Vermont offers some of the most comprehensive health coverage options in the country, but 2026 brings significant changes that every Vermonter needs to understand. Whether you are shopping through Vermont Health Connect for the first time or renewing existing coverage, the rules around financial help have shifted in ways that could affect your costs and eligibility. This guide explains exactly who qualifies for ACA marketplace plans and Medicaid in Vermont, what the income limits are, and how to get enrolled.
Check your eligibility with our free screener to see which programs you may qualify for before you apply.
What Is Vermont Health Connect?
Vermont Health Connect (VHC) is Vermont's state-run health insurance marketplace, created under the Affordable Care Act. It is where Vermonters can shop for qualified health plans and apply for financial help to lower the cost of premiums. Vermont Health Connect also serves as the single application point for Green Mountain Care (Vermont Medicaid) and Dr. Dynasaur, the state's children's health program.
Vermont has had its own marketplace since 2014, giving the state more control over the enrollment process and plan options than states that use the federal HealthCare.gov portal. All plans sold through Vermont Health Connect meet ACA minimum essential coverage standards, meaning they cover preventive care, prescription drugs, mental health services, and more.
Major Changes to Vermont ACA Subsidies in 2026
This is the most important thing to know for 2026: the enhanced premium tax credits that had been available since 2021 expired on December 31, 2025. Congress chose not to extend them, which means the rules for financial help are substantially different this year.
Here is what changed:
The subsidy cliff is back. Under the enhanced credits, people with incomes above 400% of the federal poverty level (FPL) could still receive some financial help. That cap no longer applies. Starting in 2026, if your household income exceeds 400% FPL, you do not qualify for premium tax credits. For 2026, the 400% FPL threshold is approximately $62,600 for a single person and $128,600 for a family of four.
Subsidy amounts are smaller. Even for people who still qualify, the subsidy amounts are generally lower than they were in 2024 and 2025. You may still receive help, but your monthly premium may be higher than last year even if your income stayed the same.
New immigration-related restrictions. Customers with household incomes below 100% FPL who cannot get Medicaid because of their immigration status are no longer eligible for premium tax credits in 2026. Additionally, DACA recipients are no longer eligible to enroll in qualified health plans through Vermont Health Connect.
Vermont ACA Eligibility Requirements 2026
To qualify for a marketplace plan through Vermont Health Connect, you must meet these basic requirements:
- Be a Vermont resident
- Be a U.S. citizen or have qualifying immigration status
- Not be incarcerated
- Not have access to affordable employer-sponsored health coverage (generally defined as coverage that costs more than 9.02% of your household income in 2026)
- Not be enrolled in Medicare
Meeting these requirements allows you to enroll in a plan. Whether you qualify for financial help depends on your income.
2026 Income Limits: Who Gets Premium Tax Credits
Premium tax credits are available to households with incomes between 100% and 400% FPL. The table below shows the 2026 income limits based on the federal poverty guidelines:
| Household Size | 100% FPL (Annual) | 400% FPL (Annual) |
|---|---|---|
| 1 | $15,650 | $62,600 |
| 2 | $21,150 | $84,600 |
| 3 | $26,650 | $106,600 |
| 4 | $32,150 | $128,600 |
| 5 | $37,650 | $150,600 |
| 6 | $43,150 | $172,600 |
Note: These figures are based on 2025 FPL guidelines used for 2026 coverage. Actual thresholds are set by the federal government and may vary slightly. Confirm current numbers at Vermont Health Connect (855-899-9600) or visit portal.healthconnect.vermont.gov.
If your income falls between 100% and 400% FPL, you likely qualify for an advanced premium tax credit (APTC) that reduces your monthly premium. The exact amount depends on your income, household size, and the benchmark plan in your area.
Cost-Sharing Reductions: Extra Savings on Silver Plans
In addition to premium tax credits, some lower-income Vermonters qualify for cost-sharing reductions (CSR). These reduce what you pay out of pocket when you use health care services: think lower deductibles, copays, and out-of-pocket maximums.
