Vermont Medicaid Long Term Care Eligibility for 2025

Vermont Long Term Care

Eligibility in 2025:

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1. Residency and Citizenship – the applicant must be a resident of Vermont and a U.S. citizen or have proper immigration status.

2. Age/Disability – the applicant must be age 65 or older, or blind, or disabled. The applicant must meet certain medical requirements consistent with the level of care requested.

3. Income Limitations – If single, the applicant’s income (wages, Social Security benefits, pensions, veteran’s benefits, annuities, SSI payments, IRAs, etc.) must be less than $2,901 per month. If married, the income limit increases to $5,802 per month for both spouses.

  • If the applicant lives at home and is receiving care there, they can keep $1,333 per month ($1,441 in Chittenden County).
  • If the recipient lives in a nursing home, they can keep $79.93/month as a personal needs allowance.
  • The recipient can keep an additional $767/month for upkeep of a home if they reside in a nursing facility but plan to return within six months, and no one else living in the home receives the institutionalized person’s income.
  • Up to $646.33/month may be kept for dependents beyond a spouse.

4. Asset Limitations (Exempt vs. Available) – Medicaid divides assets into two categories: Exempt and Available. Exempt assets are specifically designated under the rules, and ownership of an exempt asset by the applicant will not result in a denial of benefits. If an asset is not listed as exempt, it needs to be liquidated and applied toward the costs of nursing home care before the applicant can receive Medicaid benefits. Vermont has a look-back period of 5 years with a penalty for people who sell assets below fair market price, transfer assets to others, or give money and property away. Basically, all money and property, and any item that can be valued and turned into cash, is a countable asset unless it is listed as exempt.

Exempt Assets in 2025 for an applicant in Vermont include:

i. $2,000 or less in cash/non-exempt assets if single.

ii. One home is exempt (equity limit $730,000) if planning to return, a spouse, a child under 21, or a disabled person resides in it. Whenever an institutionalized person sells a previously exempted residence, the money from the sale becomes a countable asset. The recipient may then lose eligibility for Medicaid until they have spent down the money and their countable resources are once again less than the maximum.

iii. One automobile, no equity amount specified.

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iv. Burial plans, not exceeding $10,000 in value. This includes the value of pre-paid burial contracts, the cash value of life insurance policies, bank accounts, CDs, burial plots, and headstones.

v. Non-saleable property, household furnishings, furniture, clothing, jewelry, and other personal effects are not counted.

Spousal Rules for 2025:

Amount of assets a community spouse may retain: The community spouse can keep one-half of countable assets with a maximum value of $157,920. If the community spouse’s assets do not equal $157,920, the community spouse is able to retain assets from the institutionalized spouse until the amount is reached.

Community spouse impoverishment protection: The community spouse can keep part of the institutionalized spouse’s income if the community spouse has a monthly income of less than $2,555. The maximum amount of income that can be retained is $3,948, depending on unique living expenses. Shelter costs that exceed $767/month will increase the standard community spouse’s income allowance.

Further Reading:

Adult Services Division Information: http://asd.vermont.gov/services/choices-for-care-program

Vermont Programs and Waivers, policies and guidelines: http://dvha.vermont.gov/global-commitment-to-health/global-commitment-to-health-1115-waiver-2017-documents