Assisted Living in Vermont
The 2022 Senior Living Report places Vermont in the number one spot overall for senior living in the United States, so it’s worth taking a closer look at this retirement destination. In fact, Vermont is ranked among the top 10 in health care, affordability, transportation and quality of life. There’s a higher than average number of primary care physicians in the state, and world-class hospitals like UVM Medical Center are nearby in case of emergency. The crime rate is significantly below the national average, adding to seniors’ sense of well-being.
When it comes to affordability, seniors in Vermont benefit from a cost of living lower than the national average; however, assisted living costs are on the higher side at $5,250 per month. Currently, 20% of the state’s 645,000 residents are aged 65 and older, meaning there’s a large community of seniors, as well as programs and entertainment to serve that population.
This guide provides an overview of the cost of senior living in Vermont, with a more detailed look at assisted living prices in the state. It also has information regarding Medicaid, assisted living regulations and resources available to help older Vermonters.
The Cost of Assisted Living in Vermont
According to the Genworth Cost of Care Survey 2021, the average monthly price of assisted living in Vermont is $5,250. This is $750 higher than the national average of $4,500. Compared to its neighbors, Vermont’s costs are in the middle of the range. New York is more affordable at $4,580, while in New Hampshire, seniors pay $6,053 monthly. Massachusetts has the highest prices among Vermont’s neighbors at $6,500 per month, $1,250 higher than Vermont’s costs.
The United States
At $6,371 per month, prices in Burlington are more than $1,000 higher than the state average. As it’s a small state, prices aren’t available for Vermont’s other cities; however, lower prices can be found just over the state border. In Glens Falls, New York, seniors pay $4,250. Springfield, Massachusetts, is also more affordable at $5,048 per month. This isn’t the case to the east of Vermont; in Manchester, New Hampshire, the average price is $8,061, which is $2,811 higher than the Vermont average.
Glens Falls, NY
Vermont has a wide range of senior living options available for older residents. Adult day health care is the most affordable at $3,224 per month. The costs of home care and home health care are almost $500 higher than assisted living costs, at $5,720. Nursing home care is the most expensive choice, with seniors paying $10,585 for a semiprivate room and $11,102 for a private room.
Home Health Care
Adult Day Health Care
Nursing Home Care (semiprivate)
Nursing Home Care (private room)
Does Medicaid Cover Assisted Living in Vermont?
In Vermont, Medicaid is known as Green Mountain Care. It’s operated under the authority of the Global Commitment to Health Waiver, which is generally just called Medicaid to avoid confusion. It provides a wide range of services to diverse beneficiaries throughout the state.
Seniors living in assisted living facilities may be able to receive financial assistance directly through Medicaid. Alternatively, there’s a waiver program that can help people pay for assisted living care. Both programs pay for care provided in a facility but don’t provide funds for room and board.
What Assisted Living Services Are Covered by Medicaid in Vermont?
There are two programs that can help seniors pay for assisted living in Vermont. The first, known as the Assistive Community Care Services (ACCS) care program, provides services directly through Medicaid. It’s available for people enrolled in the community Medicaid program who live in or are moving to a Level III assisted living facility or residential care home. It’s intended to help people who can’t live independently at home but don’t need the level of care found in nursing homes.
The ACCS is an entitlement, so services are available to everyone who qualifies for the program. These services include personal care, case management, routine nursing, medication assistance, assistive therapy and restorative nursing. In addition to being eligible for Medicaid, applicants must require ACCS services and live in a participating facility. If you aren’t already on Medicaid, you must apply to ensure you’re eligible. Otherwise, the first step in applying is to find a participating facility that meets your needs.
Assisted Living Waiver Programs in Vermont
Choices for Care
Choices for Care (CFC) is the second program that offers assisted living support. It provides long-term support services to adults in Vermont who require a nursing home level of care and is available to people aged 65 and older and those 18-64 who have a physical disability. Applicants must also meet the financial eligibility criteria for Medicaid waivers in the state.
The program is designed to delay or prevent nursing home placement, so the services provided are intended to help people remain living at home or in the community. Services include case management, personal care, assistive technology and emergency response systems. Assisted living is listed as a separate benefit and incorporates many of the program’s other benefits. Each recipient is approved for a specific suite of services based on their needs and where they reside.
To apply for the program, seniors can contact the Department of Children and Family Services benefit hotline at (800) 479-6151. Alternatively, local Area Agencies on Aging can provide information and assistance.
