVHA uploader and check your images before sending. (dvha.vermont.gov)
- Not cancelling NEMT rides you can’t make (3 no‑shows triggers stricter rules). (vpta.net)
- Ignoring hospital bills—call the hospital early, request financial assistance, and set a payment plan while they review. Vermont law is on your side. (legislature.vermont.gov)
Quick contacts by region (Health Dept. WIC district offices)
| District | Main phone(s) |
|---|---|
| Barre | 888‑253‑8786 / 802‑479‑4200 |
| Bennington | 800‑637‑7347 / 802‑447‑3531 |
| Brattleboro | 888‑253‑8805 / 802‑257‑2880 |
| Burlington | 888‑253‑8803 / 802‑863‑7323 |
| Middlebury | 888‑253‑8804 / 802‑388‑4644 |
| Morrisville | 888‑253‑8798 / 802‑888‑7447 |
| Newport | 800‑952‑2945 / 802‑334‑6707 |
| Rutland | 888‑253‑8802 / 802‑786‑5811 |
| St. Albans | 888‑253‑8801 / 802‑524‑7970 |
| St. Johnsbury | 800‑952‑2936 / 802‑748‑5151 |
| Springfield | 888‑296‑8151 / 802‑885‑5778 |
| White River Junction | 888‑253‑8799 / 802‑295‑8820 |
Source: Vermont Commission on Women – Public Assistance contacts. (women.vermont.gov)
FAQs (Vermont‑specific)
- How do I know if I qualify for Medicaid or a marketplace plan?
Use VHC’s Plan Comparison Tool or call 855‑899‑9600. It screens you for Medicaid/Dr. Dynasaur and marketplace subsidies. (info.healthconnect.vermont.gov) - I’m pregnant—what’s my coverage and for how long?
Pregnant Vermonters qualify under Dr. Dynasaur with $0 premiums and 12 months postpartum coverage; many are income‑eligible up to ~213% FPL. (medicaid.gov, info.healthconnect.vermont.gov, vtlawhelp.org) - Do kids get covered at higher incomes than adults?
Yes—Dr. Dynasaur covers children up to an effective ~317% FPL. Premiums for kids are currently suspended. (vtlawhelp.org, info.healthconnect.vermont.gov) - What will I pay for prescriptions on Medicaid?
Small copays: 1/1/2/$3 depending on the drug’s price. Preventive services and pregnancy/postpartum are exempt from cost sharing. (dvha.vermont.gov) - Is there dental coverage for adults?
Yes. Preventive cleanings/exams twice a year are outside the cap; other adult dental is covered up to $1,500/year. Pregnant and postpartum members are exempt from the cap. (dvha.vermont.gov, legislature.vermont.gov) - I lost Medicaid during unwinding—now what?
Most Vermonters can get very low marketplace premiums in 2025 (many <25/month∗∗,some“Goldfor∗∗<25/month**, some “Gold for **<1”). Use VHC or an Assister to switch without a gap. (dvha.vermont.gov) - I don’t have a car. Can Medicaid get me to my appointments?
Yes—call 833‑387‑7200 at least 2 business days in advance to schedule NEMT. (vpta.net) - I’m undocumented but pregnant. Any options?
Yes. Vermont’s IHIP covers pregnant individuals and children <19 regardless of immigration status (not long‑term care). Apply with the IHIP application or the standard Medicaid form. (dvha.vermont.gov) - I’m on Medicare and struggling with costs. Help?
Apply for a Medicare Savings Program (e.g., QMB at $1,305/mo for singles in 2025) and VPharm (≤225% FPL) to lower premiums and drug costs. (dvha.vermont.gov, legislature.vermont.gov) - My hospital bill is impossible. Can I get it reduced?
