Vermont Medicaid (Green Mountain Care) Long Term Care Programs, Benefits & Eligibility Requirements
Summary
Medicaid’s rules, benefits and name can all vary by state. In Vermont, Medicaid is also called Green Mountain Care. This article focuses on Vermont Medicaid Long Term Care for seniors, which will pay for care in nursing homes, beneficiary’s homes, assisted living residences and other settings through the Choices for Care program or Medicaid for the Aged, Blind and Disabled (MABD). These programs are for persons who are seniors (65+), blind or disabled and are different from the Medicaid programs for adults 19-64 years old, pregnant women, children, and parents.
Table of Contents
Last Updated: Sep 24, 2026
Vermont Medicaid Long Term Care Programs
Nursing Home / Institutional Medicaid
Vermont Medicaid, via its Choices for Care program (specifically the High/Highest Needs Group), will cover the cost of long-term care in a nursing home for financially limited Vermont seniors who require a Nursing Facility Level of Care. Vermont Nursing Home Medicaid coverage includes payment for room and board, as well as all necessary medical and non-medical goods and services, such as:
- Personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting)
- Skilled nursing care
- Physician’s visits
- Prescription medication
- Medication management
- Mental health counseling
- Social activities
Items not covered include a private room, specialized food, comfort items not considered routine (tobacco, sweets and cosmetics, for example) and any care services not considered medically necessary.
Vermont Nursing Home Medicaid beneficiaries are required to give most of their income to the state to help cover care expenses. They are only allowed to keep a “personal needs allowance” of $79.93/month, which can be spent on personal items such as clothes, snacks, books, haircuts, flowers, etc. They can also keep enough of their income to make Medicare premium payments if they are “dual eligible,” and enough to make any Medicaid-approved spousal income allowance payments to financially needy spouses who are not Medicaid applicants or recipients.
Vermont Nursing Home Medicaid is an entitlement. This means all qualified applicants are guaranteed by law, aka “entitled,” to receive benefits without wait. However, not all nursing homes accept Medicaid, and those that do may not have any available spaces when you or your loved one needs care. So, eligible applicants are guaranteed nursing home coverage without wait, but they are not guaranteed coverage in any facility they choose.
Home and Community Based Services via Choices for Care
Vermont’s Choices for Care (CFC) program provides home and community based long-term care services and supports to Vermont seniors. CFC is divided into two groups: High/Highest Needs and Moderate Needs.
Choices for Care High/Highest Needs Group
While CFC High/Highest Needs Group long-term care benefits include nursing home care, seniors can also receive home and community based services, given they require a Nursing Facility Level of Care. Potential benefits include adult day care, assistive devices, companion care, home modifications, housekeeping services (including meal prep) and personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting). Program participants also receive basic healthcare coverage.
The Department of Vermont Health Access can assign a licensed caregiver to provide CFC High/Highest Needs Group benefits, but program participants also have the option to self-direct their care through the Flexible Choices program. This means they can hire caregivers of their choice (including friends, spouses and other family members), and they have greater flexibility in the type of medical equipment and supports they can purchase.
Program participants receiving home and community based services can live in their own home, the home of a loved one, an adult family care home, an assisted living residence, a Level III Residential Care Home or a home for the terminally ill. CFC will not cover room and board expenses.
Home and community based services via CFC High/Highest Needs Group are not an entitlement. Remember, entitlement means guaranteed by law. So, even if an applicant is eligible, they are not guaranteed by law to receive the benefits. For CFC High/Highest Needs Group, there are a limited number of enrollment spots. Once those spots are full, additional eligible applicants will be placed on a waitlist. Priority is based on need for care.
Choices for Care Moderate Needs Group
Vermont’s Choices for Care (CFC) Moderate Needs Group program does not require that an applicant be eligible for Medicaid (even though it is a Medicaid program). The Moderate Needs Group provides long-term care services and supports to Vermont Medicaid recipients who have a medical need and are at risk of nursing home care, but who do not require a Nursing Facility Level of Care. Potential benefits include adult day care, home modifications, housekeeping services (including meal prep) and personal care assistance with the Activities of Daily Living. Note: Persons who want basic healthcare coverage via Medicaid must apply for this benefit separately.
