Vermont Long-Term Care Medicaid can pay for care in an approved residential care home or assisted-living facility, but it pays for the services, not the room-and-board portion of the stay.,

Assisted living in Vermont runs about $103,167 a year in CareScout's 2025 survey, the 5th highest median of any state. Vermont Medicaid reaches residential settings through two named services rather than one: Assistive Community Care Services and Enhanced Residential Care. This guide shows which of those services can reach your parent's residence, and how families cover the rest of the bill.

In This Guide

What Assisted Living Costs in Vermont

In the CareScout 2025 Cost of Care Survey, released March 2, 2026, Vermont's assisted living median is about $103,167 a year, the 5th highest of any state and 9 percent above the 2024 figure, against a national median of $74,400 a year or about $6,200 a month. At that price, a single year in a Vermont residence can take a six-figure bite out of a parent's savings, which is why the plan matters so much here.

Vermont is not expensive in just one category: the CareScout 2025 survey places Vermont in the top 10 highest costs in every category it measures.

Care setting Vermont median (2025) National median (2025)
Assisted living about $103,167 a year about $74,400 a year
Non-medical caregiver at home about $102,960 a year about $80,080 a year
Nursing home, semi-private room about $169,360 a year about $114,975 a year
Nursing home, private room about $186,333 a year about $129,575 a year

In CareScout's 2025 survey, Vermont's non-medical caregiver median, about $102,960 a year, is the 2nd highest in the country, so staying home with paid help is not an obvious discount in Vermont. A semi-private nursing home room in Vermont, at about $169,360 a year in CareScout's 2025 survey, runs well above the Vermont assisted living median.

CareScout's Vermont figures are industry-survey medians collected from providers at the metropolitan statistical area level between July and November 2025, not government rates, and costs vary within the state and rise as care needs grow. Treat them as planning anchors rather than quotes. Ask each residence for an all-in monthly price that separates the base rate from the care-level add-ons; that number is what everything below has to cover.

Level III, Level IV, or an Assisted Living Residence?

In Vermont the difference that matters most for money is licensure: both Vermont Medicaid routes below are defined by the license a home holds.

Vermont's Department of Disabilities, Aging and Independent Living (DAIL) licenses residential long-term care through its Division of Licensing and Protection. Vermont's Residential Care Home and Assisted Living Residence licensing rules are issued as a single rule document, effective April 1, 2025, which licenses two settings.

  • A residential care home is licensed at Level III or Level IV. Both levels must provide room and board, assistance with personal care, general supervision and medication management. A Level III home must additionally provide nursing overview.
  • An assisted living residence combines housing, health and supportive services to support resident independence and aging in place, and must offer, within a homelike setting, a private bedroom, private bath, living space, kitchen capacity and a lockable door. Vermont's licensing agency will not issue an assisted living residence license unless the applicable residential care home requirements for a Level III home are met, with limited exceptions the rule lists.

So the question to ask on a tour is not "are you assisted living?" It is "what license do you hold, are you enrolled as a Medicaid provider, and will you keep my parent once the savings run out?" Both Vermont Medicaid routes below are written around a Level III residential care home or an assisted living residence, so the license decides whether either route could apply. A Vermont residential care home is not required to accept SSI or ACCS payments, and its admission agreement must tell the resident whether it will accept them, and so whether a privately paying resident can stay once they can no longer pay the home's rate. A Vermont home that reserves that decision may transfer or discharge a resident whose financial status changes and who can no longer pay privately. Get the answer in writing before a deposit changes hands, because a move forced by money is the hardest kind of move on a parent.

Paying Privately for Assisted Living in Vermont

Until Medicaid eligibility is in place, the bill is yours, and the hardest part is watching a balance fall without knowing what happens when it runs out. Putting a date on that turns dread into a plan.

