How Medicaid Can Help Pay for Long-Term Care in Vermont

Q: Does Vermont have a waitlist for long-term care Medicaid?

For the Highest Needs group — people requiring a full Nursing Facility Level of Care — no. Vermont's Choices for Care program is described as a national model specifically because nearly all eligible seniors in this group receive care at home or in a residential care home without a waitlist.

Q: What is Vermont's Moderate Needs Group?

A distinctive tier within Choices for Care covering people who aren't otherwise Medicaid-eligible under standard rules — a lower-bar entry point most states don't offer, made possible by Vermont's broader 1115 waiver structure.

Q: Does Vermont's asset limit really increase if I own my home?

Yes — a single applicant who owns and continues living in their home can have up to $5,000 in assets, rather than the standard $2,000 limit.

Published August 28, 2026 How we keep this accurate

This page is Vermont-specific. Medicaid long-term care rules vary significantly by state. See our national Medicaid Waivers Explained guide if you're elsewhere.

A genuine national model, and no waitlist for the highest-need group

Vermont's Medicaid program, Green Mountain Care, delivers long-term care through Choices for Care (CFC), operating under a broader 1115 demonstration waiver. The Highest Needs group — people requiring a full Nursing Facility Level of Care — has no waitlist. Nearly all eligible seniors in this group receive care at home or in a residential care home rather than being required to enter a nursing facility.

A tier most states don't offer

Vermont's Moderate Needs Group covers people who aren't otherwise Medicaid-eligible under standard rules — a genuinely distinctive, lower-bar entry point made possible by Vermont's broader waiver structure. If you or a family member needs some help but doesn't clearly meet the full nursing-facility standard, this tier is worth asking about specifically.

A real benefit for homeowners

Vermont's standard asset limit is $2,000 for a single applicant — but there's a genuine exception: if you own and continue living in your home, that limit increases to $5,000. Married couples with both spouses applying have a $4,000 combined limit.

Two very different personal allowances

	Nursing Home Medicaid	Choices for Care (at home)
Personal allowance	$79.93/month	$1,483/month
Why the difference	Medicaid covers room and board	Medicaid isn't covering room and board

Source: Vermont Department of Vermont Health Access (DVHA); figures effective 2026.

A favorable rule for retirement accounts

IRAs and 401(k)s in payout status — meaning at least the required minimum distribution is being withdrawn — are exempt from Vermont's asset limit, a genuinely favorable treatment for retirees.

No Miller Trust required

Vermont doesn't require a Qualified Income Trust — it uses a medically needy spend-down instead, meaning even a resident with substantial monthly income can qualify, simply contributing more toward their own care after allowances and deductions.

The 2026 financial numbers

Income limit: $2,982/month for the Highest Needs group.

Community Spouse Resource Allowance: up to $162,660, with a $32,532 minimum, plus a spousal income allowance up to $4,066.50/month.

A real cost worth knowing

Vermont's average nursing home cost runs around $13,500/month — among the highest nationally, making the state's genuinely accessible home-based alternatives especially valuable.

How to actually start

Apply through Vermont Health Connect or contact DVHA directly to begin a Choices for Care assessment — ask specifically which needs tier (Highest, High, or Moderate) fits your situation.

If you don't think you'll qualify based on standard Medicaid rules, ask about the Moderate Needs Group before ruling yourself out.

Common Questions

Does Vermont have a waitlist for long-term care Medicaid?

No, for the Highest Needs group — Vermont's Choices for Care is a national model with no waitlist for this tier.

What is Vermont's Moderate Needs Group?

A distinctive tier for people who wouldn't otherwise qualify for Medicaid, a genuinely lower-bar option most states don't have.

Does Vermont's asset limit really increase if I own my home?

Yes — up to $5,000 for a single applicant who owns and lives in their home, versus the standard $2,000.