We scoured the internet to bring you everything you need to know about Vermont’s Medicaid Benefits.
Medicaid is a joint federal-state program that provides health insurance to low-income people who satisfy specific criteria, such as children, pregnant women, the elderly, and people with disabilities. It is simple to apply for Medicaid in person, by phone, or online.
This article will tell you all you need to know about Medicaid in Vermont.
What is the Vermont Medical Program?
Vermont Medicaid is a service for adults and families with specific income and resource requirements. Within the confines of stated laws, resources broadly apply to the elderly, blind, or crippled population.
Who is eligible for the Vermont Medical Program?
Vermont Medicaid provides some financial assistance with Medicare premiums and copayments or coinsurance to select limited Medicaid beneficiaries who are not eligible for the complete Medicaid benefit package through the Medicare Savings Plan.
- Expectant mothers
- People who are blind or disabled or who have a spouse who is blind or disabled;
- People whom someone adopts;
- People whom someone adopted;
- People who are blind or disabled or have a spouse who is disabled.
The Annual Household Income Limits (before taxes)
|Household Size*||The Maximum Income Level (Per Year)|
*For households with more than eight people, add $6,277 per additional person.
How do I contact Medicaid in Vermont?
Department of Vermont Health Access
280 State Dr., NOB 1 South
Waterbury, VT 05671-1010
What are the Medicaid plans in Vermont?
Global Commitment to Health (GCH) Demonstration program
As part of extensive changes to the state’s healthcare system, Vermont launched the Global Commitment to Health (GCH) Demonstration program, also known as Green Mountain Care, in 2005.
The program built on the state’s experience expanding Medicaid coverage through managed care and running a public worked care model.
The program employs a public managed care model. The Department of Vermont Health Access (DVHA), the state’s only managed care company, is supervised by the Vermont Agency for Human Services (AHS), the state’s Medicaid agency.
Choices for Care program
Except for long-term treatments and supports, which are delivered on a fee-for-service basis under a different Choices for Care program, Green Mountain Care is required for most of the state’s beneficiaries and covers most of the Medicaid services.
The DVHA has agreements with other state agencies to provide specialty care, including behavioral health services, developmental disability services, and specialized child and family services. It contracts with providers and pays them for all Medicaid benefits.
For more details regarding Medicaid plans in Vermont, visit here.
How do I apply for Vermont Medicaid?
Call 1-855-899-9600 to enroll.
Apply in person at the Department of Vermont Health Access.
Online: Download and print the application.
Mail: To 280 State Dr., NOB 1 South, Waterbury, VT 05671-1010
What is covered by Vermont Medicaid?
Vermont Medicaid covers the following services:
|Ambulatory surgery||Hospital stays|
|Audiology services||Laboratory tests|
|Behavioral health services||Vision care|
|Women’s health care||Non-emergency transportation|
|Dialysis||Orthotic and prosthetic devices|
|Doctor visits||Occupational therapy|
|Smoking cessation services||Pharmacy (medications)|
|Emergency care||Physical rehabilitation|
|Family planning services||Preventive care|
|Hearing aids||Hospital outpatient care|
|Home health care||X-rays and other radiology services|
Can I have both Vermont Medicaid and Medicare?
People who are disabled or older than 65 may be considered “dual eligible.” Dual-eligible people are split into two categories: Duals with full benefits: They are covered by both Medicaid and Medicare.
- Global Commitment to Health
- Choices For Care
They do not have to pay a copayment. When a member is
- under 21 years old;
- Held by the state
- Placed under government supervision
- Native American participants who qualify for Contract Health funding
- Services or Tribal Union of Indian Health Services
- The hospital (inpatient)
- A facility for skilled nursing
- A nursing home
What is not covered by Vermont Medicaid?
In Vermont, Medicaid is not required to provide in-home care or private nursing coverage. Bandages, adult diapers, and other disposable products, as well as cosmetic surgery and other elective operations, are routinely excluded from insurance coverage.
What is the highest income limit for Vermont Medicaid?
The highest income limit for Vermont Medicaid is $18,075 for an individual and $24,353 for a family of two per year.
What if a person’s income is too high to qualify for regular Medicaid benefits?
Even if your income is too high, thanks to the asset spend-down option; you may still be eligible for Vermont Medicaid.
What documents do I need to apply for Medicaid?
The following documents are required with the application:
- The Social Security Number;
- Evidence of citizenship or authorized residency in the United States, such as a passport, driver’s license, birth certificate, green card, or job authorization card
- Evidence of all income sources, both legal and illegal
- Proof of origin
- Proof of residency
- Including the Medicare card, any insurance cards
- When non-parents apply for Medicaid on their behalf, they must provide evidence of their financial position.
What is the best Medicaid in Vermont?
Because it differs from person to person, the ideal plan for you is the one that fulfills your needs and provides the most benefits in terms of health insurance and monetary assistance.
Where do I find the letter showing the reason(s) for denial or discontinuance from Vermont Medicaid?
By signing into your account at Portal, you can see the progress of your Vermont Medicaid application.