Written by a parent, not a doctor. Nothing here is medical advice.

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Vermont program

Health coverage for your child (Dr. Dynasaur)

Vermont's health coverage for children under 19, called Dr. Dynasaur. Medicaid can sit behind work insurance.

What it is

Vermont's health coverage for children under 19, called Dr. Dynasaur. Medicaid can sit behind work insurance.

Dr. Dynasaur covers children whose household income fits Vermont's rules. A recent pay drop can change the result. Vermont Health Connect decides who belongs in your child's household and which income counts.

Eligibility rules
  • Vermont children must be under 19. Current monthly income is the test; annual income divided by 12 is an estimate.
  • The line by household size, per month: 1: $4,217 · 2: $5,717 · 3: $7,218 · 4: $8,719 · 5: $10,218.
  • Dr. Dynasaur is Vermont’s coverage for eligible children under 19. The April 2026 leaflet gives a preliminary income screen, not a decision. Work insurance does not by itself rule out Medicaid; Vermont Health Connect must identify the correct coverage and funding category and confirm any current premium rule.
What you get
  • Covered hospital stays, cancer treatment and medicines, with no Medicaid copays for children.
  • Rides and nursing at home when your child meets those programs' separate rules.
  • Help with eligible bills from before the application month.
What the help includes
  • Each clinic and pharmacy needs to accept the coverage for the care being billed.
  • Your work plan is billed first. For covered care, the clinic cannot bill you the deductible or copay the work plan left, even when Medicaid pays nothing extra. If a bill arrives anyway, ask the billing team to check it before paying.
  • Worked example (illustrative figures): the work plan allows $10,000, pays $5,600 and lists $4,400 as your share. Medicaid allows $5,000 and so pays nothing extra. For covered care from an enrolled clinic, you still owe $0, not $4,400.
If you decide to apply
  1. Talk with the hospital social worker about whether adding coverage could help. If you decide to pursue it, ask who can help with the application.
  2. Have recent pay stubs, insurance information and earlier medical bills ready. Include the months when pay changed.

Vermont Health Connect: 855-899-9600. · Official page ↗

After you ask
  • For applications during 2026, Medicaid may cover up to three earlier months when your child was eligible. For children’s applications on or after January 1, 2027, federal law reduces that period to two earlier months. Each month and bill still needs review.
  • Children under 19 generally keep Medicaid for 12 months after an eligibility decision even if income rises. Turning 19, moving out of Vermont, death, a voluntary request to end coverage, or a mistaken decision involving fraud or perjury can end that protection earlier. Vermont Health Connect can confirm whether a longer period applies to a young child.
  • Ordinary Medicaid applications have a 45-day decision standard. A disability decision can take up to 90 days, with limited documented exceptions. A qualified participating hospital can assess temporary hospital presumptive eligibility. This coverage starts on the hospital’s decision date and does not cover earlier bills. It ends with the full application decision or, if no timely application is filed, at the end of the following month.
Good to know

Work insurance does not by itself rule out Medicaid. Vermont Health Connect identifies the correct child coverage category.

Other details
  • Keeping both plans means keeping the work premium and handling two insurance cards. The hospital can check how each plan covers your child's team.

Federal background: Medicaid, CHIP and Medicaid alongside work insurance.

Official sources
Ask your social worker

“Could Dr. Dynasaur lower our treatment bills? What would adding it mean for our existing insurance, and would you help us decide whether to apply?”

Why I’m asking: I want to understand whether this coverage would make treatment more affordable without disrupting care.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File at VermontHealthConnect.gov or on 855-899-9600, report this month's income and any insurance, and name the months with bills already run up.

Your social worker

The hospital's financial advocate helps you file and chases the decision; the oncology social worker confirms the team takes the coverage.

The care team

Nothing for ordinary Dr. Dynasaur. Medical records are needed only for the disability route.

Who decides
Vermont Health Connect checks the income and opens the coverage.
Ask your social worker
“Can you help me file the Dr. Dynasaur application today, ask for the three months before we applied, and check that the oncology team is covered? We are keeping the work plan.”

How to apply

First step: Apply at VermontHealthConnect.gov or call 855-899-9600 this week, and ask the hospital's financial advocate on 802-847-1122 to help while you are there.

