Vermont Medicaid Income Limits 2026: Eligibility & Assets

Vermont Medicaid has no hard income ceiling for long-term care. Instead of turning away an applicant who earns a few dollars too much, the state lets that person spend the excess down on care and still qualify. That single design choice separates Vermont from income-cap states, and it changes how a family should approach long-term-care eligibility here.1,2

This guide covers the 2026 income and asset rules for Vermont Medicaid long-term care, run by the Department of Vermont Health Access (DVHA) through its Choices for Care program. It explains the $2,000 asset limit, how the medically-needy spend-down works (and why there is no Miller Trust), what a nursing-home resident keeps, what a spouse who stays home is protected from, and the look-back and estate-recovery rules that catch families off guard.

In This Guide

• Vermont Medicaid in 2026: the numbers that matter
• What Choices for Care actually is
• The asset limit, and what does not count
• How Vermont Medicaid income limits work: spend-down, not a cap
• Vermont Medicaid income limits for working-age adults (before 65 or Medicare)
• Which income test applies to a senior
• Long-term care: what a nursing-home resident keeps
• Protecting the spouse who stays home
• After death: estate recovery
• How to apply in Vermont
• Where to get help
• Frequently Asked Questions
• Learn More

What Choices for Care actually is

Vermont Medicaid (Green Mountain Care) covers long-term care for older and disabled residents through Choices for Care, one of four programs under Vermont's long-term-care Medicaid umbrella. The Department of Vermont Health Access (DVHA) decides financial eligibility; the Department of Disabilities, Aging and Independent Living (DAIL) runs the program and decides clinical eligibility. It serves Vermonters who need a nursing-home level of care, at home, in a family member's home, an Adult Family Care home, Enhanced Residential Care, or a nursing facility.1,6

The point worth holding onto is that Choices for Care covers care outside a nursing home, not just inside one. A Vermonter who qualifies financially and clinically can choose to receive Medicaid-funded help at home or in an enhanced residential care setting, not only in a facility.6 The financial rules below (the asset limit, the spend-down, the spousal protections) apply across those settings.

The asset limit, and what does not count

For a single long-term-care applicant, Vermont limits countable assets to $2,000. An aged or disabled applicant without a spouse who owns and lives in their home receives an additional $3,000 resource disregard on top of that, but only if they choose to receive their long-term-care services in that home. It is a home-care disregard, not a general one: it stops once the person begins long-term care in an institution or in a residential care home providing enhanced residential care, continuing at most six months longer if they meet the home-upkeep-deduction rules. A family pricing a nursing home should plan on the $2,000 alone.1

"Countable" is the word doing the work. Vermont exempts a long list of assets from the count: the home (subject to an equity cap, covered below), all automobiles used to provide necessary transportation, home furnishings, apparel, personal effects and household goods, and fully paid burial spaces. So the $2,000 applies to things like bank accounts and investments, not the roof over your head or the car in the driveway.1

That low resource limit is the part of Vermont's rules that catches families by surprise, because the income side is far more forgiving than they expect.

How Vermont Medicaid income limits work: spend-down, not a cap

Here is where Vermont parts ways with several other states. Vermont runs two income paths for long-term care, and the second is what removes the cliff.

The first is a special income standard. For someone living in a medical institution it is a four-part test, and all four must be met: at least 30 consecutive days in an institution, countable income at or below the institutional income standard, resources within the asset limit, and the program's non-financial rules. That standard is 300% of the maximum SSI payment: $2,982 per month for an individual, $5,964 for a couple, effective 1/1/26.1,7

Someone seeking Choices for Care at home does not need a 30-day nursing-home stay first. Vermont applies that test as if the person were in an institution, then adds an income test and a state finding that they can get appropriate long-term care in the community.1

The second is the medically-needy path, and it is the reason income above that standard does not end the conversation. Someone who would fit a categorically needy coverage group can still qualify even though their income exceeds the group limit, by incurring enough expenses to spend down their income to the Protected Income Level (PIL); resources can be spent down to the asset limit the same way. Vermont sets the PIL by county: for a household of one or two it is $1,375 per month outside Chittenden County and $1,483 per month inside it (HBEE § 29.14, effective 1/1/26).1

The mechanics differ a little by setting. For a nursing-facility resident, the spend-down effectively happens through the cost of care itself: the resident contributes income above their protected allowances toward the monthly bill, and Medicaid covers the balance. For community applicants whose income exceeds the protected level, the excess becomes a spend-down amount that is met by incurring medical or care expenses.1

This is why Vermont does not require a Qualified Income Trust, also called a Miller Trust. In states where higher-income applicants can qualify only under that 300% special income level, someone over it may still qualify by diverting income into that special trust.2 Vermont has no such cliff, because the medically-needy path catches the applicant the $2,982 standard turns away. If your income is high, you spend it down toward care; you are never simply "too rich" for Choices for Care.1

Vermont Medicaid income limits for working-age adults (before 65 or Medicare)

Everything above this point is about long-term-care Medicaid. But someone who searches "Vermont Medicaid income limits" may not be pricing a nursing home at all; they may be a working-age adult, perhaps in their early 60s and not yet on Medicare, asking whether they qualify for regular health coverage. That is a different pathway, with a different, and far simpler, rule.

Vermont adopted the Affordable Care Act Medicaid expansion, one of the 41 states including the District of Columbia that did.8 So an adult aged 19 to 64 who is not pregnant and not enrolled in Medicare generally qualifies for full Medicaid (in Vermont, Medicaid for Children and Adults) with income up to 138% of the federal poverty level: about $22,000 a year, or roughly $1,835 a month, for one person in 2026, measured against the $15,960 annual poverty guideline for a single-person household.9,10,8 The ceiling rises with household size.

