Vermont Medicaid

Last verified: June 2026

What is Vermont Medicaid?

Vermont Medicaid is administered by the Department of Vermont Health Access (DVHA), within the Agency of Human Services. DVHA also administers Vermont's state-based health insurance exchange, Vermont Health Connect — making it one of the few states that integrates Medicaid and commercial marketplace enrollment under one agency.

Vermont expanded Medicaid under the ACA. Approximately 220,000 Vermonters are enrolled, out of a total state population of under 650,000 — one of the highest Medicaid enrollment rates per capita in the country. Vermont has near-universal insurance coverage overall, with Medicaid serving as a primary mechanism for reaching low- and moderate-income residents.

Vermont delivers Medicaid through managed care organizations rather than straight fee-for-service. DVHA contracts with managed care plans that coordinate care for members. Vermont also operates under a Global Commitment to Health 1115 waiver, which gives Vermont unusual flexibility in structuring Medicaid spending and integrating it with other state health investments.

Who qualifies for Vermont Medicaid?

Vermont covers multiple eligibility categories with income thresholds that are among the most generous in the country — particularly for children and pregnant women. Adults qualify under standard ACA expansion rules at 138% FPL, but children and pregnant women qualify at significantly higher income levels.

• Adults ages 19–64 (Medicaid Expansion): at or below 138% FPL
• Children (Dr. Dynasaur program): up to 312% FPL — one of the most generous children's programs nationally
• Pregnant women: up to 208% FPL
• Aged, blind, or disabled (MABD — Medicaid for the Aged, Blind and Disabled): separate income and asset rules
• Long-term care (Choices for Care waiver): separate LTC eligibility
• Former foster care youth through age 26

Source: DVHA Vermont Medicaid Programs page (dvha.vermont.gov/members); Vermont Health Connect eligibility information. Verify current figures at dvha.vermont.gov or by calling 1-855-899-9600.

Vermont's single-payer history and what it means today

Vermont made a serious attempt to implement a statewide single-payer health care system. Act 48, passed in 2011, established the Green Mountain Care Board and directed the state to create a universal coverage plan. Governor Peter Shumlin abandoned the effort in December 2014, citing unsustainable financing requirements — the plan would have required an 11.5% payroll tax and a new income tax of up to 9.5%.

The Green Mountain Care Board continues to operate today with a different mandate — regulating hospital budgets and health care costs in Vermont. Vermont remains the only state with an all-payer model for hospital rate setting. The Board's ongoing work on cost containment and quality oversight makes Vermont's health system meaningfully different in structure from most other states, even without universal coverage.

Applying for Vermont Medicaid

Apply through Vermont Health Connect at portal.healthconnect.vermont.gov, by calling 1-855-899-9600, or by working with a local Assister (find one at info.healthconnect.vermont.gov/find-local-help/find). Paper applications are available at info.healthconnect.vermont.gov/how-apply/paper-applications. DVHA integrates Medicaid and marketplace enrollment — one application covers both.

Vermont Medicaid topics

What does Vermont Medicaid (Green Mountain Care) cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the Vermont Medicaid (Green Mountain Care) website for the current state-specific benefit package.

How to apply

Most people can apply online through Vermont's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). Vermont must follow that federal timeline.