How To Know If You’re Eligible for Medicaid in Vermont
The primary eligibility criteria for Medicaid is financial, as the program is designed to help low-income people access health care. Applicants must meet both asset and income limits, and these can be different depending on the program you’re applying for.
People in Vermont applying for Community Medicaid, which includes the ACCS program, cannot receive more than $1,166 per month in income. People residing in Chittenden County have a higher limit, currently $1,266 monthly. Single applicants can have up to $2,000 in assets, while married applicants can have up to $3,000.
Income limits for those applying for CFC are higher, currently $2,523 in income and $2,000 in assets for singles. The income limit is $5,046 for married people if both are applying, while the asset limit is $4,000. This is the same for people in Chittenden County.
If only one spouse is applying for CFC, the limits are the same as for singles; however, the non-applicant spouse may be eligible for a Minimum Monthly Maintenance Needs Allowance. This allows the applicant to transfer income to their spouse to ensure their financial needs can be met. Additionally, the non-applicant can have up to $137,400 in assets.
Not all assets are counted when calculating Medicaid eligibility. Personal belongings, an automobile and irrevocable burial trusts are generally not counted. A home is not included if a person’s spouse still lives there.
2022 Medicaid Income Limits* for Seniors in Vermont
(Only One Person Applying)
(Both People Applying)
Community Medicaid including ACCS
$13,992 income; $2,000 assets
$13,992 income; $3,000 assets
$13,992 income; $3,000 assets
Choices for Care Waiver
$30,276 income; $2,000 assets
$30,276 income; $2,000 assets applicant, $137,400 assets non-applicant
$60,552 income; $4,000 assets
In addition, applicants must meet certain functional and other eligibility requirements. Recipients must be:
- A Vermont resident
- A U.S. national, citizen, personal resident or legal alien
- In need of a particular level of care, which depends the program requirements
How To Apply for Medicaid in Vermont
Vermonters can apply for Medicaid online through Vermont Health Connect. You can also work with an assister to apply. Other options include applying by phone by calling the Customer Support Center at 1-855-899-9600 or completing a paper application and returning it by mail.
Information You Will Need
Medicaid needs to verify certain information to process your application. The documentation you may need to provide includes proof of:
- Citizenship or immigration status
- Social Security Number
- Current health insurance
How to Get Help Applying for Medicaid
Vermont has an assisters program that provides in-person assistance to people applying for Medicaid and other health insurance. In addition, Medicaid has a comprehensive website that can answer questions and a health insurance counseling program to assist seniors.
Local assisters online
Vermont’s Assister Program has three types of roles: navigators, certified application counselors and brokers. Of particular interest to seniors are the navigators, who are funded by state grants and can assist anyone in the community who requires help with their health care coverage.
The State Health Insurance Program helps Medicare beneficiaries navigate their health insurance benefits. Counselors can assist with both private and public programs, including Medicaid. The program is run through local Area Agencies on Aging.
The Vermont Medicaid website has information about the various programs offered by the state, plus the eligibility requirements and application processes.
The short answer is that no, Medicare does not cover the cost of assisted living in Vermont. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Vermont.
Other Financial Assistance Options for Assisted Living in Vermont
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.
How to Apply
How It Works
Aid and Attendance
Learn more and apply online at va.gov.
Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.
Learn more about your options and how to apply at ftc.gov
If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) Insurance
Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for an LTC insurance policy.
Free and Low-Cost Resources for Seniors in Vermont
Vermont has a range of government and nonprofit organizations that support seniors. Older Vermonters can access advice, technology and financial resources to assist them as they age. There are also information services that connect seniors to local resources.
There are five Area Agencies on Aging located across Vermont that provide support and advocacy for seniors in the state. Services available include nutrition programs, transportation, home health services and wellness programs. AAAs also run the Senior Helpline that provides information and connects seniors to local resources.
Although this program falls under the larger Choices for Care program, it is available to people not eligible for Medicaid. There are also less rigorous functional requirements, as the program accepts people who don’t need a nursing home level of care. Those who need minimal assistance to stay living at home can access a wide range of in-home services and support, although it does not cover care provided in assisted living. Applicants may be placed on a waitlist.
Healthy Vermonters and VPharm are Vermont’s prescription assistance programs. Healthy Vermonters provides discounts on medications with no monthly premiums, while VPharm has a small monthly premium and helps people pay for prescriptions. The programs are available to those who meet income and other guidelines.
