Respite Care in Vermont: A 2026 Guide for Family Caregivers

Vermont family caregivers can get funded respite through Choices for Care Medicaid, the federal NFCSP caregiver program, Dementia Respite Grants, and the VA. The National Family Caregiver Support Program (NFCSP) and the Dementia Respite Grants both run through Vermont's five Area Agencies on Aging, and a call to the Vermont Senior Helpline at 1-800-642-5119 is directed to the Area Agency on Aging in your area.1,2,3

Caregiving without breaks is not sustainable. A break is not stepping away from your responsibility. It is what makes showing up tomorrow possible.

Why Respite Matters

Family caregiver burnout is not a personal failing. Vermont's Department of Disabilities, Aging and Independent Living says its Dementia Respite Grant and family caregiver programs help family caregivers by reducing stress, maintaining their health, and continuing their caregiving roles.2

If you need help now, call the Vermont Senior Helpline at 1-800-642-5119, which directs callers to their local Area Agency on Aging.1,3

How Vermont Pays for Respite Care

Several programs pay for respite in Vermont, and which one fits depends on your loved one's Medicaid eligibility, diagnosis, and veteran status. Here is how they compare before the detail below.1,5,2,10

Can Vermont Medicaid Pay for Respite? (Choices for Care)

It can. Vermont's Choices for Care (High/Highest), Vermont's Medicaid long-term care program administered by the Department of Disabilities, Aging and Independent Living (DAIL), provides a package of long-term services and supports to Vermonters who need a nursing home level of care. Age 18 is only the floor: the Department of Vermont Health Access requires a person to be at least 65, at least 18 with a physical disability, or eligible under Medicaid for Children and Adults rules. DAIL's Choices for Care manual also requires anyone seeking services other than nursing facility services to have a functional physical limitation from a physical condition (including stroke, dementia, or traumatic brain injury) or associated with aging, and a person whose need is due to a developmental disability, autism, or mental illness is not eligible. Eligible people choose where to receive their services: in their home, in their family's home, an Adult Family Care home, Enhanced Residential Care, or a nursing facility.1

How eligibility is decided: Your loved one must meet both a clinical and a financial eligibility test for long-term care Medicaid in Vermont, so the "nursing home level of care" label alone does not settle it. For help applying, call the Vermont Senior Helpline at 1-800-642-5119.1

Who directs the care: Enrollees can self-direct their services, have a qualified designated representative direct them on their behalf, or select traditional agency-based services.1

Can a family member be the paid caregiver? Within limits. DAIL's Choices for Care manual says a spouse or civil union partner shall not be paid to provide respite or companion care, and a spouse is paid only for personal care with activities of daily living (ADLs). DAIL's 2007 spousal-caregiver guidelines add that a paid spouse cannot be the participant's surrogate employer or legal guardian, and that a plan targeted specifically for the spouse's relief must be in place; adult day, respite, or companion services may be used to meet it. A pandemic-era expansion that let spouses be paid for companionship, respite, and IADLs ended after November 11, 2023. A legal guardian appointed by probate court may not be paid for personal care or Flexible Choices services unless DAIL grants an individual variance. DAIL's limits don't name adult children either way, so ask DAIL before you count on pay. The Choices for Care family caregiver rules cover who else can be paid and the hour limits.4

Best for: Vermont families where the care recipient needs a nursing home level of care and wants services at home or in a family member's home.

Dementia Respite Grants Through Your Area Agency on Aging

If your loved one has Alzheimer's disease or another dementia, Vermont's DAIL supports family caregivers through Dementia Respite Grants, which Vermont's five Area Agencies on Aging manage. Grants may be used to pay for a range of services including in-home care, respite care, homemaker services, and Adult Day services.2

How to access: Ask your regional Area Agency on Aging about a Dementia Respite Grant, including how much it can cover and who qualifies. The Eldercare Locator at 1-800-677-1116 can connect you to your local Area Agency on Aging.10

Best for: Vermont families caring for someone with dementia who want help paying for a break.