The state can assign a licensed caregiver to provide CFC Moderate Needs Group services, but program participants also have the option to self-direct their care through “flexible funds”. While friends and some relatives, such as one’s adult child, can be hired to provide care, one’s spouse cannot be hired. And program participants also have greater flexibility in the type of medical equipment and supports they can purchase.
The number of persons who can enroll in this program may be limited do to funding. When funded is depleted, a waitlist forms. CFC Moderate Needs Group applicants who are already covered by Vermont’s Medicaid for the Aged, Blind and Disabled will receive priority.
Medicaid for the Aged, Blind, and Disabled
Vermont’s Medicaid for the Aged, Blind and Disabled (MABD) provides healthcare coverage and long-term care services and supports to Vermont residents with limited financial means who are aged (age 65+), blind or disabled. MABD is sometimes called Regular Medicaid for seniors, but it should not be confused with the Medicaid programs for adults 19-64 years old, pregnant women, children, and parents.
Vermont’s MABD is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive healthcare coverage without wait. Access to long-term care benefits via MABD depends on the availability of funds, programs and caregivers in the area where the beneficiary lives.
The state will conduct an assessment of MABD beneficiaries to determine what type of long-term care benefits they need and the state will cover. They can receive these long-term care benefits through three programs.
- Attendant Services Program – covers long-term care in the beneficiary’s home or the home of a loved one
- Adult Day Services Program – provides adult day care and health services
- Assistive Community Care Services – covers long-term care in assisted living residences and residential care homes
Attendant Services Program
Vermont’s Attendant Services Program (ASP) covers long-term care services and supports for MABD beneficiaries who have a “permanent and severe disability” and require help with at least two Activities of Daily Living (mobility, bathing, dressing, eating, toileting). ASP participants must live in their own home or the home of a loved one.
The Attendant Services Program provides personal care assistance with the Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning and medication management). This assistance will be provided depending on the needs and circumstances of each individual. The state can provide a licensed caregiver to deliver these services, or the program participant can self-direct their care by hiring caregivers of their choice, including friends and some family members. Spouses cannot be hired as caregivers.
Adult Day Services
Vermont’s Adult Day Services program provides adult day care, supervision and health services to Vermont adults with physical and/or cognitive impairments.
This program operates approximately 11 day health centers across the state. These centers offer social interaction and activities, health and therapy services, as well as nutritional meals. The centers also provide support, education and respite care for the program participant’s family members and caregivers.
For Vermont residents enrolled in MABD, the Adult Day Services program is an entitlement, which means all eligible applicants are guaranteed to receive benefits.
Assistive Community Cares Services (ACCS)
Vermont’s Assistive Community Cares Services (ACCS) covers long-term care services and supports for MABD beneficiaries who are at risk of a nursing home placement and live in assisted living residences or licensed Level III residential care homes. ACCS applicants must require assistance with their Activities of Daily Living (mobility, bathing, dressing, eating, toileting).
ACCS benefits include assistive therapy, case management, housekeeping assistance, routine nursing tasks, medication management and personal care assistance with the Activities of Daily Living.
Like Vermont’s MABD coverage, ACCS is an entitlement. This means that all eligible applicants are guaranteed to receive benefits.
Eligibility Criteria For Vermont Medicaid Long Term Care Programs
To be eligible for Vermont Medicaid, a person has to meet certain financial and functional (medical) requirements. The financial requirements vary by the applicant’s marital status, if their spouse is also applying for Medicaid, and what program and services they are applying for – Nursing Home Medicaid coverage through Choices for Care High/Highest Needs Group, Home and Community Based Services (HCBS) through Choices for Care, or Medicaid for the Aged, Blind, and Disabled (MABD).
Vermont Nursing Home Medicaid Eligibility Criteria
Financial Requirements
Vermont residents have to meet an asset limit and an income limit in order to be financially eligible for nursing home coverage through Vermont Medicaid’s Choices for Care High/Highest Needs Group. For a single applicant in 2026, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts (if not paying out), stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Counts the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The 2026 income limit for Vermont Nursing Home Medicaid for a single applicant is $2,982/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. However, Vermont Medicaid beneficiaries who reside in nursing homes must give most of their income to the state to help pay for the cost of care. They are only allowed to keep $79.93/month of their income as a “personal needs allowance,” and they are allowed to make Medicare premium payments if they are “dual eligible.”