To qualify for CSR in Vermont, you must:
- Have income at or below 250% FPL
- Enroll in a Silver-tier plan through Vermont Health Connect
Vermont also offers Enhanced Silver plans with additional cost-sharing reductions. For 2026, these enhanced plans are available to individuals earning up to approximately $31,300 per year, couples earning up to approximately $42,300, and families of four earning up to approximately $64,300. These thresholds come directly from Vermont Health Connect's 2026 eligibility tables.
Green Mountain Care: Vermont Medicaid Eligibility 2026
Not everyone who needs health coverage will use the marketplace. Many low-income Vermonters qualify for Green Mountain Care, which is Vermont's Medicaid program. Green Mountain Care is free or very low cost and provides comprehensive benefits including doctor visits, hospital care, prescriptions, mental health services, dental, and vision.
Vermont expanded Medicaid under the ACA, meaning income is the primary eligibility factor for most adults. There is no asset test.
Adults (Ages 19 to 64)
Adults qualify for Green Mountain Care if their household income is at or below 138% FPL. Based on 2025 FPL guidelines used for Medicaid determinations through early 2026, the monthly income limits are approximately:
| Household Size | Monthly Income Limit (138% FPL) |
|---|---|
| 1 | $1,732 |
| 2 | $2,351 |
| 3 | $2,969 |
| 4 | $3,588 |
If you are below this threshold, you qualify for Medicaid rather than marketplace subsidies. You can still apply through Vermont Health Connect and the system will direct you to the appropriate program.
Dr. Dynasaur: Children and Pregnant Women
Vermont's Dr. Dynasaur program covers children and pregnant women at higher income levels.
- Children under 19: Household income up to 317% FPL
- Pregnant women: Household income up to 213% FPL
- Coverage continues for 12 months postpartum for new mothers
Children in households above 138% FPL but below 317% FPL may have a small monthly premium, but coverage is still comprehensive and much more affordable than marketplace plans.
Immigrant Health Insurance Program (IHIP)
Vermont also provides health coverage through IHIP for children and pregnant women who would qualify for Medicaid based on income but are not eligible due to immigration status. This is a state-funded program, not a federal one, and it reflects Vermont's commitment to broad health coverage.
How to Apply: Step-by-Step
Step 1: Gather Your Information
Before you start your application, collect:
- Social Security numbers for all household members applying
- Immigration documents if applicable
- Proof of Vermont residency (utility bill, lease agreement)
- Income information: pay stubs, tax returns, or documentation of all household income sources
- Employer information if you have a job offer with health insurance
Step 2: Go to Vermont Health Connect
Visit portal.healthconnect.vermont.gov to create an account or log in. The portal handles applications for both Medicaid (Green Mountain Care/Dr. Dynasaur) and marketplace plans in a single application.
You can also apply by phone at 1-855-899-9600 or get in-person help from a certified navigator or broker. Vermont Health Connect maintains a network of local helpers across the state.
Step 3: Complete the Application
Enter your household size, income, and personal information. The system will determine whether you qualify for Green Mountain Care, Dr. Dynasaur, or a subsidized marketplace plan. If you are eligible for Medicaid, coverage can start relatively quickly. Marketplace coverage typically starts the first day of the month following enrollment.
Step 4: Compare Plans (If Using the Marketplace)
If you qualify for a marketplace plan, Vermont Health Connect will show your plan options across four metal tiers: Bronze, Silver, Gold, and Catastrophic. Your subsidy will be applied automatically. For most people who qualify for cost-sharing reductions, a Silver plan will offer the best value.
Step 5: Enroll and Pay Your First Premium
Select your plan and pay your first month's premium to activate coverage. You must pay before coverage begins. Vermont Health Connect will provide instructions on how to pay your insurer directly.