Don't count on Medicare for this part. Medicare Part A and Part B don't pay the room-and-board or custodial-care costs of an assisted living facility, meaning the help with bathing, dressing and eating that most assisted living provides, and a Medigap policy doesn't fill that gap. A Medicare-covered medical service stays covered while your parent lives in assisted living; what Medicare won't pay is the facility's own room-and-board and personal-care charge.

The sources families draw on instead:

  • Income: Social Security, pensions and retirement-account withdrawals.
  • Savings and investments: drawn down on a written schedule against the residence's actual monthly price, so you know roughly which month they would run low.
  • The family home: selling it, or borrowing against it through a home-equity line.
  • Annuities and life-insurance conversions: turning a policy into a long-term-care benefit, or a lump sum into predictable monthly income.

Do the arithmetic early rather than in a crisis. Federal Medicaid law sets a 60-month look-back on assets disposed of for less than fair market value, and the look-back applies to Vermont Long-Term Care Medicaid, so decisions about the house and about gifts to children are the expensive ones to make late.

Long-Term Care Insurance and VA Benefits

If your parent bought a long-term care policy years ago, find it this week. For the long-term care Medicare won't pay for, Medicare.gov names buying private long-term care insurance as one alternative, alongside Medicaid and paying privately. Call the carrier and ask whether the policy pays in a Vermont residential care home or assisted living residence before you plan around it. Our national guide to how to pay for assisted living explains how these policies work.

Veterans and surviving spouses may qualify for VA Aid and Attendance, which our guide to VA Aid and Attendance for assisted living in Vermont explains.

What Vermont Medicaid Pays For in a Residence

Vermont's Global Commitment to Health is a demonstration waiver authorized under Section 1115(a) by the federal Centers for Medicare and Medicaid Services, and Vermont's Long-Term Care Medicaid program includes Choices for Care. Vermont Long-Term Care Medicaid can pay for care in your own home or another person's home, in an approved residential care home or assisted-living facility, or in an approved nursing home.

Two Vermont Medicaid routes reach a licensed residence, and both pay for the services rather than the room-and-board portion of the stay.

  • Assistive Community Care Services (ACCS) is the Medicaid State Plan service that pays for a bundle of health care services for beneficiaries living in participating Level III residential care homes. A home must be licensed at Level III and enrolled as a Medicaid provider to take part.
  • Enhanced Residential Care (ERC) is a 24-hour package of services provided by an approved Level III residential care home or an assisted living residence under Choices for Care, Vermont's Section 1115 Medicaid long-term care waiver.

One caution: the federal compendium of Vermont's residential care regulations describes Choices for Care as serving people who meet Medicaid's nursing home level of care criteria, and as providing enhanced residential care as an entitlement to those at the highest classification of need, and to as many people at the high need classification as state funds permit. Ask the Department of Vermont Health Access (DVHA) and DAIL where your parent's assessed need falls before you count on ERC.

That leaves the room and board. Vermont pays an optional state supplement to Supplemental Security Income recipients and, per that same federal compendium, limits room and board charges for Medicaid-eligible residents to the combined SSI and optional-state-supplement payments minus a personal needs allowance the resident keeps. The federal compendium gives no current dollar amount, so treat the mechanism as the reliable part and get the number from DVHA. An ACCS resident's agreement must state the ACCS services, the specific room and board rate, the amount of personal needs allowance, and the provider's agreement to accept room and board and Medicaid as sole payment. Ask to see a sample agreement before you sign; the rate you will owe is written into it.

Do You Qualify? Vermont's 2026 Income and Resource Rules

Long-Term Care Medicaid in Vermont has four gates: Vermont residency, age 65 or older or 18 or older with a physical disability, the financial criteria, and the clinical criteria for nursing home level of care. Vermont's DVHA determines financial eligibility and Vermont's DAIL determines clinical eligibility for Choices for Care, and Vermont reviews Long-Term Care Medicaid eligibility at least once a year once it is granted.