For married applicants with both spouses applying, the 2026 asset limit for nursing home coverage through Vermont Medicaid is a combined $4,000, and the income limit is a combined $5,964/month. For a married applicant with just one spouse applying, the 2026 asset limit is $2,000 for the applicant spouse and $162,660 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The income limit is $2,982/month for the applicant, and the income of the non-applicant spouse is not counted. Married Vermont Nursing Home Medicaid recipients are also required to give most of their income to the state. They are allowed to keep $79.93/month as a personal needs allowance and enough to make Medicare premium payments. In addition, they are allowed to keep enough income to make any allowable spousal income allowance payments (up to $4,066.50/month in 2026) to financially needy spouses who are not enrolled in Medicaid.
Functional Requirements
The functional, or medical, criteria for nursing home coverage through Vermont Medicaid is needing a Nursing Facility Level of Care (NFLOC), which means the applicant requires the kind of full-time care that is normally associated with a nursing home. The state will conduct a functional assessment of applicants to determine if they do require that level of care. The assessment will take into consideration an applicant’s ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting), their need for skilled nursing and their cognitive state. Take a Medicaid Functional Eligibility Test developed by Eldercare Resource Planning to determine if you or a loved one might meet the functional criteria.
Eligibility Criteria for Home and Community Based Services via Choices for Care
Financial Requirements
Vermont residents have to meet an asset limit and an income limit in order to be financially eligible for home and community based services through Vermont’s Choices for Care program. For a single applicant in 2026, the asset limit is $2,000, with two exceptions. Single applicants for the High/Highest Needs Group who own and live in their own home have a $5,000 asset limit. And the asset limit for the Moderate Needs Group is $10,000 for single applicants. The asset limit takes into account almost all countable assets, such as bank accounts, retirement accounts (if not paying out), stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The 2026 income limit for a single applicant for Choices for Care home and community based services is $2,982/month. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. To understand exactly how your income might impact Medicaid eligibility, consult with a professional like a Certified Medicaid Planner or Elder Law Attorney. Single applicants for the Moderate Needs Group have an “adjusted” income limit of $2,982/month. To calculate “adjusted income”, countable assets above the $10,000 asset limit are calculated towards the income limit.
For married applicants with both spouses applying for Choices for Care High/Highest Needs Group, the 2026 asset limit is a combined $4,000, and the income limit is $2,982/month per spouse. For a married applicant with just one spouse applying, the 2026 asset limit is $2,000 for the applicant spouse and $162,660 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. The 2026 income limit is $2,982/month for the applicant, and the income of the non-applicant spouse is not counted. Additionally, the non-applicant spouse may receive up to $4,066.50/month from their applicant spouse as a spousal income allowance.
For married applicants for the Choices for Care Moderate Needs Group (with one or both spouses applying), the 2026 asset limit is $10,000, and the income limit is an “adjusted” $5,964/month. To calculate “adjusted income”, a couple’s countable assets above $10,000 are calculated toward their monthly income limit.
Functional Requirements
The functional, or medical, criteria for Choices for Care (CFC) depends on the program. CFC High/Highest Needs Group applicants must require a Nursing Facility Level of Care. Vermont’s Department of Disabilities, Aging and Independent Living will conduct a functional assessment of applicants to determine if they do require that level of care. The assessment will take into consideration an applicant’s ability to complete the Activities of Daily Living (mobility, bathing, dressing, eating, toileting), their need for regular skilled nursing (such as dialysis, tube feedings and wound care) and their cognitive state. Take a Medicaid Functional Eligibility Test developed by Eldercare Resource Planning to determine if you or a loved one might meet the functional criteria.
CFC Moderate Needs Group applicants do not have to meet a Nursing Facility Level of Care, but they must meet one of the following functional, or medical, criteria:
• Their health will worsen if they do not receive benefits.
• They have a chronic health condition that requires monitoring at least once a month.
