Located along the northern border between Hampshire and New York, Vermont is a small state that’s home to 638,989 residents. Seniors age 65 and older make up 19.4% of the population, and with a statewide median age that’s the third-highest in the country, the number of seniors in Vermont is expected to rise in the next decade.

As one of the least-populated states, there are fewer senior living options in Vermont than in many other locations. Limited availability means the cost of senior living care is relatively high. For example at $5,338 per month, assisted living care in Vermont is $1,287 above the national average.

This guide covers the cost of senior care in Vermont and neighboring areas, financial resources to help cover care costs and information on local, state and federal services for seniors who need help navigating their long-term care options.

The Cost of Senior Living in Vermont

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

According to Genworth’s 2021 Cost of Care Survey, average costs of long-term care in Vermont typically run higher than national figures. Vermont seniors have several types of care to choose from, depending on their care requirements, preferences and financial situations.

Active seniors who have no medical or personal care needs may appreciate the social aspect and low-maintenance lifestyle provided by independent living communities. Older adults who require frequent assistance with day-to-day activities might be ideal candidates for assisted living facilities. Memory care, which is generally provided in assisted living communities, supports seniors with Alzheimer’s disease and other forms of dementia. Individuals who require skilled nursing care and continuous monitoring will likely benefit from nursing home care.   

Nursing homes provide the highest level of care. As such, nursing facility care is the costliest care option in Vermont, with average monthly rates of $10,585. Costing an average of $3,413 per month, independent living is the most affordable choice. At around $5,250, assisted living is a little more expensive. Although memory care is generally offered in assisted living communities, the specialized care and additional regulations result in a higher average cost of $6,563.  

The Cost of Assisted Living in Vermont

With a median cost of $5,250 per month, assisted living care in Vermont is costlier than the national average of $4,500. At $4,580 per month, New York shares similar costs with the U.S. average. Seniors in New Hampshire and Massachusetts typically pay more for assisted living, with average monthly rates of $6,053 and $6,500, respectively.

The Cost of Nursing Home Care in Vermont

Nursing home care in Vermont costs around $10,585 per month, which is more than $2,500 pricier than the nationwide average of $7,908. However, nursing home residents in Vermont generally pay less than those in neighboring states. In New Hampshire, median monthly fees are $10,950. Prices rise significantly in Massachusetts and New York, where the same type of care runs around $12,623 and $12,775, respectively.   

Can You Use Medicaid to Pay for Senior Living in Vermont?

Long-term care can be expensive. Fortunately, Vermont has programs to help older adults pay for care. Medicaid provides health insurance to help qualifying seniors close the gap between what they can afford and the overall cost of long-term care services.  

Vermont Medicaid, known as Green Mountain Care, operates using a unique restructured model that combines the state’s funds for institutional care and home- and community-based waiver services in one budget. The result is the long-term Choices for Care program, which operates within the Global Commitment to Health waiver.  

In Vermont, Medicaid covers nursing home services and care through the Choices for Care program.

Residents of assisted living or memory care communities may be eligible for assistance via the Choices for Care program. Those with the highest care needs receive services in an assisted living or memory care community as an entitlement. Those with lower care requirements, and classified as being High Need, may be eligible for assistance via the program. In this case, a wait list applies.

Alternatively, residents of participating Assisted Living Residences or Licensed Level III Residential Care Homes may be eligible for financial assistance via Medicaid’s Assistive Community Care Services (ACCS) program.

Because independent living is for seniors who don’t require clinical or personal care, Vermont Medicaid doesn’t cover this type of care.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Partial	Medicaid Waivers	YesNo
Independent Living	None	N/A	N/A
Memory Care	Partial	Medicaid Waivers	YesNo
Nursing Home Care	Full	Medicaid Waivers	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list. 

Medicaid’s Coverage of Assisted Living & Memory Care in Vermont

Seniors may qualify for assistance under the Choices for Care program, which operates under the Global Commitment to Health waiver. The Assistive Community Care Services (ACCS) program may help those who don’t meet the requirements of Choices for Care.

Choices for Care

Because of Vermont Medicaid’s unique framework, and with the option for individuals to choose their care setting, some residents of assisted living and memory care facilities are entitled to Medicaid assistance via the Choices for Care program.

Eligible seniors assessed as needing the highest level of care can opt to receive services in an assisted living community or residential care home rather than in an institutional setting.