Income. Vermont's institutional income standard is 300 percent of the maximum SSI federal payment to a person living independently in the community: $2,982 a month for 2026, three times the $994 SSI federal benefit rate effective January 1, 2026. Vermont also runs a medically needy coverage group, so someone whose income or resources exceed Vermont's categorically-needy limits may still qualify by spending down. And if the Social Security Administration grants your parent SSI, your parent is automatically eligible for Vermont's Medicaid for the Aged, Blind and Disabled, with no separate income or resource test.

Resources. The Choices for Care countable resource limit is $2,000 for a single person and $3,000 for two people, or $5,000 if you own your home and continue to live in it. Vermont's Choices for Care limits apply only to countable resources, such as cash, savings, bank accounts, stocks, bonds and non-home real property; Vermont's rule excludes, among other things, any car used to provide necessary transportation and up to $10,000 of burial funds designated for burial expenses. For a single parent moving into a residence, that means a lifetime of savings generally has to come down to $2,000 in countable resources before Vermont Medicaid can help with the care, and that is a hard thing to watch. Knowing the number early lets you spend it on your parent's comfort rather than lose it to a rushed decision.

The higher $5,000 figure is not meant for a residence. Vermont's $5,000 Choices for Care limit for a homeowner is a home-based long-term care disregard: an extra $3,000 on top of the standard $2,000 for an aged or disabled person without a spouse who owns and lives in their home and chooses to receive Medicaid long-term care there. Vermont's home-based disregard ends once the person begins receiving Medicaid long-term care in an institution or in a residential care home that provides enhanced residential care, with up to 6 more months allowed if the home upkeep deduction requirements are met. Plan the resource picture for the residence, not for the house.

The house itself. A Vermont applicant's home is fully excluded when its equity value is under $752,000, the 2026 federal minimum home equity limit; Vermont's own rule fixes no dollar figure and ties the limit to annual consumer price index changes, so the number rises each January. Substantial home equity does not block Vermont Medicaid coverage at all when the owner's spouse, a child under 21, or a blind or permanently and totally disabled child of any age lawfully lives in the home.

What your parent keeps, and what a spouse keeps. A nursing-facility resident on Vermont Medicaid keeps a personal needs allowance of $79.93 a month, while a Vermont Medicaid recipient living at home or in an apartment keeps $1,483 a month for maintenance needs, which DVHA publishes as the community maintenance allowance in the home-and-community-based waiver program. Those two DVHA figures name a nursing facility and the home-and-community-based waiver, not a residential care home or an assisted living residence, so ask DVHA which amount applies to your parent's setting and year. When one spouse needs care, the at-home spouse can keep up to $162,660 in additional resources in 2026 under Vermont Medicaid. See Vermont Medicaid spousal impoverishment rules.

Estate recovery. Federal law requires Vermont to seek recovery from the estate of a Vermont Medicaid recipient who was 55 or older when they received nursing facility services, home and community-based services and related hospital and prescription drug services. Vermont Medicaid estate recovery may be made only after the death of any surviving spouse, and only when there is no surviving child under 21 or blind or permanently and totally disabled child. Vermont's protections for a family home are in Vermont Medicaid estate recovery.

Building Your Plan to Pay for Assisted Living in Vermont

You will probably combine several of these, and needing every one is not a sign anyone planned badly. Private income and savings carry the first stretch; a long-term care policy or VA benefits can narrow the monthly gap for households that have them; and Vermont Medicaid, through Assistive Community Care Services or Enhanced Residential Care, takes over the care portion, never the room and board. The step families miss is the admission agreement: settle whether the home will accept SSI and ACCS before the savings run low, not after.

To apply for Vermont Long-Term Care Medicaid, complete the Application for Long-Term Care Medicaid (form 202LTC), printed from DVHA or mailed to you if you call 1-802-476-0100 or toll-free 1-833-840-0061, and mail it to Green Mountain Care, Application and Document Processing Center, 280 State Drive, Waterbury, VT 05671-1500. For help applying for Choices for Care, DVHA points Vermonters to the Vermont Senior Helpline at 1-800-642-5119, their local Area Agency on Aging, or their local home health agency. Our guide to applying for Vermont Medicaid walks through the steps.