• They need daily supervision due to impaired decision making.
• They need help with at least one Activity of Daily Living (mobility, bathing, dressing, eating, toileting) or one Instrumental Activity of Daily Living (such as shopping, cooking, cleaning, medication management) at least three times in a seven-day period.
Vermont Medicaid for the Aged, Blind, and Disabled Eligibility Criteria
Financial Requirements
Vermont residents have to meet an asset limit and an income limit in order to be financially eligible for Medicaid for the Aged, Blind and Disabled (MABD). For a single applicant in 2026, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. For married applicants, the asset limit is a combined $3,000 combined, which applies to couples with both spouses applying or with just one spouse applying. Countable assets include bank accounts, retirement accounts (if not paying out), stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset (see the How Medicaid Treats the Home section below for more details), and there are other non-countable assets, like Irrevocable Funeral Trusts and Medicaid Compliant Annuities.
The 2026 income limit for MABD applicants is $1,375/month outside of Chittenden County and $1,483/month inside of Chittenden County. These limits are for both single and married applicants with one or two spouses applying. To be clear, this means the combined income of a married couple is calculated towards the income limit. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc.
The Look-Back Period does not apply to MABD. However, MABD applicants should be careful about Look-Back violations because they might eventually need Nursing Home Medicaid or HCBS Waivers, and those violations will make them ineligible for either of those programs.
Functional Requirements
The only functional requirement to receive healthcare coverage via Medicaid for the Aged Blind and Disabled in Vermont is being age 65 or over, blind or disabled. For MABD applicants/recipients who need long-term care services and supports, the state will administer an assessment of their ability to perform Activities of Daily Living (mobility, bathing, dressing, eating, toileting) and the Instrumental Activities of Daily Living (such as shopping, cooking, cleaning and taking medications) to determine what kind of long-term care benefits the state will cover.
How Medicaid Treats the Home
One’s home is often their most valuable asset, and if counted toward Medicaid’s asset limit, it would likely cause them to be over the limit. However, in the following situations the home is not counted:
- If the applicant lives in their home and the home equity interest (the portion of the home’s equity value that the applicant owns minus any outstanding mortgage/debt) is less than $752,000 (as of 2026) then the home is exempt.
- If the applicant’s spouse, minor child, or blind or disabled child of any age lives there, the home is exempt regardless of the applicant’s home equity interest, and regardless of where the applicant lives.
- If none of the above-mentioned people live in the home, the home can be exempt if the applicant/beneficiary files an “intent to return” home and the home equity interest is at or below $752,000.
These rules apply to all three types of Medicaid, with one important exception – MABD applicants can disregard the home equity limit. Value does not matter regarding their home’s exempt status. To learn more about the impact of home ownership on Medicaid eligibility, click here.
Vermont Medicaid applicants and recipients may also want to consider protecting their home (and other assets) from estate recovery. States are required by law to try and collect reimbursement for long-term care after the death of Medicaid recipients. They do this through their Medicaid Estate Recovery Programs (MERPs). The rules and regulations regarding estate recovery can vary greatly by state, but all states have a MERP. To learn more about the MERP in Vermont and how you can protect your home from it, click here.
Qualifying with Medicaid Planning
Even if Vermont residents don’t meet their financial limits for Medicaid eligibility, there are still ways they can qualify. If they are over their asset limit, they can reduce their assets by “spending down” or using a Medicaid Asset Protection Trust. While the Look-Back Period prevents Nursing Home Medicaid and HCBS Waiver applicants from simply giving away their home, they could use the Child Caregiver Exemption or Sibling Exemption to transfer their home to a qualified family member, which would prevent the home from counting against the asset limit.
Vermont residents who are over their income limit can use the Medically Needy Pathway to reduce their income and become eligible. It works like an insurance deductible. Vermont Medicaid applicants/beneficiaries must pay for their medical expenses during their “spend down period” until they meet their “spend down” amount, which is calculated using their income and Vermont’s Medically Needy Income Limit, which is $1,375 outside of Chittenden County and $1,483 inside of Chittenden County. These limits are for both single and married applicants/beneficiaries. Once they have reached their spend down amount, Medicaid will cover their medical expenses for the remainder of the spend down period. In Vermont, the spend down period for Choice for Care (nursing home coverage and some home and community based programs) is one month, while the spend down period for Medicaid for the Aged, Blind and Disabled is six months.
