Medicare in Vermont
Key Takeaways
- If you’re 65 or older, Medicare in Vermont offers an affordable option for your healthcare needs.
- Original MedicareOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). offers hospital (Part A) and medical insurance (Part B), with the option of adding drug and supplemental coverage.
- Medicare AdvantageMedicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). in Vermont replaces Original Medicare and includes the benefits of Parts A and B while bundling drug and supplemental coverage like dental and vision.
As the epicenter of maple syrup production and the home of Ben & Jerry’s ice cream empire, Vermont offers a pretty sweet life.
A healthy helping of Medicare, however, can be bittersweet. Sweet because of the health insurance savings that Medicare can offer; bitter because of how overwhelming Medicare can be.
If you’re starving for answers about Medicare in Vermont, GoHealth is here to make the process palatable.
How Do I Sign Up for Medicare in Vermont?
If you are a U.S. citizen or permanent resident age 65 or older, you qualify for Medicare in VT.
Your choices for applying include:
- Enrolling online with the Social Security Administration.
- Visiting a local Social Security office.
- Enrolling over the phone at 1-800-772-1213 (TTY: 1-800-325-0778).
Private insurance companies manage Part D and Medigap plans with guidance from the federal government. That’s also the case with Medicare Advantage.
Suppose you enroll in both Parts A and B. In that case, you have the option of switching to a Medicare Advantage plan that substitutes for Original Medicare while bundling drug and supplemental coverage like dental and vision.
Find the Medicare Plan that works for you.
Does Vermont Have Free Health Insurance?
Part A of Original Medicare provides hospital coverage without a monthly premium to most Vermonters. Medicare Advantage offers both Part A coverage and the medical coverage offered by Part B.
But despite the affordability of the plans, no health insurance can fairly be called “free.” In addition to monthly premiums, Medicare in Vermont typically includes expenses like copays and coinsurance.
The closest thing to an exception is Medicaid.
Who Qualifies for Medicaid in Vermont?
Some Vermont residents facing severe needs may qualify for Medicaid, a federal/state program founded alongside Medicare in 1965 that helps those facing a financial need or a disability — regardless of age. When you turn 65, it is possible to be eligible for both Medicare and Medicaid (called dual eligibility).
Each state formulates its plan for Medicaid and can set its qualifications. Vermont’s Health Connect program offers programs geared toward adults and children in need.
Let’s find your ideal Medicare Advantage plan.
Does Medicare Pay the Same in Every State?
In the case of Original Medicare, what you pay and what percentages of your medical bills are paid by Medicare are consistent regardless of your location. You pay premiums for Part B (and in some instances Part A) based on your current income and work history, and Part A and B both have universal deductibles and coinsurance.
If, however, you add Part D or Medigap to Original Medicare, or if you have Medicare Advantage, your costs and benefits will vary based on the plan you choose, and plan availability depends on where you live.
Can You Use Medicare Advantage Out of State?
Original Medicare is accepted by providers nationwide. Medicare Advantage plans feature regional networks and generally aren’t accepted outside of your area (at least not at as affordable a rate). However, the network is one of the top reasons that Medicare Advantage may be more affordable.
What Is the Best Medicare Plan for Seniors?
When it comes to comparing different Medicare plans in Vermont, here are some things to consider:
- Some Medicare Advantage plans mirror Original Medicare but are more affordable.
- Some Medicare Advantage plans include options for dental, vision, and hearing coverage.
- Some Medicare Advantage plans offer assistance with transportation costs or over-the-counter needs.
- Some offer all of the above.
Who Has the Best Medicare Advantage Program?
The Centers for Medicare & Medicaid Services (CMS) has a Medicare Star Rating system that assigns one to five stars (five being the highest-rated) to individual Medicare Advantage plans. If you’re already on a Medicare Advantage plan and it’s not five-star, you are offered the opportunity to switch to a five-star plan each year.
While the premiums and rating systems can shed light on various Medicare Advantage plans’ value, there’s more to navigating Medicare in Vermont. A dedicated GoHealth licensed insurance agent can review your situation and figure out what plan is the right fit for you.
Still have questions? GoHealth has the answers you need.
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 142,248 people are enrolled in Medicare Part A and B in Vermont. The total number of beneficiaries enrolled in Medicare Advantage increased from 18,830 to 23,261 year over year. Medicare Advantage participation in Vermont went from 13.63% to 16.35% year over year. If you’d like to dive deeper into how Medicare in Vermont breaks down across the state, we provide a glance at who is using Medicare and how.
142,248 Beneficiaries with Part A & Part B
23,261 Medicare Advantage Beneficiaries
16.35% Medicare Advantage Participation Rate
53.94% Female
46.06% Male
93.78% Non-Hispanic White
0.43% African American
0.67% Hispanic
5.11% Other/Unknown
22.02% Eligible for Medicaid
0.82 Average HCC Score
$8,599.12 Actual Per Capita Costs
16.34% Hospital Readmission Rate
27.00% % of Beneficiaries with an Emergency Department Visit
18,830 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
13.63% Medicare Advantage Participation Rate, Previous Year
Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Vermont SHIP - Medicare Counseling
https://asd.vermont.gov/services/ship
What should I know about SHIP?
The State Health Insurance Program offers free, unbiased Medicare advice to Vermont residents via your Area Agency on Aging.
Disabilities, Aging and Independent Living
https://dail.vermont.gov/
What should I know about the Disabilities, Aging and Independent Living?
The government department’s mission is to “Make Vermont the best state in which to grow old or live with a disability — with dignity, respect and independence.”
Department of Financial Regulation
https://dfr.vermont.gov/consumers/file-complaint/insurance
What should I know about the Department of Financial Regulation?
The place to turn if you are a Vermonter with a health insurance complaint.
Department of Vermont Health Access - Medicaid
https://dvha.vermont.gov/about-us
What should I know about Vermont Health Access?
This department administers all aspects of the state’s Medicaid program.
Nationwide Resources
Speak with a GoHealth insurance agent that is licensed in Vermont about your Medicare questions.
Mon – Fri, 8 a.m. – 6 p.m. CT
Centers for Medicare and Medicaid Services
You can reach the Social Security Administration by phone for general questions. Not all questions can be answered over the phone.
Also, SSA.gov provides online resources for the following: Review information, apply for benefits, or manage your account online
1-800-722-1213
TTY 1-800-325-0778
Speak to SSA Representative, Monday – Friday, 8 AM – 7 PM ET
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Sources
- Apply for Benefits. SSA.gov.
- Social Security Office Locator. SSA.gov.
- Trump Administration Announces Historically Low Medicare Advantage Premiums and New Payment Model to Make Insulin Affordable Again for Seniors. CMS.gov.
- Eligibility Tables. Vermont.gov.
- Special Enrollment Periods. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.