Vermont Long-Term Care Medicaid and Choices for Care Ask about the 202LTC application, the financial test, and the clinical level-of-care assessment. dvha.vermont.gov
DAIL Division of Licensing and Protection Confirm a residence's license level before you sign. dail.vermont.gov
Vermont Senior Helpline DVHA points Vermonters here for help applying for Choices for Care. 1-800-642-5119

Frequently Asked Questions

Does Vermont Medicaid pay for assisted living?

Yes for the care, no for the room and board. Vermont Long-Term Care Medicaid can pay for care in an approved residential care home or assisted-living facility. In a Vermont residence, Vermont Medicaid's two residential services, Assistive Community Care Services and Enhanced Residential Care, cover the services but not the room-and-board portion of the stay.

What happens if my parent runs out of money in a Vermont residence?

It depends on the admission agreement. A Vermont residential care home is not required to accept SSI or ACCS payments, and a Vermont home that reserves that decision may transfer or discharge a resident whose financial status changes and who can no longer pay privately. Find the clause on SSI and ACCS before your parent moves in, not after the money is gone.

Does Vermont Medicaid count my parent's car or burial fund?

Not in the usual case. Vermont's Choices for Care resource rule excludes any car used to provide necessary transportation and up to $10,000 of burial funds designated for burial expenses, so those do not count toward the $2,000 Vermont limit for a single person.

Learn More

Care TypesHow to Pay for Assisted Living by StateHow to pay for assisted living by state: Medicaid programs, state help and room-and-board rules all differ. See real examples, then open your state's guide. Care TypesAssisted Living in VermontAssisted living in Vermont runs about $8,595 a month. How DAIL licenses ALRs and residential care homes, what it costs, and what Medicaid will and won't pay. Care TypesCost of Senior Care in VermontWhat senior care costs in Vermont in 2026: assisted living about $103,137 a year, a private nursing-home room about $186,333. See every setting and how to pay. Care TypesAssisted Living vs. Nursing Home in VermontAssisted living vs. nursing home in Vermont turns on level of care and who pays: about $103,137 a year private-pay assisted living vs. Medicaid-covered nursing. MedicaidHow Vermont Medicaid Pays for Home and Community CareVermont Medicaid HCBS services run through Choices for Care, the state program that pays for home and community long-term care at a nursing-home level of care. MedicaidYour Guide to Vermont Medicaid Income and Asset LimitsVermont Medicaid uses spend-down, not a hard income cap. See the 2026 $2,000 asset limit, Choices for Care rules, spousal protections, and how to qualify. VA BenefitsVA Aid and Attendance for Assisted Living in VermontVA Aid and Attendance helps pay for assisted living in Vermont. 2026 rates up to $2,874/mo, eligibility rules, UME income offset, and free Vermont VSO help. MedicaidVermont Medicaid Personal Needs AllowanceVermont lets a nursing-facility Medicaid resident keep a $79.93/month Personal Needs Allowance in 2026. Here's how it works and how it's protected. MedicareDoes Medicare Pay for Assisted Living?Does Medicare pay for an assisted living facility? No, not the room and board or personal care. Here's what it does cover, why, and how families actually pay. Care TypesTypes of Senior Care: A Guide to Every OptionFrom a few hours of help at home to 24-hour nursing care: the types of senior care, what each costs in 2026, whether Medicare or Medicaid pays, and how to pick. FinancialHow to Pay for Assisted Living: the national guideHow to pay for assisted living in 2026: what it costs and how private pay, Medicaid waivers, VA Aid and Attendance, and long-term care insurance each fit.

Find personalized help paying for assisted living in Vermont at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

Still have questions?

Brevy answers from this guide and every other guide here, and can check what you qualify for.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.