[arel]

I am unhappy with the Freelancers Union health insurance I brought with me from New York. I've had too many bad experiences with them, and I've read of even worse ones.

It has been suggested that I apply for VHAP here in Vermont. It is very inexpensive but it is pretty much limited to Vermont. There are only a few out of state facilities that accept it, and they tend to be by the Vermont border. Unfortunately, I am not eligible for Catamount.

My biggest concern, and it is a major, major one, is that if I were ever to get sick or injured out of state, I would be stuck with the bill. They say to ask the facility to apply for VHAP, but if they won't, then find a way to reduce the bill or pay it over time. That seems equivalent to not having health insurance at all!

Also, I think relatively few doctors even here in Vermont accept VHAP.

People I have spoken to seem happy with it, I think, but I wonder if using this insurance can be false economy, due to the risk of not being covered out of state and finding oneself tens of thousands of dollars in medical debt.

Can anyone share experiences and/or give advice?

Thanks.

[Sherylcatmom]

VHAP is the Vermont Health Access Plan, or Vermont's state-administered Medicaid plan for very low income Vermonters. If you didn't qualify for Catamount, chances are you aren't eligible for VHAP. More info here:
Vermont Health Access Program, VHAP

One way to check eligibility:

https://greenmountaincare.vermont.gov/

[68vette]

The Catamount plan seems like a good deal, but if anyone is considering the plan, look into providers that will accept the plan before getting on this plan. One of the biggest problems with this plan is many providers don't accept it. the reimbursement rates to the physicians are low.

[Sherylcatmom]

Originally Posted by 68vette

The Catamount plan seems like a good deal, but if anyone is considering the plan, look into providers that will accept the plan before getting on this plan. One of the biggest problems with this plan is many providers don't accept it. the reimbursement rates to the physicians are low.

We've never had a problem with providers accepting Catamount. That includes two primary-care practices, several specialists, and Hitchcock. We wish we hadn't needed to find out that all these providers accepted Catamount, but we sure are glad they were there for us when needed!

[arel]

People starting up businesses can get VHAP.

It is for people with low income, without regard for assets.

You can have lots and lots of assets, but if your income is low, you can get vhap.

I don't think Medicaid in Vermont has the stigma of Medicaid in, say, NY.

My primary concern is the lack of coverage out of state.

I really want to have Vermont based insurance rather than NY based insurance. Vermont is much smaller than New York, so there is less administrative congestion. I would think things will get done more quickly and more thoroughly. And Vermont is a lot less corrupt than New York is. I would think that because it is smaller and cleaner, the government is more reposnsive to consumer complaints.

I hope my faith is not misplaced.

[GypsySoul22]

We have VHAP for our son--Dr. Dynosaur.
It's taken here and in NH. It's been wonderful. He was just sick with a bad flu and then pneumonia. Doctor cost zero/same for medicines.

In NY many people on medicaid are foreigners/immigrants/illegals. Yes, there was a stigma and I would have never pursued it there.

We actually pay a bit towards it with my husband's insurance. It's kind of complicated but we are happy with it.

[68vette]

Originally Posted by Sherylcatmom

We've never had a problem with providers accepting Catamount. That includes two primary-care practices, several specialists, and Hitchcock. We wish we hadn't needed to find out that all these providers accepted Catamount, but we sure are glad they were there for us when needed!

Not all providers refuse the Catamount plan, but they don't have to accept it. WCAX just recently ran a story on the increasing number of providers refusing Catamount. It was due to the low reimbursement rate. The highest rate of refusals were in offices that had high numbers of Medicare/Medicaid patients.

[Sherylcatmom]

Originally Posted by 68vette

Not all providers refuse the Catamount plan, but they don't have to accept it. WCAX just recently ran a story on the increasing number of providers refusing Catamount. It was due to the low reimbursement rate. The highest rate of refusals were in offices that had high numbers of Medicare/Medicaid patients.

Thanks -- just found the WCAX story:

"So far, more than 1,600 Vermonters have signed up. But some doctors are considering getting out.

St. Albans Primary Care is affiliated with several practices across the state totaling about 45 doctors. All may stop taking patients covered by Catamount Health. 130 other health care providers have already said they won't accept Catamount. But it's a small fraction of the more than 5,000 medical practices expected to accept Catamount." (emphasis mine)

And, "Catamount Health administrators say since the program pays more than Medicare and Medicaid they're shocked doctors want out."

The article simply warns: "The advice to Catamount patients-- if you have a doctor you want to see make sure they are part of the plan before your next visit."

As I said, all our providers, which now include family practices in two different towns plus GI, urology, dermatology, and ophthalmological specialists, plus Dartmouth Hitchcock, have all accepted Catamount without a hitch.

[elk]

Does Catamount pay for out of state physicians? Near the border? Far away?

[Sherylcatmom]

Originally Posted by elk

Does Catamount pay for out of state physicians? Near the border? Far away?

Simple answer: Yes to all. When purchasing Catamount, consumers choose whether they'd like coverage through MVP or Blue Cross and Blue Shield of Vermont. More details:

Click here to search for network providers for Catamount through MVP.
Click here (http://www.bcbsvt.com/member/MemberBenefits/FindADoctor.html - broken link) to search for network providers for Catamount through Blue Cross and Blue Shield of Vermont.

Catamount Health general Q&A:
Catamount Health Information