Following assessment, older adults classified as having high levels of care requirements may be put on a wait list for services. Enrollment depends on the availability of funds. For these individuals, Choices for Care operates in a similar way to a regular Medicaid waiver.

While funding doesn’t cover the costs of room or board for either resident category, each receives the same services, including:

• Assistance with personal care 
• Housekeeping and laundry
• 24-hour supervision
• Nursing overview and medication management
• Recreational activities
• Meal preparation

To qualify for the Choices for Care program, seniors must satisfy financial and medical criteria.

Beneficiaries must undergo annual reassessments, which may result in a reclassification of care needs and subsequent change to Medicaid entitlement.   

Individuals can download form 202LTC, Application for Long-Term Care Medicaid. Alternatively, seniors can call (800) 479-6151 to request a paper application. Completed forms should be returned to:

Green Mountain Care
Application and Document Processing Center
280 State Drive
Waterbury, VT  05671-1500  

Assistive Community Care Services

Medicaid’s Assistive Community Care Service (ACCS) program provides financial assistance for qualifying seniors who live in a participating assisted living facility or a Licensed Level III Residential Care Home. 

The program covers various supportive services, including:

• Case management
• Restorative and routine nursing care
• Assistive therapy
• Medication management
• Personal care

It does not cover the costs of room and meals.

To qualify for Assistive Community Care Services, individuals must:

• Live in a participating residential care facility
• Need program services
• Satisfy financial criteria
• Be 65 or older or have a disability

Before applying, seniors should find a participating facility that can meet their care needs.

If individuals aren’t already enrolled in Medicaid, they must apply for coverage.

If Medicaid is approved, applications for services are made via the care home using the Verification of Eligibility for ACCS form.

Medicaid’s Coverage of Nursing Home Care in Vermont

In Vermont, Medicaid for institutional care and home- and community-based services are combined in the Choice for Care program. Although this program operates under the Global Commitment to Health waiver, seniors who are eligible for nursing home care are entitled to services. Around five in eight nursing home residents use Medicaid to cover care costs.  

Medicaid funding covers wide-ranging services for nursing home residents, including:

• Room and meals
• Skilled nursing care
• Medication management
• Rehabilitation therapies
• Nutrition
• Assistance with daily activities and personal care
• Recreational activities
• Housekeeping and laundry
• Transportation

Eligibility depends on medical need; applicants must satisfy criteria for the highest needs category of care as defined by Vermont’s Department of Disabilities, Aging and Independent Living (DAIL). Clinical need is determined through an in-person assessment, and needs are reassessed each year.

Medicaid recipients must use all their available income to pay for care, except for a monthly personal needs allowance of $72.66 and the cost of Medicare premiums. Medicaid provides further necessary funds to cover the full cost of care.

Eligibility for Medicaid in Vermont

Individuals applying for long-term care Medicaid in Vermont must satisfy income and asset limits. Single applicants and sole applicants from a two-person household cannot exceed a yearly income of $30,276. For joint-applicant couples, the annual income limit is $60,552. All applicants have an asset cap of $2,000. For couples where only one spouse applies for Medicaid, the non-applicant spouse has an increased resource limit of $137,400.  

2022 Vermont Medicaid Income Limits 

	Income Limits*	Asset Limits
Single Person	$30,276	$2,000
Two-Person Household(Only one applicant)	$30,276 for applicant	$2,000 for applicant$137,400 for non-applicant
Two-Person Household(Two applicants)	$60,552	$4,000

*per year

Seniors must also meet these eligibility requirements:

• Be U.S. citizens or qualifying noncitizens
• Reside in Vermont
• Satisfy clinical need criteria 

Applying for Medicaid in Vermont

Individuals can apply for regular Medicaid online via the Vermont Health Connect website or over the telephone at (855) 899-9600. Alternatively, seniors can complete a paper application form and return it to:

Vermont Health Connect
280 State Drive
Waterbury, Vermont 05671-8100

Note: Applications for Long-Term Care Medicaid must be made by mail.

Before You Apply

Having necessary documents on hand can make the application process easier. Before applying, individuals should gather:

• Social Security number
• Proof of identification and citizenship status
• Proof of in-state residency
• Information about all countable assets
• Current bank statements
• Health insurance policies
• Information about income
• Medical expenses

How To Get Help

Although applying for Medicaid can be daunting, there are several resources to help Vermonters understand eligibility and coverage and submit applications and appeals.   