Two features make this pathway simpler than the long-term-care rules above:

• There is no asset test. This track uses Modified Adjusted Gross Income (MAGI), and federal law bars states from applying any resource or asset test to the MAGI groups. Your bank account, your car, and your retirement savings do not count.3 This is the opposite of the $2,000 long-term-care limit above.
• What counts as income is the tax measure, and Social Security counts in full. On the MAGI track, a Social Security benefit is counted in full, including any portion that is not taxable, with none of the SSI-style income disregards the aged-and-disabled track allows.11 If your income runs above 138% of the poverty level, this pathway is closed; Vermont Health Connect, the route for Vermont's other health-care plans, is where to look next.1

Turning 65, or getting Medicare, closes this door. The expansion adult group is written for people under 65 who are not entitled to or enrolled in Medicare, so reaching either milestone ends eligibility on this pathway even if your income never changes.9 Turning 65 does not end every MAGI route, though: a parent or caretaker relative of a dependent child is still assessed under MAGI rules, with no asset test.12 Most seniors move to the Aged, Blind, and Disabled (ABD) track described in the next section, which applies an asset test and a medically-needy income test at Vermont's Protected Income Level ($1,375 a month outside Chittenden County, $1,483 inside, for one or two people).1 A 63-year-old covered here at $1,600 a month can find themselves over that level at 65 without a dollar of income changing, so it is worth knowing the switch is coming.

Which income test applies to a senior

A percentage-of-the-poverty-level figure, like the 138% above, belongs to the Modified Adjusted Gross Income (MAGI) test, tied to the Federal Poverty Level (FPL). It governs eligibility for working-age adults, children, pregnant women, and parents, not the long-term-care pathway a senior usually needs.3

A senior applying for long-term care goes through the Aged, Blind, and Disabled (ABD) pathway, which uses Supplemental Security Income (SSI)-related rules. That pathway is where the $2,000 asset limit and Vermont's spend-down rules apply. If you are pricing long-term care for a parent, the ABD/spend-down rules on this page are the ones that matter, not the MAGI poverty-level chart.1

Long-term care: what a nursing-home resident keeps

When Vermont Medicaid pays for nursing-facility care, DVHA computes a monthly patient share: the part of the resident's income that must be paid to the facility toward that care. What the resident keeps for themselves is the Personal Needs Allowance (PNA), money for anything the facility does not provide. Vermont sets its PNA at $79.93 per month, well above the federal floor of $30.1,3

The same $2,000 asset limit applies to nursing-home applicants.1 Because Vermont has a medically-needy spend-down path, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care after the PNA and other recognized deductions come out. For the national picture on how the PNA is calculated and what it covers, see our explainer on the Medicaid personal needs allowance.

The $79.93 figure is for institutional care only. Someone receiving the same level of care at home through a Choices for Care home- and community-based waiver keeps a community maintenance allowance of $1,483 per month instead, effective 1/1/26, because Medicaid is not paying their room and board. If your parent is being cared for at home, the number that applies to them is $1,483, not $79.93.1

The five-year look-back

Vermont reviews asset transfers made in the 60 months before a long-term-care application.1,13 Giving away money or property for less than fair market value during that window (gifting a grandchild a down payment, signing a house over to a child for a dollar) can trigger a penalty period during which Medicaid will not pay for long-term-care services, even though you are otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first. If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains in the community, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Vermont applies the federal framework for 2026:1,4

Read $162,660 as a standard, not a ceiling: Vermont's rule protects the greatest of that maximum, an amount set at a fair hearing, or an amount transferred under a court order, though a hearing first counts the income the applicant could make available to the at-home spouse.1,4 The home-equity limit Vermont applies is the $752,000 federal minimum: equity above it makes the applicant ineligible for long-term care, unless a spouse, a child under 21, or a child who is blind or permanently and totally disabled lives in the home.1,13 Vermont's own spousal-protection rules are covered in more depth in our guide to Vermont Medicaid spousal-impoverishment protections.

After death: estate recovery

Federal law requires states to seek repayment from certain Medicaid recipients' estates. In Vermont, when a recipient dies who was 55 or older when they received nursing-facility or home-based long-term care, DVHA will file a claim in probate court for what Medicaid paid for that care and related hospital and prescription-drug services, not for routine coverage.5

Read the survivor protections as a delay, not a cancellation. Federal law says recovery may be made only after the death of a surviving spouse, and only at a time when there is no surviving child who is under 21, blind, or permanently and totally disabled. A surviving spouse therefore postpones recovery for their lifetime rather than extinguishing the claim, and a child's protection based on being under 21 lapses when that child turns 21. Families who hear "my mother is survived by a spouse, so the state can never collect" have heard the rule one step short. Each state must also have a procedure to waive recovery for undue hardship.5

Vermont adds a protection of its own. Under 33 V.S.A. § 1906a, the state may not recover medical expenses against a homestead that would pass to a lineal heir or a sibling of the person who died, where that heir either has income below 300% of the federal poverty level or contributed significantly, financially or otherwise, to letting the person delay or avoid nursing-home placement.1 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Vermont

Vermont long-term-care Medicaid is run by the Department of Vermont Health Access (DVHA), under the Agency of Human Services' Health Benefits Eligibility and Enrollment (HBEE) rules. Two agencies decide the two halves of your eligibility: DVHA's long-term-care unit determines financial eligibility, and the Department of Disabilities, Aging and Independent Living (DAIL) determines clinical eligibility for Choices for Care. Here is how the process works.1

Where to get help

Learn More

Find personalized help working through Vermont Medicaid eligibility and the Choices for Care spend-down for your family 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.