When Can You Enroll?
Open Enrollment: Vermont's open enrollment period for 2026 plans runs November 1 through January 15. If you enrolled during open enrollment, your coverage for 2026 is already active.
Special Enrollment Period: If you missed open enrollment, you can still enroll if you experience a qualifying life event. The special enrollment window is generally 60 days after the event. Qualifying life events include:
- Losing health coverage (job loss, aging off a parent's plan, loss of Medicaid)
- Getting married or divorced
- Having a baby or adopting a child
- Moving to Vermont from another state
- A significant change in household income
Medicaid Enrollment: Green Mountain Care has no enrollment periods. You can apply any time of year.
Vermont Premium Assistance (VPA)
Vermont offers an additional state-level benefit called Vermont Premium Assistance. This program helps certain lower-income Vermonters who have access to employer-sponsored insurance but cannot afford the employee share of the premium. VPA can help pay a portion of what the employee owes toward employer coverage. Eligibility and benefit amounts depend on income and the cost of employer coverage.
What Happens If Your Income Changes During the Year?
If your income changes significantly during 2026, report it to Vermont Health Connect right away. Your subsidy is based on your projected annual income. If you end up earning more than you projected:
- If your income ends up above 400% FPL, you will have to repay all credits received when you file your 2026 taxes
- If your income stays below 400% FPL but was higher than projected, you will repay a portion of excess credits
Reporting changes promptly helps you avoid a large tax bill in April 2027.
Frequently Asked Questions
What if my income is below 100% FPL and I do not qualify for Medicaid?
If you are a U.S. citizen or qualifying immigrant with income below 100% FPL, you should qualify for Green Mountain Care (Medicaid). In Vermont, there is very little gap coverage situation because the state has expanded Medicaid to 138% FPL. However, if you are in an unusual situation, contact Vermont Health Connect to explore options.
Can I get help if I am self-employed?
Yes. Self-employed Vermonters qualify for marketplace plans and premium tax credits based on their net self-employment income. You estimate your income for the year when you apply and reconcile at tax time.
What plans are available through Vermont Health Connect in 2026?
Vermont's marketplace offers plans from Blue Cross and Blue Shield of Vermont and MVP Health Care. Plans are available in Bronze, Silver, Gold, and Catastrophic tiers. Catastrophic plans are only available to people under 30 or those who qualify for a hardship exemption.
Does Vermont Health Connect cover dental and vision?
Standard marketplace plans do not include dental or vision. Separate standalone dental plans are available through Vermont Health Connect. Children covered through Dr. Dynasaur receive comprehensive dental and vision coverage through that program.
What if I need help understanding my options?
Vermont Health Connect has certified application counselors and navigators available at no cost. Call 1-855-899-9600 or visit the Vermont Health Connect website to find a local helper. Many community organizations across Vermont also provide free enrollment assistance.
Can my kids get coverage even if I do not qualify?
Yes. Children can qualify for Dr. Dynasaur even if you are not eligible for Medicaid. The income threshold for children (317% FPL) is much higher than for adults.
What if I already have a plan and just need to update it?
Log into your Vermont Health Connect account to report changes in income, household size, or other circumstances. Changes can affect your subsidy amount or move you between Medicaid and a marketplace plan.
Get Started Today
Health coverage options in Vermont are more complicated in 2026 due to the end of the enhanced premium tax credits. But most Vermonters at low and moderate incomes still have access to affordable coverage through Green Mountain Care or subsidized marketplace plans.
The best first step is to check what you qualify for. Use our free eligibility screener to get a quick estimate based on your income and household, then head to Vermont Health Connect to complete a full application.
For a broader view of Vermont benefits programs beyond health insurance, including food assistance (3SquaresVT), heating help, and childcare assistance, visit our Vermont Benefits Overview.
Vermont Health Connect: portal.healthconnect.vermont.gov | Phone: 1-855-899-9600
