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Access to Health Care Through Catamount Health; Do Providers Know Enough to Refer?

Abstract

Background: On November 1, 2007, Vermont launched ‘Catamount Health,’ a state-sponsored private insurance plan. The goal: to close the gap between privately insured and Medicaid insured Vermonters. Previous programs such as Dr. Dynasaur and VHAP were already in place to care for children and low-income residents respectively. Now, under the umbrella title of “Green Mountain Care,” Catamount Health joins them. Catamount Health offers private coverage through either Blue Cross/Blue Shield of VT or MVP Health Care, the cost of which is offset by the state according to income level and household size. To qualify for Catamount, an individual must have an income of at least 1,277(lowerincomesqualifyforVHAP),andmeetanumberofcriteria:Vermontresidents18yearsorolderNotcurrentlyeligibleforotherstatesponsoredhealthinsuranceprogramsHavebeenlivingwithouthealthinsurancefor12monthsormoreunlessinsurancewaslostdueto:LossofemploymentDivorcefromordeathofaspouse/partnerDisenrollmentfromcollegeoryourparentsplanNolongereligibleforMedicaidorVHAPNolongerhaveCOBRAcoverageDonothaveaccesstoinsurancethroughemployerTheestimateofuninsuredVermontersis65,000,or101,277 (lower incomes qualify for VHAP), and meet a number of criteria: • Vermont residents 18 years or older • Not currently eligible for other state-sponsored health insurance programs • Have been living without health insurance for 12 months or more unless insurance was lost due to: - Loss of employment - Divorce from or death of a spouse/partner - Dis-enrollment from college or your parent’s plan - No longer eligible for Medicaid or VHAP - No longer have COBRA coverage • Do not have access to insurance through employer The estimate of uninsured Vermonters is 65,000, or 10% of the state population (National rate: 15.7%). 73% of all uninsured residents are between the ages of 18-49, which has been cited as the target population for Catamount. The State of Vermont has budgeted close to 1.6 million dollars to fund a large-scale advertising campaign on television, radio, newspaper, and on foot. Following this campaign, there is a high likelihood that Vermonters will bring questions and concerns about Catamount to their physician offices and community leaders, emphasizing the importance of a well-educated provider.https://scholarworks.uvm.edu/comphp_gallery/1021/thumbnail.jp

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