Vermont

What Is Vermont Medicaid Long-Term Care?

Vermont Medicaid, known as Green Mountain Care, provides health coverage for low-income residents of all ages. For those aged 65 and older, it offers various long-term care services including nursing homes, assisted living, and in-home support to help seniors maintain independence.

What Are the Main Types of Long-Term Care Medicaid in Vermont?

There are three categories of long-term care Medicaid in Vermont:

• Institutional / Nursing Home Medicaid – Guaranteed for all who qualify; care is only available in nursing homes.
• Medicaid Waivers / Home and Community Based Services (HCBS) – Not guaranteed; limited spots and waiting lists apply. Services are available at home, in assisted living, or adult day care settings.
• Regular Medicaid / Medicaid for the Aged, Blind and Disabled (MABD) – Guaranteed benefits for eligible individuals. Offers support such as personal care assistance and adult day services.

What Are the 2025 Income and Asset Limits for Vermont Medicaid Long-Term Care?

‡ May have to contribute income toward care costs.
¶ SSI recipients in Vermont are automatically eligible for MABD.
Moderate Needs Group income cap: $2,996.04 (single), $4,562.40 (couple).
Home equity limit for exemption: $730,000 in 2025.

How Is Income Treated for Medicaid Eligibility?

What Income Is Counted?

Most types of income are counted, such as wages, Social Security, pensions, IRA withdrawals, and dividends. Exceptions in Vermont include VA Aid & Attendance benefits and Holocaust restitution payments.

How Is Income Handled for Married Couples?

For Nursing Home Medicaid and HCBS, only the applicant’s income is considered. The non-applicant spouse may be eligible for a Spousal Income Allowance to avoid financial hardship.

For Regular Medicaid, both spouses’ incomes are combined when determining eligibility, and no spousal allowance is available.

How Are Assets Evaluated?

What Assets Are Counted?

Countable assets include cash, savings, stocks, and real estate not used as a primary residence. Exempt assets include one’s home (under specific conditions), a car, personal belongings, and burial trusts up to $10,000. Retirement accounts in payout status are also exempt.

How Are Assets Handled for Couples?

Married couples’ assets are considered jointly owned. The non-applicant spouse of a Nursing Home Medicaid or HCBS applicant can retain up to $157,920 in 2025 through the Community Spouse Resource Allowance (CSRA). This does not apply to Regular Medicaid.

What Is Vermont’s Medicaid Look-Back Rule?

Vermont enforces a 60-month (5-year) look-back period for Nursing Home Medicaid and HCBS. Any asset transfers for less than fair market value may result in a period of ineligibility. Regular Medicaid is not subject to this rule.

Is a Home Always Protected Under Medicaid?

The applicant or their spouse must live in the home, or the applicant must intend to return. A home equity limit of $730,000 applies in 2025. While a home may be exempt during the applicant’s life, it can be subject to Medicaid Estate Recovery after death.

What Medical Needs Must Be Met?

Applicants must demonstrate a medical need for long-term care. Nursing Home Medicaid and HCBS require a Nursing Home Level of Care (NHLOC). Regular Medicaid requires help with Activities of Daily Living (ADLs) but not necessarily NHLOC.

Can Seniors Qualify If They Exceed Income or Asset Limits?

What Is the Medically Needy Pathway?

Vermont allows individuals with high medical expenses to “spend down” income to become eligible. In 2025, the income limits are $1,333/month outside Chittenden County and $1,444/month within. The asset limits are $2,000 for individuals and $3,000 for couples.

What Is an Asset Spend Down?

Seniors can spend excess assets on exempt items such as home improvements or burial plans to meet asset limits. Gifts or transfers within the 60-month look-back period can trigger penalties.

What Is Medicaid Planning?

Those over income or asset limits can seek help from a Medicaid Planner to use legal strategies that protect assets and gain eligibility while avoiding pitfalls like the estate recovery process.

What Specific Programs Are Available Under Vermont Medicaid?

Choices for Care Program

This program supports individuals who need nursing home-level care but wish to remain in their homes or other non-institutional settings. There is also a Moderate Needs Group that offers limited services without requiring full Medicaid eligibility.

Attendant Services Program (ASP)

Also called PDAC, this allows eligible individuals to hire personal attendants (including some relatives) to help with daily living tasks.

Adult Day Services

This program offers supervision, meals, therapy, and transportation for seniors during the day, providing relief for family caregivers.

Assistive Community Care Services (ACCS)

Provides support in assisted living-like environments for seniors who don’t need full nursing home care but cannot live alone.

Money Follows the Person

This federal initiative helps people in institutions transition back into home or community living settings with Medicaid support.

How Can Seniors Apply for Vermont Medicaid?

How Do You Apply for MABD?

Apply online, request a paper application by calling 855-899-9600, or download from Vermont Health Connect. Mail completed applications to Vermont Health Connect, 280 State Drive, Waterbury, VT 05671-8100.

How Do You Apply for Choices for Care?

Use the Long-Term Care Medicaid Application (Form 202LTC), available online or by calling 800-479-6151. Mail the completed form to the address above.

Where Can You Get Help Applying?

Local Area Agencies on Aging and trained Assisters are available to guide applicants through the process. Visit Vermont’s Medicaid website to find an Assister near you.

What Should You Do Before Applying?

Verify all eligibility criteria are met. If income or assets are too high, or eligibility is uncertain, consider Medicaid planning to improve the chance of approval.