These Medicaid Planning strategies tend to be complicated, so consulting with a professional like a Certified Medicaid Planner or an Elder Law Attorney before attempting any of them on your own is recommended.
Applying For Vermont Medicaid Long Term Care Programs
The first step in applying for Vermont Medicaid Long Term Care is deciding what type of coverage you’re applying for – Nursing Home Medicaid through Choices for Care, Home and Community Based Services through Choices for Care, or Medicaid for the Aged Blind and Disabled (MABD).
The second step is determining if the applicant meets the financial and functional criteria, also discussed above, for that program. Applying for Vermont Medicaid when not financially eligible will result in the application, and benefits, being denied.
During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Vermont Medicaid applicant. These documents will be needed for the official Medicaid application. Necessary documents may include tax forms, Social Security benefit letters, deeds to the home, proof of life insurance and quarterly statements for all bank accounts, retirement accounts and investments. For a complete list of documents you might need to submit with your Medicaid Long Term Care application, go to our Medicaid Application Documents Checklist.
After financial eligibility requirements are checked and double checked, documentation is gathered, and functional eligibility is clarified, Vermont residents can apply for nursing home coverage and home and community based services through Choices for Care using application 202LTC, which can be found halfway down this webpage. They can also get the application by calling 1-833-840-0061 or 1-802-476-0100. Completed applications should be mailed to Vermont Health Connect, 280 State Drive, Waterbury, VT, 05671-1500.
Vermont residents can apply for Medicaid for the Aged Blind and Disabled (MABD) online, by downloading the 205ALLMED application from this webpage, or requesting an application by calling 855-899-9600. Completed applications can be mailed to Vermont Health Connect, 280 State Drive, Waterbury, VT, 05671-1500.
For step-by-step guides to applying for each of the 3 types of Medicaid Long Term Care, just click on the name: 1) Nursing Home Medicaid 2) HCBS Waivers 3) Medicaid for the Aged Blind and Disabled.
Choosing a Vermont Medicaid Nursing Home
After being approved for nursing home coverage through Vermont Medicaid, seniors have to choose which Medicaid-accepting nursing home best meets their needs. Even though Nursing Home Medicaid is an entitlement, not all nursing homes accept Medicaid, and those that do may not have available space. Finding the right residence can be a challenge, especially if you’re looking in a specific location.
Vermont has 34 nursing homes, and 33 of them accept Medicaid. They are spread throughout the state with a few clusters around Burlington, Montpelier and Rutland. Residents in some Vermont communities, like Brattleboro and Rutland, often cross the state line for personal and business reasons, including healthcare, but Medicaid coverage does not cross state lines. So, someone with Vermont Medicaid would not be covered for nursing homes in New Hampshire, Massachusetts or New York, even if facilities in those states are convenient or well-suited for the Vermont resident.
When you’ve found nursing homes that meet your needs and accept Medicaid, you can start comparing them, if you have multiple options. The search on Nursing Home Care Compare can be filtered by staffing, health inspections, quality measures and overall rating, which can be a good place to start. The healthcare professionals who work with you are another great source of information. You can also contact your local Area Agency on Aging to find out more information about nursing homes in Vermont.
After doing some research, you or someone you trust should visit any nursing homes you’re considering before making a final decision. Call first to make an appointment for the visit, and arrive with a list of questions, like: How does the facility handle dental and vision care? Does it offer social activities? What is the food like? Who are the staff doctors? CMS has a comprehensive “Nursing home checklist” you can use to evaluate a nursing home while visiting.
Data collected by CMS reveals that nursing homes in Vermont fare well when it comes to fire safety. They averaged just 5.6 fire safety deficiencies during a sample taken from 2018-2023, while the national average was 13.5 during that same time frame. Vermont nursing homes also averaged 24.5 health deficiencies, which was in line with the national average of 27.2. On the down side, 15% of residents in Vermont nursing homes had depressive symptoms, but the national average was 9%.