  1. Apply at VermontHealthConnect.gov or on 855-899-9600 this week.
  2. Ask for the three months before the application month, so the admission is covered.
  3. Say your child already has a work plan, if there is one. Do not cancel it.

Official application / program page ↗

Where it starts: Apply at VermontHealthConnect.gov or call 855-899-9600. Ask the hospital's financial advocate to help you file while your child is admitted.

What to gather

  • Your child's birth certificate or identification and Social Security number
  • A Vermont address
  • This month's pay for each parent in the tax household
  • Insurance cards, if any
  • Hospital bills from the three months before you apply

How long: Ordinary applications have a 45-day standard, or 90 days for a disability determination, with limited exceptions. For 2026 applications, up to three prior eligible months may be covered.

What a yes looks like

A notice with coverage dates and a Green Mountain Care identification card. Check the oncology team and the hospital are covered before you rely on it.

What a no looks like, and the next move

Read whether the no is on income, on a document or on a category. If it is income and your child needs heavy care at home, ask for Disabled Children's Home Care in the same breath, and appeal by the date on the notice. The Health Care Advocate on 1-800-917-7787 will help free.

Watch out

  • Do not cancel a work plan to apply. Vermont Medicaid pays second, and behind a work plan it can wipe out copays.
  • Vermont counts this month's income for the tax household, not last year's return and not everyone under the roof.
  • If the answer is no on income and your child needs heavy care at home, ask for Disabled Children's Home Care by name. It leaves your income out entirely.

Dates that change this

2026-04-01: The income figures come from the health department's April 2026 screening leaflet. The state's own eligibility chart was not readable, so treat these as a guide and let Vermont Health Connect do the real sum. (not yet confirmed against the final rule)

2027-01-01: Coverage reaches back three full months before the application month today. A federal change narrows that to two months for applications made from January 1, 2027; whether Vermont has an exception was not published. (not yet confirmed against the final rule)

2027-01-01: The health department told families in May 2026 that federal rules are bringing changes to how some people apply for or stay enrolled in Medicaid from 2027. The details are not published. (not yet confirmed against the final rule)

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Child health coverage. The April 2026 screening leaflet lists monthly income from $4,216.50 for one person to $10,218.20 for five; Vermont makes the eligibility decision.

  • $4,216.5/month — Household of 1, monthly screening figure
  • $5,717.2/month — Household of 2, monthly screening figure
  • $7,217.85/month — Household of 3, monthly screening figure
  • $8,718.5/month — Household of 4, monthly screening figure
  • $10,218.2/month — Household of 5, monthly screening figure
  • $3 — Months of coverage before the application month

Covers: Hospital and clinic care · Chemotherapy and prescriptions · Medically necessary children's services within federal Medicaid benefit categories, subject to the applicable clinical and coverage rules · Home nursing and personal care when authorised · Rides to appointments · Dental and vision

Legal protection: Vermont Medicaid pays after any other insurer, so a work plan stays in place

What it costs the family: Children under 21 are exempt from Medicaid copays. Vermont Health Connect confirms any current premium rule for the child's coverage category.

The eligibility facts, as published

Age
under 19
Age max exclusive
19
Income
Screening figures at 317 percent of the poverty guideline for households of 1 to 5, from the health department's April 2026 leaflet. The controlling chart, with its base and 5 percent disregard columns, was not readable.
Insurance status condition
Work insurance does not by itself bar Medicaid. Vermont Health Connect must confirm the current Medicaid/CHIP funding category and any insurance restrictions or exceptions.
Residency
Vermont
Continuous eligibility
Generally 12 months for children under 19, with exceptions for aging out, moving away, death, voluntary termination and specified erroneous determinations involving fraud or perjury.
Retroactive months
3 now; a federal change narrows it to 2 from 2027-01-01
Processing standard
Ordinary applications have a 45-day standard; disability determinations have a 90-day standard, subject to limited documented exceptions.

Expect friction on: The state has not published the controlling 2026 income chart, so the exact line is not checkable from outside

The trap: Do not cancel a work plan to apply. Vermont Medicaid pays second, behind the work plan, and the health department says in its own leaflet that having it as secondary insurance can wipe out copays and help with the deductible.

Where I read this

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