Respite Through the National Family Caregiver Support Program (Vermont's Five Area Agencies on Aging)

What it is: The National Family Caregiver Support Program (NFCSP), authorized by Title III-E of the Older Americans Act and administered federally by the Administration for Community Living, is delivered in Vermont through the state's five Area Agencies on Aging. They provide information about available services, help gaining access to services, individual counseling, support groups and caregiver training, respite care, and supplemental services on a limited basis.5,1

Who qualifies: Adult family members or other informal caregivers of someone 60 or older, or of someone of any age with Alzheimer's disease or a related disorder; relatives (not parents) 55 and older caring for a child under 18; and relatives, including parents, 55 and older caring for an adult 18 to 59 with a disability.5

The condition for respite: Federal law makes respite and supplemental services available to a family caregiver only when the person cared for is an older individual who is frail: unable to perform at least two activities of daily living without substantial human assistance, or needing substantial supervision because a cognitive or other mental impairment leads them to behave in a manner that poses a serious health or safety hazard. Information, access assistance, counseling, support groups, and training carry no such condition.5

How much respite will I get? NFCSP services are provided by your Area Agency on Aging or an entity it contracts with, so ask your regional AAA at intake what respite it can offer you.5

How to access: Call the Vermont Senior Helpline at 1-800-642-5119, which directs callers to their local Area Agency on Aging, or use the Eldercare Locator at 1-800-677-1116 to reach your regional AAA.10,1,3

Best for: Vermont family caregivers of a frail older adult who need a break, training, or counseling.

Adult Day Programs

What they are: Adult day health care services provide supervision, engagement, and structured daytime support.11

Who pays: Nationally, CareScout's 2025 Cost of Care Survey put the median daily rate for adult day health care at $95 per day, about $24,700 a year at five days a week. That is a provider rate, not necessarily what your family pays: private-pay rates in this setting are heavily influenced by Medicaid reimbursement rates, and actual costs vary with care needs, provider availability, and local market conditions. Dementia Respite Grants may be used for Adult Day services.11,2

Finding programs: The Eldercare Locator at 1-800-677-1116 connects families to services in their community, including the local Area Agency on Aging.10

Best for: Caregivers who need consistent daytime relief and care recipients who benefit from structured activity and engagement.

Respite for Veteran Families (VA)

PCAFC respite: Primary Family Caregivers in the Program of Comprehensive Assistance for Family Caregivers (PCAFC) receive at least 30 days of respite care per year as part of the benefit package, along with caregiver education and training and mental health counseling. A spouse can serve as the caregiver. Confirm authorized respite days and any cost-sharing with your local VA Caregiver Support Program team.6

Veteran eligibility: VA publishes four conditions, and they are the first screen rather than the decision. The veteran must meet all four:6

• A VA disability rating, individual or combined, of 70 percent or higher.6
• Discharge from the U.S. military, or a date of medical discharge.6
• A need for at least six months of continuous, in-person personal care services.6
• Enrollment in VA health care.6

Meeting those four is necessary, not sufficient. The binding test is 38 CFR 71.20(a), which states seven requirements and requires every one of them. Four of the seven have no counterpart in the four above, and VA assesses them during the application process:6

• Participating in the program is in the veteran's best interest.6
• The personal care services the family caregiver would provide are not simultaneously and regularly provided by or through another individual or entity.6
• The veteran receives care at home, or will do so if VA designates a family caregiver.6
• The veteran receives ongoing care from a primary care team, or will do so if VA designates a family caregiver.6

The no-other-provider condition is the one most likely to surprise a family, because a household already receiving regular personal care through another program or entity can fail PCAFC on that ground alone.6

How to access: Call the VA Caregiver Support Line at 1-855-260-3274, staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern. It can connect you directly to your local VA Caregiver Support Program team. It is not a crisis line: anyone in crisis or having thoughts of suicide should call 988 and press 1, text 838255, or chat at VeteransCrisisLine.net, any hour of any day.7

Best for: Family caregivers of a veteran who may qualify for PCAFC.

Does Medicare Cover Respite in Vermont?

Only in two narrow situations. The Medicare hospice benefit pays for inpatient respite care, one of its four levels of care, for a person who has elected hospice after a doctor certifies a terminal illness with a life expectancy of 6 months or less. The beneficiary pays 5% of the Medicare-approved amount for inpatient respite care, capped at the inpatient hospital deductible.8

Medicare's GUIDE dementia model also pays for respite, but not to the family. CMS pays a participating provider up to $2,625 per eligible patient for performance year 2026 (July 1, 2026 onward) for respite it delivers. Only patients aligned to a participating dementia care program qualify: the patient needs dementia confirmed by the program's clinician, Medicare Parts A and B with Medicare as primary payer, no Medicare Advantage plan, no hospice election, and no long-term nursing home stay. Residents of an assisted living or other residential care community are not eligible for GUIDE respite from performance year 2026 on, and a patient in a memory care unit cannot be aligned at all. Respite is limited to patients with moderate or severe dementia who have a relative or unpaid nonrelative as their primary caregiver. Ask your loved one's provider whether it participates.9

Beyond those two, the funded routes in this guide are Choices for Care, NFCSP, a Dementia Respite Grant, the VA, or private pay.

How to Start Respite Care in Vermont

Where to Get Respite Help in Vermont

Learn More

Find personalized help navigating respite care options 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.