The Vermont Assistive Technology Program helps people find solutions to overcome barriers related to aging and disability. Local Tryout Centers give people the opportunity to try assistive technology, and there’s a loan program that allows you to borrow equipment and try it at home for 30 days. The program also has an exchange that allows people to access used items for a lower cost.
The Long-Term Care Ombudsman Program works to improve the lives of people living in nursing homes, residential care homes and assisted living facilities. It also helps people who receive long-term care in their homes through CFC. Volunteers can resolve complaints, educate people about their rights and advocate for seniors at a facility and in the state legislature. It’s run by Vermont Legal Aid.
COVID-19 Rules for Assisted Living in Vermont
The following information is based on research done on several government websites, including healthvermont.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 4/25/22, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Outings & Social Activities
Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?
Are residents who leave required to quarantine when they return?
Are senior living communities required to cancel all group outings?
Are residents allowed to eat meals together in a common area?
Are residents allowed to gather in common areas for group activites?
COVID-19 Safety Measures for Staff and Residents
Are staff members regularly required to do a temperature check?
Are staff members regularly tested for COVID-19?
Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?
Are residents regularly screened for COVID-19 symptoms?
Are residents regularly checked for elevated temperatures?
Are residents regularly tested for COVID-19?
Assisted Living Laws and Regulations in Vermont
Assisted living facilities in Vermont are licensed and regulated by the Department of Disability, Aging and Independent Living, Division of Licensing and Protection. The division makes sure that facilities comply with the rules and regulations that protect the welfare and rights of residents and ensure that people receive quality care. Assisted living communities are governed by both assisted living and residential care home regulations.
Assisted Living Service Plan Requirements
Residents must be assessed within 14 days of admission to a facility. The facility and the resident or their authorized representative work together to develop a care plan that describes the needs and choices of the residents and how the facility will meet these needs. The plan must be reviewed at least annually or whenever a change in the resident’s condition or circumstances warrant a review.
Assisted Living Admission Requirements
Assisted living facilities may accept any individual who requires a nursing home level of care and whose needs can be met by the facility.
Facilities can’t admit anyone who requires medical, surgical or nursing care from a hospital. People who require specific types of treatment or equipment also can’t be admitted. This includes those who need a ventilator, respirator or people who need two-person assistance to walk or transfer from bed.
Assisted Living Scope of Care
Assisted living facilities combine housing, health and supportive services for residents. They must promote self-direction and active participation in decision-making by residents.
Assisted Living Medicaid Policy
Vermont has various Medicaid programs that can fund care in assisted living facilities, including Choices for Care and Assistive Community Care Services. Facilities that participate in these programs must be licensed to do so and may have additional requirements that must be met. Not all facilities can receive Medicaid funding, so you should confirm the payment options available to you before finalizing your choice of facility.
Assisted Living Facility Requirements
In Vermont, all apartments must have private occupancy unless the resident voluntarily chooses to share. These apartments must contain a private bedroom, bath, living space, kitchen capacity and lockable door. A studio apartment can meet these requirements. In addition, the apartment must be at least 225 square feet, excluding the bathroom and closets. Residents must also receive adequate storage space.
All doors must be accessible or able to be adapted for wheelchair use. Facilities must provide at least two common areas and access to outdoor recreation areas.
Medication Management Regulations
Staff in assisted living facilities can’t assist with or administer medications, whether prescription or over-the-counter, unless there’s a written, signed order by a physician.
Not all facilities offer medication management. For those that do, medication must be administered under the direction of a licensed nurse. Unlicensed staff may administer medication if an RN has assessed the resident’s needs and delegated the task. Any medication that’s administered must be documented.
Facilities must have sufficient staff to provide necessary care and maintain a safe and healthy environment.
Staff Training Requirements
Staff must be adequately trained to perform the required services. People providing direct care must receive at least 12 hours of continuing training each year.
In addition, facilities must provide new staff with an orientation that includes training in the philosophy and principles of assisted living.
Background Checks for Assisted Living
All staff who provide personal and healthcare services are subject to a background check through the abuse registry and the Vermont Criminal Information Center.
Requirements for Reporting Abuse
Any incidents of abuse or suspected abuse must be reported to Adult Protective Services within 48 hours of the facility becoming aware of it. In addition, a written report must be filed with the licensing agency.