Yes. By law, large Vermont hospitals must grant free or discounted care up to 400% FPL and catastrophic help up to 600% FPL. Ask for Financial Assistance. (legislature.vermont.gov)
Program tables you can use now
1) Medicaid/Dr. Dynasaur income thresholds (effective with 5% disregard, monthly, 2025)
| HH Size | Adult 138% | Pregnant 213% | Child 317% |
|---|---|---|---|
| 1 | $1,799.75 | $2,777.88 | $4,134.21 |
| 2 | $2,432.25 | $3,754.13 | $5,587.13 |
| 3 | $3,064.75 | $4,730.38 | $7,040.04 |
| 4 | $3,697.25 | $5,706.63 | $8,492.96 |
Source: VTLawHelp 2025 income chart; program descriptions at VHC (base thresholds 133/208/312). (vtlawhelp.org, info.healthconnect.vermont.gov)
2) Adult dental benefits at a glance (Vermont Medicaid)
| Item | Rule |
|---|---|
| Preventive cleanings/exams | 2 per year; do not count against annual cap |
| Adult annual cap | $1,500 per member per calendar year |
| Copay per dental visit | $3 (preventive services have no copay) |
| Pregnant/postpartum, youth, certain waiver members | Not subject to cap |
Sources: DVHA Dental Benefit pages and statute. (dvha.vermont.gov)
3) Medicare Savings Programs (2025 quick view)
| Program | 2025 monthly income | What it pays |
|---|---|---|
| QMB | Single ≤**1,305∗∗;Couple≤∗∗1,305**; Couple ≤**1,763** | Part A & B premiums, deductibles, coinsurance, copays |
| SLMB | Single 1,306–1,306–1,565; Couple 1,764–1,764–2,115 | Part B premium |
| QI | Single 1,566–1,566–1,761; Couple 2,116–2,116–2,380 | Part B premium (not on Medicaid) |
| QDWI | Single ≤**2,609∗∗;Couple≤∗∗2,609**; Couple ≤**3,525** (resource limits apply) | Part A premium only |
Source: DVHA Medicare Savings Program page (2025). (dvha.vermont.gov)
4) You First (breast/cervical) income examples (250% FPL, 2025)
| HH Size | Annual income cap |
|---|---|
| 1 | $39,125 |
| 3 | $66,625 |
| 4 | $80,375 |
Source: Vermont Department of Health — You First. (healthvermont.gov)
5) Hospital financial assistance (minimums required by Vermont law)
| Situation | Minimum help Vermont hospitals must provide |
|---|---|
| Uninsured ≤250% FPL | 100% discount (free care) |
| Uninsured 250–400% FPL | ≥40% discount |
| Insured ≤250% FPL | waive all out‑of‑pocket costs |
| Insured 250–400% FPL | ≥40% discount on out‑of‑pocket |
| Catastrophic (≤600% FPL with bills >20% of income) | reduce amount due to 20% of household income |
Source: 18 V.S.A. § 9482. (legislature.vermont.gov)
If you’re stuck: one‑call solutions
- Vermont Health Connect customer support: 855‑899‑9600 (apply, report changes, pick a plan, find Assisters). (info.healthconnect.vermont.gov)
- Medicaid Member Services (copays, covered benefits): 800‑250‑8427. (dvha.vermont.gov)
- Office of the Health Care Advocate (free help): 800‑917‑7787. (vtlawhelp.org)
- Medicaid rides (VPTA): 833‑387‑7200; schedule ≥2 business days ahead. (vpta.net)
- WIC helpline: 800‑464‑4343 (or text 844‑839‑8942). (healthvermont.gov)
What to do if this still doesn’t work (Plan B)
- Get care at a free clinic (Barre, White River Junction, Middlebury—see numbers above) while your application processes. They can document your medical need and help push appeals. (phwcvt.org, goodneighborhealthclinic.org, opendoormidd.org)
- Ask the hospital for immediate financial assistance and a hold on collections while your Medicaid/VHC application is pending. Vermont hospitals must comply with state assistance rules. (legislature.vermont.gov)
- Call Vermont 2‑1‑1 for a quick referral to local case workers who can ride shotgun with paperwork and transportation. (women.vermont.gov)
About This Guide
Compiled by the ASingleMother.org Editorial Team
This guide uses official sources from Vermont Department of Vermont Health Access (DVHA)/Vermont Health Connect, Vermont Department of Health, the Vermont Legislature, Medicaid.gov, HHS/ASPE, USDA FNS, and established nonprofits (Vermont Legal Aid/VTLawHelp, Vermont Care Partners, community clinics). It’s produced based on our Editorial Standards and is updated regularly; we are not a government agency and cannot guarantee individual outcomes. Last verified September 2025, next review April 2026. Found an error? Email info@asinglemother.org and we’ll respond within 48 hours.
Disclaimer
Program details, amounts, and deadlines can change. Always verify with the relevant agency or the official links above before you apply or decide. Health information is sensitive—use only secure, official portals (like Vermont Health Connect and DVHA’s Document Uploader) when sending documents, and avoid public Wi‑Fi. This article is informational and not legal or medical advice.
Sources cited (selected)
- Vermont Health Connect: eligibility, enrollment windows, plan tool, Medicaid/Dr. Dynasaur descriptions. (info.healthconnect.vermont.gov)
- DVHA news: 2025 Open Enrollment savings examples; record enrollment. (dvha.vermont.gov)
- HHS/ASPE: 2025 Federal Poverty Guidelines (for our dollar conversions). (aspe.hhs.gov)
- VTLawHelp (Vermont Legal Aid): 2025 monthly income tables at 138%/213%/317% FPL. (vtlawhelp.org)
- DVHA member/copay/dental/NEMT pages; statute on adult dental cap. (dvha.vermont.gov)
- Medicaid.gov SPAs: VT postpartum 12‑month coverage and postpartum cost‑sharing exemption. (medicaid.gov)
- VPTA: Medicaid ride scheduling & contacts. (vpta.net)
- 18 V.S.A. § 9482 (hospital financial assistance). (legislature.vermont.gov)
- DVHA: Medicare Savings Program income limits (2025). (dvha.vermont.gov)
- VT Dept. of Health: You First eligibility; WIC application and contacts. (healthvermont.gov)
- DVHA: Non‑citizen information & IHIP. (dvha.vermont.gov)
- 42 CFR §435.912 (timeliness standards). (law.cornell.edu)
- Free clinics: Good Neighbor/Red Logan, People’s Health & Wellness, Open Door Clinic. (goodneighborhealthclinic.org, phwcvt.org, opendoormidd.org)
If any link is broken or unclear, please tell us at info@asinglemother.org so we can fix it promptly.
🏛️More Vermont Resources for Single Mothers
Explore all assistance programs in 34 categories available in Vermont
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