Haven’t applied for Medicaid or other health insurance yet? Here are things you need to know.
Using your Medicaid and other health insurance to get health care.
If you don’t speak or read English, call Customer Service for free at 1-855-899-9600. We are open from 8 AM to 4:30 PM Monday to Friday. You can get free interpreters on the phone. Tell us if you need notices or other information written in your language.
This page is about using Medicaid for health care. Do you have Refugee Medical Assistance? To get help, call US Committee for Refugees and Immigrants (USCRI) at 802-655-1963. OR call Customer Service for free at 1-855-899-9600. Do you have a Qualified Health Plan? To get help, call Customer Service for free at 1-855-899-9600. We are open from 8 AM to 4:30 PM Monday to Friday.
Things you need to know to use and keep your Medicaid health insurance
- Make sure we always have your address and phone number. You could lose Medicaid if we can’t reach you. Give us an address that will not change, if you can.
- Learn more about Medicaid: Read the Member Health Care Handbook. In Pashto. In Dari. In English.
- You must tell us when something changes. This includes changes to income, health insurance, household members, your address, marriage/divorce and pregnancy. You must tell us if you move out of state or get Medicaid in another state. Call Customer Service at 1-855-899-9600 to report changes. For Medicaid, you must report changes within 10 days. Some change may mean you no longer meet the rules to get Medicaid.
- If you apply for Medicaid, when you will get a decision? In most cases, we must decide within 45 days. If you are applying for Medicaid because of a disability, we have 90 days. It may take longer if you cause a delay. If it takes longer, call Customer Service at 1-855-899-9600. Or you can file an appeal. To find out how to appeal see below, What to do if you do not agree with a decision.
- You will get a Medicaid card. Always take it with you to the doctor or health provider.
- What Medicaid covers for people under age 21 (EPSDT).
- What Medicaid covers for adults. Look under “Services Covered.”
- Extra help for adults with special needs.
- Extra help for children with special needs.
- How to find a doctor or other health provider.
- Your rights in Vermont health care programs.
- Rights of People with Disabilities. If you have a physical, mental, or learning condition that makes it hard to do things we ask you to do, we can make changes to help you. The Americans with Disabilities Act (ADA) and Vermont law say that we may have to make changes (called reasonable accommodations) to our requirements so people with disabilities can get health benefits. Here are examples of changes we can make:
- Someone can write down your answers if you can’t.
- We can give you more time or help you get the documents we need.
- We can send documents with a larger print.
If you need changes so you can get health benefits, call Customer Service at 1-855-899-9600.
- Right to Privacy. Information about your application and health benefits is confidential and protected by state and federal law. We will not share any information about you unless it is directly connected to program administration, allowed by law or a court order, or we have your permission.
- What to do if you do not agree with a decision about whether you can GET MEDICAID. You have the right to appeal. This means you are asking for a State fair hearing. Please look at your eligibility notice to find out more about your right to appeal. You must appeal within 90 days of the date of your eligibility notice.
- In most cases, we must send you a final decision on your appeal within 90 days. Will it harm you to wait that long? You can ask for a fast (expedited) appeal and we may decide your appeal sooner. We decide most fast appeals in 7 working days. To appeal, call Customer Service at 1-855-899-9600. You may also write to the Human Services Board, 120 State Street, Montpelier, VT 05620-4301.
- Can someone speak for me at my fair hearing? Yes. You need to be at the hearing. But you may have someone else, like a friend, relative, or lawyer, speak for you. You may be able to get free legal help. Call the Health Care Advocate at Vermont Legal Aid at 1-800-917-7787 or https://vtlawhelp.org/health.
- What to do if you do not agree with a decision about whether you can GET A HEALTH CARE SERVICE COVERED BY MEDICAID.
What if you don’t get the language services you need? Call Customer Service at 1-855-899-9600. If we don’t give you the language services you need, you can file a discrimination complaint. We can’t discriminate because of race, color, national origin, sex, age, sexual orientation, gender identity or disability. Learn how to file a discrimination complaint.