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Learn About CHIP in Vermont

The Vermont CHIP program is called Dr. Dynasaur and is focused on assisting children living in low-income families and pregnant women by providing comprehensive health, dental and vision insurance. This coverage is helpful because it allows eligible applicants to seek medical treatments and procedures for a fraction of the regular cost. If this insurance was not available to eligible households, most children would not receive the preventive health care and emergency medical treatments they need to successfully grow and thrive. The Children’s Health Insurance Program (CHIP) is designed to ensure these growing children are provided with the proper care and can remain healthy while growing into adults.

CHIP insurance in VT is administered by the Green Mountain Care program, along with Medicaid. However, households that are eligible for Medicaid cannot also seek benefits through the Dr. Dynasaur program. Both low-cost health insurance programs provide comprehensive coverage, so only one is needed for low-income children in the state. To find out more about how CHIP and Medicaid are similar, along with the eligibility criteria for Dr. Dynasaur and the application methods available, parents of potential beneficiaries can read through the following information.

What is CHIP in Vermont?

Vermont health insurance for kids, also referred to as Dr. Dynasaur, is federally funded to ensure children living in low-income households still have access to health care without any monetary barriers. This health care is important to allow these children to grow up healthy and become productive adults. The program provides comprehensive coverage to eligible children and pregnant women, including coverage for:

  • Doctor’s visits.
  • Physicals.
  • Over-the-counter drugs.
  • Surgeries.
  • X-rays.
  • Lab tests.

The child health insurance plan allows beneficiaries to seek these and other treatments for affordable costs. Some enrollees do not need to pay monthly premiums, but some families may be required to pay these low-cost premiums. The program keeps these costs affordable and much lower than what is charged for private insurance. In addition, some services require co-payments. However, these payments are also affordable for the low-income households that meet CHIP qualification requirements.

Who does Vermont CHIP cover?

Not every resident will meet the Vermont CHIP eligibility guidelines that are set for the program. Since there is limited federal funding provided to keep the program running, the department must set strict qualifications for enrollees. To prove eligibility for coverage, an applicant must be:

  • Younger than the age of 19 years or a pregnant woman.
  • A Vermont resident.
  • Not currently covered by health insurance.
  • Not eligible for Medicaid.
  • Living in a household that is considered low income by state standards.

The VT CHIP application asks for extensive information on a household’s earnings, government benefits it receives and its recurring expenses. The low-income guidelines set by the program are determined by the Federal Poverty Level (FPL) and the number of household members in a family. To find out more the program, download our comprehensive online guide.

How to Apply for CHIP in Vermont

If you are seeking Vermont CHIP dental, medical and vision insurance through the Dr. Dynasaur program for yourself or your child, you must thoroughly complete the application process. Throughout the process, you will be responsible for providing information on yourself, your child and your household, including the earnings of all household members. Before attempting to complete an application, you should gather important documents so you can provide accurate information, including:

  • Social Security Numbers for all household members.
  • Paycheck stubs, government benefit statements and other income information.
  • Information on other health insurance or employer-based insurance options.
  • Potential medical or prescription drug needs.

You can apply for CHIP online in VT through the state’s website. To complete the online application, you must sign up for an online account with the program and complete all information, as requested. Once you submit the online application, a department representative will contact you with information on your program eligibility. If you need help completing the process online, you can call the toll-free number and have a representative assist you.

Additionally, you can apply for CHIP coverage in person at a local agency. The program provides a list of in-person assisters that you can contact and make an appointment with. This professional assister can help you to complete the application and ensure it is submitted properly to the department.

What is included with Vermont CHIP coverage?

The Vermont CHIP benefits provided to eligible program applicants is expansive. Depending on a beneficiary’s needs, the program can provide medical supplies, mental health care and other preventive services. Children who are enrolled in the program can receive free Early and Periodic Screening, Diagnostic and Treatment (EPSDT). Additionally, program beneficiaries may seek the following covered services:

  • Diabetic supplies
  • Prescription drugs
  • Eye exams
  • Nutrition therapy
  • Specialist services

CHIP insurance beneficiaries who seek services and treatments must only do so through medical providers who participate in the program. If a beneficiary seeks treatment from a provider who does not accept Dr. Dynasaur insurance, he or she may be responsible for paying out-of-pocket for the medical expenses.

How much is CHIP health insurance in Vermont?

Vermont CHIP is free for some program beneficiaries who have low incomes. For applicants who have slightly higher incomes but who still qualify for this insurance, affordable monthly premiums may be due. However, the premiums due are always much lower than what is usually charged for private health insurance.

In addition to these potential monthly premiums, CHIP benefits may also include co-payments. For certain services and treatments, a beneficiary may be responsible for paying small co-payments to the medical provider. The amount of the co-payment may vary and depends on the type of treatment needed. Preventive health care is always free. To find out more about these co-payments and potential monthly premiums, download and review our comprehensive guide.

How long do CHIP benefits last in Vermont?

Generally, Vermont CHIP coverage lasts for one year. Upon program approval, a beneficiary will receive his or her insurance card and a list of participating medical providers in the area.

The department will send out a notification when the policy is due to expire. At this time, an enrollee can attempt to renew his or her benefits. However, the beneficiary can be disenrolled from the program if he or she:

  • Obtains private health insurance.
  • Qualifies for Medicaid.
  • No longer meets low-income guidelines.
  • Is too old for the program now.

If CHIP eligibility is no longer met by a program enrollee, he or she can speak to a Vermont Health Connect representative. There may be other coverage programs, including Medicaid, that the former beneficiary may now qualify for.