	Contact	What You Should Know
Vermont Senior Helpline	(800) 642-5119	Trained advisors can help seniors navigate the Medicaid application system and complete applications. Helpline staff can also advise on diverse aging-related topics, including health insurance, transportation, support groups and senior centers.
Adult Services Division	(802) 241-0294	The Adult Services Division is responsible for assessing medical needs for long-term care Medicaid eligibility. Older adults can contact a member of the team for information about clinical requirements and eligibility.
Area Agencies on Aging	(800) 642-5119	Vermont’s five local Area Agencies on Aging (AAA) provide free supportive services to people aged 60 and above. Seniors can connect with their local agency for information and assistance related to Medicaid, as well as topics such as Medicare counseling, care options, social programs and nutrition.

Can You Use Medicare to Pay for Senior Living in Vermont?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Older adults in Vermont can obtain information and assistance related to Medicare from several sources. The following resources can help seniors and their loved ones understand health insurance plans, prices and policy coverage, compare health insurance plans and apply for coverage.

	Contact	What You Should Know
The Office of the Health Care Advocate	(800) 917-7787	Operated by Vermont Legal Aid, the Office of the Health Care Advocate provides free information and services related to health insurance. Advisors can help people obtain lower-cost health coverage, complete enrollment applications, understand medical bills and health plan coverage, appeal adverse decisions and file complaints. The helpline is staffed on weekdays between 8:30 a.m. and 4:30 p.m., or individuals can contact the office via an online form.
Vermont State Health Insurance Program	(800) 642-5119	Vermont State Health Insurance Program offers free, unbiased Medicare counseling to help individuals understand their options for health insurance coverage.
Social Security Administration	(800) 772-1213	The Social Security Administration (SSA) provides general information about Medicare, and advisors can check eligibility and help individuals enroll in health insurance coverage. Assistance is available via the toll-free number, the online contact form or in person at local Vermont SSA offices.

Are There Other Financial Assistance Options for Senior Living in Vermont?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Vermont. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Vermont

Various free and affordable services support Vermont’s seniors to maintain a good quality of life as they age.

	Contact	What You Should Know
Vermont Assistive Technology Program	(800) 750-6355	Operated by the Department of Disabilities, Aging and Independent Living, Vermont Assistive Technology Program runs four AT Tryout Centers where individuals can learn more about assistive technology and try new equipment. Individuals may also borrow equipment for up to 30 days to see if it meets their needs. The program also maintains the AT Exchange marketplace, where people can purchase used devices for a lower cost than purchasing new equipment.
Community of Vermont Elders	(802) 229-4731	The nonprofit Community of Vermont Elders (COVE) provides a free helpline through which seniors can obtain information and signposting for resources. The organization operates the state’s Senior Medicare Patrol (SMP) program, which educates older adults about abuse, fraud and mistakes within the Medicare system. Active seniors may choose to train as an SMP volunteer to assist their peers. The Building Bridges program provides further scam-avoidance education on topics including safe internet use and consumer fraud.
Vermont State Colleges System	(802) 224-3000	Seniors aged 65 and above who enjoy education can obtain tuition-free waivers to audit courses at the four educational institutions within the Vermont State College System: Community College of Vermont, Castleton University, Vermont Technical College and Northern Vermont University. Wide-ranging course options include languages, sciences, art, history, mathematics and computing, and some courses are offered online.
Vermont Senior Centers	(800) 642-5119	Vermont has a statewide network of senior centers that offer supportive programs and social opportunities for older adults. Services vary by location but typically include health, nutrition, benefits and wellness education, transportation and congregate meal programs, recreational activities, fitness classes and transportation.
Elder Law Project	(800) 889-2047	Operated by Vermont Legal Aid, the Elder Law Project offers free confidential legal services to seniors aged 60 and above. Services include advocacy, advice, representation and help with legal documents in varied areas of civil law, such as benefits, abuse, housing, wills, powers of attorney, health care and consumer issues. Seniors can also sign up for telephone legal advice clinics.
Alzheimer’s Association Vermont Chapter	(800) 272-3900	The nationwide Alzheimer’s Association provides information, education and support to seniors with dementia as well as their loved ones. There’s a 24-hour helpline, and the Vermont Chapter arranges diverse community events and fundraisers.

