Vermont Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Vermont.
7.6 million Medicaid long-term care recipients nationwide
Vermont Department of Vermont Health Access
Processing Time
30-45 days for standard Medicaid; Choices for Care enrollment typically occurs within 30-45 days of Medicaid approval. Vermont has relatively streamlined processing.
Vermont Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Vermont, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Vermont follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$3,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Vermont Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $11,889/month average (semi-private), $13,044/month (private) (the average monthly nursing home cost in Vermont).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Vermont
Nursing Home Care
Medicaid pays 100% of nursing home costs in Vermont once eligibility is established. The average monthly cost is $11,889/month average (semi-private), $13,044/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Choices for Care - Enhanced Residential Care (ERC): Vermont's Choices for Care program includes Enhanced Residential Care services for individuals living in licensed residential care homes or assisted living residences. Medicaid covers personal care, medication administration, and care coordination. Room and board costs are not covered by Medicaid - residents must pay housing costs from their monthly income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Vermont offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Choices for Care (CFC) Program
Vermont's comprehensive long-term services and supports program serving individuals age 18+ (including elderly) who meet nursing facility level of care. Provides adult day services, assistive technology, care coordination, environmental modifications, home-delivered meals, homemaker services, nursing oversight, personal care, respite care, and specialized medical equipment. Approximately 5,000 participants statewide.
Program Details →Enhanced Residential Care (ERC)
Part of Choices for Care program, specifically for individuals residing in residential care homes or assisted living residences. Provides enhanced services beyond standard residential care.
Program Details →How to Apply for Medicaid in Vermont
Vermont Medicaid applications typically take 30-45 days for standard Medicaid; Choices for Care enrollment typically occurs within 30-45 days of Medicaid approval. Vermont has relatively streamlined processing.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Vermont through:
- Online at VermontHealthConnect.gov (state health exchange)
- Phone: 1-855-899-9600 (Vermont Health Connect)
- Download application at dvha.vermont.gov and mail to: Vermont Health Connect, 312 Hurricane Lane, Suite 201, Williston, VT 05495
- In-person at district Department for Children and Families office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Vermont from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Vermont-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MoreDr. Dynasaur (CHIP)
Vermont's Children's Health Insurance Program providing comprehensive coverage for children up to age 19.
Learn MoreVermont Health Connect
State health exchange that also processes Medicaid applications with integrated enrollment.
Learn MoreNeed Help with Vermont Medicaid?
Contact Vermont Department of Vermont Health Access for specific questions about eligibility, application status, or covered services.