This online application is for: 3SquaresVT, Essential Person, Fuel Assistance, Reach Up, and most health care programs.

Exceptions:

• Do not use this online application for Long-Term Care Medicaid or Catamount Health without Premium Assistance.
• If you are only applying for prescription assistance, use the Pharmacy Programs Application.

You can also apply for most benefits in person at one of our 12 district offices.

Before You Apply

Step One - Gather Information About the People Living in Your Home

• Dates of birth and Social Security numbers for those who are applying;
• Pay stubs and check stubs for unearned income (e.g., Unemployment, Workers’ Comp, retirement pension, and child support);
• Information about the resources you own such as bank accounts, investment accounts, and property; and
• Household bills (e.g., fuel, phone, and electric).

Step Two - Read the Information Below

• You must complete all information marked with a red asterisk* in order to submit the application.  Please note that it is important to answer all questions with as much detail as possible. 
• You have the right to have another person apply for benefits for you. You'll get the chance to appoint someone as your "authorized representative" later in the application.
• If you don't submit the application within 30 days, your information will be deleted and you will need to start over.
• You have the right to submit an incomplete 3SquaresVT application at any time as long as you provide your name, address, and electronic signature. This will only set your filing date. If you are found eligible, your 3SquaresVT benefits will be computed from the date your application was filed. Other programs calculate benefits on the day of approval.
• You may have a right to get 3SquaresVT benefits faster. We'll ask some questions to see if you are able to get faster service.
• Social security numbers (or proof that you have applied for a social security number) must be given for everyone in your household who is applying for benefits or else they will not be eligible. You do not have to give social security numbers for people who are not applying for benefits, but you may have to provide other information for those people, such as, income and resources. Social security numbers are confidential and secure and are only used for verification purposes. See Privacy Act Statement 7 CFR 273.2 (4)
• Only U.S. citizens and certain legal immigrants can get benefits. If there are noncitizens living with you who are not eligible, you can still apply for and get benefits for other eligible members.You do not have to give immigration information for people not applying for benefits but you may need to provide other information for those people, such as, income and resources. 

Step Three - Internet Explorer 9 Compatibility Issues

If you are having issues displaying the Online Application, here are the complete instructions with regards to changing the compatibility view :

• First open explorer-go to Tools then compatibility view settings-add website address- follow directions below.

• When you turn on Compatibility View, the website you're viewing will be displayed as if you were using an earlier version of Internet Explorer.
• If Internet Explorer recognizes a webpage that isn't compatible, you'll see the Compatibility View button on the Address bar. To turn Compatibility View on, click the Compatibility View button to make the icon change from an outline to a solid color.
• From now on, whenever you visit this website, it will be displayed in Compatibility View. However, if the website receives updates to display correctly in the current version of Internet Explorer, Compatibility View will automatically turn off.

Notes:

• Not all website display problems are caused by browser incompatibility. Interrupted Internet connections, heavy traffic, or problems with the website can also affect how a webpage is displayed.
• If your computer is part of a network at an organization such as a school, government agency, or a business, your organization's system administrator might have turned on Compatibility View for all websites by using Group Policy. If a website doesn't display correctly, you can turn off Compatibility View by clicking the Compatibility View button 

To find out more about Agency of Human Service programs
for you and your family visit our website:
www.screendoor.vermont.gov
To find out about other services in your community visit:
www.vermont211.org
or dial 211 on your phone.

Apply for Benefits

If you have problems using the online application, call our Benefits Service Center during regular business hours:1-800-479-6151. If you submit your application after 4:30 p.m. or on a weekend or holiday, the filing date is the next business day.

After You Apply

• Before we approve your benefits, we may need to verify some of the information you provided. In some cases, you'll need to talk to a worker. We will contact you by mail or phone if we need more information.

• You may be asked to verifiy the following:

  • Identification (licenses, birth certificates) and social security numbers for all members applying for assistance.  If you don't have a social security number, we can help you apply for one.
  • All gross wages received by your family in the last 30 days.  Pay stubs or written statements from employers.
  • If self-employed, most recent federal income tax return including all W2's, forms, and schedules or record books showing income and expenses for the current year.
  • Written statement for any person paying you for room or meals.
  • Income you received from providing dependent care to children or adults in your home (Self employment records or statement from person paying).  Also note the number of snacks, and the number and type of meals you provide unless you receive reimbursement for them.
  • Unearned income such as social security, SSI, verteran's benefits, unemployment or workers's compensation, dividends, or child support (award letter, divorce/seperation papers or statement from person paying support, 1099).
  • Phone bill  (page that shows the name).
  • Amount of room only, meals only, or room and meals that you pay.
  • Dependent care expenses you paid in the last calendar month.
  • Alimony or child support payments you made to anyone outside your household (cancelled checks or statement from the person receiving payment).
  • Savings, checking, credit union account numbers or statements of all accounts, including children's accounts.
  • IRAs and profit sharing accounts.
  • Automobile payment book or schedule to show any balances due.
  • Rent receipt, lot rent receipt.
  • Proof of mortgage payment such as cancelled check, payment book or payment schedule.
  • Property tax bill and fire insurance premium.
     
• Parents who get health care or Reach Up benefits may be asked to cooperate with the Office of Child Support.