Covid-19 Rules and Restrictions for Vermont Senior Living Facilities

The following information is based on research done on several government websites, including healthvermont.gov/covid-19 and vermont.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes (Conditions Apply)
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Yes
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	Not Available*
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors 

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents 

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

*NOTE: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

Senior Living Laws and Regulations in Vermont

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

Senior living facilities in Vermont are licensed by the Vermont Department of Disabilities, Aging and Independent Living, Division of Licensing and Protection. In Vermont, senior living residences must meet or exceed Level III residential care home standards. Below is a brief overview of admission requirements, regulations around medication management and dementia care, and staffing levels for licensed senior living communities in Vermont.

Scope of Care

Vermont AFLs are required to provide the following:

• 24-hour awake staff
• Hands-on assistance with activities of daily living, such as bathing, grooming and toileting
• Intermittent skilled nursing care, including an intake assessment and ongoing health monitoring
• Supervision and support for residents with dementia
• Medication management
• Access to third-party services for medical care, home health care, barber and beauty services, and social activities
• A comprehensive intake assessment completed by a licensed registered nurse within 14 days of move-in

Individuals who require nursing home placement due to medical need or who exhibit behavior that poses a threat to themselves, staff or other residents are ineligible for placement in a senior living facility.

Medication Administration

All senior living facilities must provide medication management services under the supervision of a licensed nurse. These services can include helping residents self-administer prescription medications by providing reminders, opening containers and dispensing the dose into a med cup. Staff who have been trained in medication administration by a registered nurse are permitted to administer oral and topical medications.

Dementia Care

Senior living facilities that offer dementia care in a dedicated unit must only do so with prior authorization from the licensing agency.

In order to provide dementia care services, ALFs must:

• Provide the licensing agency with an outline of the scope of the services
• Develop a clear description of the physical environment
• Provide an in-depth description outlining how the unit will be staffed, including the credentials of the staff and staffing levels
• Establish clear protocols regarding admission, residency and discharge planning

Memory care staff need to have specialized training in communicating with residents who have Alzheimer’s disease and other forms of dementia.

Staffing Requirements

Although Vermont doesn’t have regulations regarding staffing ratios in senior living facilities, by law at least one personal care attendant must be on-site, awake and available to the residents at all times. AFLs must also have a registered nurse or licensed practical nurse on-site as needed to monitor medication administration, perform wellness checks and oversee service plans.

Accommodations

Senior living facilities must provide each resident with a private unit measuring at least 225 square feet, excluding closets and bathrooms. The units must include a private bathroom, private bedroom, living space, storage space, kitchen capacity and locking door. Residents can volunteer to share a unit if they so choose.

Frequently Asked Questions

How much does assisted living cost in Vermont?

On average, assisted living in Vermont costs approximately $5,338 per month. Actual costs vary depending on the location and facility and may be significantly higher or lower than the state average cost of assisted living care.

Are there financial assistance programs for assisted living in Vermont?

Yes. Low-income seniors who are SSI or Medicaid-eligible may qualify for financial assistance through Assistive Community Care Services or the Choices for Care Medicaid waiver. These programs cover the cost of assisted living care for eligible seniors, while seniors are responsible for room-and-board costs. Veterans and their dependents may also qualify for additional funds through the two VA pension top-up programs, Aid and Attendance benefits and Housebound allowance.

What are “Activities of Daily Living”?

Activities of Daily Living, or ADLs, are self-care tasks that an individual needs to perform on a daily basis to maintain basic hygiene and wellness. These self-care tasks include using the toilet, grooming, dressing and moving about. As seniors age, they may develop physical and cognitive limitations that make completing ADLs independently a challenge.

What is the difference between assisted living and nursing homes?

While both assisted living facilities and nursing homes provide 24-hour supervision along with room and board, there are some significant differences between these two types of care. In general, assisted living facilities are geared toward those who can perform many daily tasks with minimal help and who don’t need constant medical monitoring and support. By comparison, nursing homes are medical facilities that provide around-the-clock medical care and monitoring for residents who may be bedridden, have complex medical needs or require skilled nursing services.

What types of amenities are commonly in assisted living communities?

Most assisted living facilities have a number of common areas that are available to all residents, such as a dining room, recreation area and outdoor space such as a garden, yard or patio. Many communities also offer enhanced amenities, including barbershops and beauty salons, fitness centers, music rooms and resident gardens. Pet-friendly assisted living facilities may have a designated dog walking area, and some communities have on-site movie theaters, swimming pools and transportation to appointments and events.

Learn More About Senior Living in Vermont

For more information about specific types of senior living in Vermont read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Vermont

Learn more about the cost of senior living in the top Vermont cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.