The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the Vermont Medicaid Income Limits for 2021. Medicaid in Vermont is called Green Mountain Care.
Based on this information, you will be able to determine whether your income qualifies you for Vermont Medicaid or not.
However, before we get into details about the income limit, we will first explain the Medicaid program in Vermont and how it works.
Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
How Many People are on Medicaid?
According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:
- 78,521,263 individuals were enrolled in Medicaid and CHIP
- 72,204,587 individuals were enrolled in Medicaid
- 6,695,834 individuals were enrolled in CHIP
Vermont Medicaid
The Vermont Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 169,380 people.
This includes 63,539 children as shown by the image below.
The Medicaid program in Vermont is run by the Department of Vermont Health Access (DVHA).
Who Can Get Medicaid in Vermont?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
Vermont Medicaid Income Limit
The Vermont Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the Vermont Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2021.
| 2021 Federal Poverty Levels for the 48 Contiguous States & D.C. | |||
| Household Size | Poverty Guideline for 48 states & DC | Alaska | Hawaii |
| 1 | $12,880 | $16,090 | $14,820 |
| 2 | $17,420 | $21,770 | $20,040 |
| 3 | $21,960 | $27,450 | $25,260 |
| 4 | $26,500 | $33,130 | $30,480 |
| 5 | $31,040 | $38,810 | $35,700 |
| 6 | $35,580 | $44,490 | $40,920 |
| 7 | $40,120 | $50,170 | $46,140 |
| 8 | $44,660 | $55,850 | $51,360 |
| Over 8 people | add $4,540 for each additional person | $5,680 | $5,220 |
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 312 percent of FPL
- Any child age 1-5 with a family income up to 312 percent of FPL
- Children ages 6- 18 with family income up to 312 percent of FPL
- CHIP for children with family income up to 312 percent of FPL
- Pregnant women with family income up to 208 percent of FPL
- Parents of minor children with family income up to 49 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL
- Adults without dependents under Medicaid expansion with income up to 133% of the FPL
Vermont Medicaid Income Limit Charts
The Vermont Medicaid eligibility income limit charts are divided by groups.
For example, the first chart is focused on income limits for children who qualify for Medicaid.
Similarly, the second chart below focuses on the Medicaid income limits for adults in Vermont who qualify for Medicaid.
Vermont Medicaid Income Limit for Children
Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.
| Vermont Medicaid Income Limit – Children | ||||||
| Children Medicaid Ages 0-1 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 312% | 312% | 312% | 312% | |
|
Household Size
|
1 | $12,880 | $40,186 | $40,186 | $40,186 | $40,186 |
| 2 | $17,420 | $54,350 | $54,350 | $54,350 | $54,350 | |
| 3 | $21,960 | $68,515 | $68,515 | $68,515 | $68,515 | |
| 4 | $26,500 | $82,680 | $82,680 | $82,680 | $82,680 | |
| 5 | $31,040 | $96,845 | $96,845 | $96,845 | $96,845 | |
| 6 | $35,580 | $111,010 | $111,010 | $111,010 | $111,010 | |
| 7 | $40,120 | $125,174 | $125,174 | $125,174 | $125,174 | |
| 8 | $44,660 | $139,339 | $139,339 | $139,339 | $139,339 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
Vermont has expanded Medicaid to include adults without dependents.
Therefore, adults without dependents can apply for Medicaid in Vermont.
For an update on the Medicaid expansion debate and timeline in Vermont, see our Vermont Expansion update below.
Vermont Medicaid Income Limit for Adults
| Vermont Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 208% | 49% | 74% | 133% | |
|
Household Size
|
1 | $12,880 | $26,790 | $6,311 | $9,531 | $17,130 |
| 2 | $17,420 | $36,234 | $8,536 | $12,891 | $23,169 | |
| 3 | $21,960 | $45,677 | $10,760 | $16,250 | $29,207 | |
| 4 | $26,500 | $55,120 | $12,985 | $19,610 | $35,245 | |
| 5 | $31,040 | $64,563 | $15,210 | $22,970 | $41,283 | |
| 6 | $35,580 | $74,006 | $17,434 | $26,329 | $47,321 | |
| 7 | $40,120 | $83,450 | $19,659 | $29,689 | $53,360 | |
| 8 | $44,660 | $92,893 | $21,883 | $33,048 | $59,398 | |
How to Read the Vermont Medicaid Income Limits Charts Above
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 208% of the Federal Poverty Level – which for a family of two is $36,234 as shown in the chart above.
How to Apply for Vermont Medicaid
There are 3 ways you can apply for Medicaid in Vermont.
Option 1 – Apply online
You can apply online through the VermontHealthConnect.gov Portal – as shown in the image below.
If you have an account, you can log in or create your VermontHealthConnect.gov account. Click here to be taken to the website.
Option 2 – Apply at Certified Assister Office Near You
You can apply in person at a Certified Assister Office office near you. Click here to locate an office.
Option 3 – Download Application
Call 1-855-899-9600 to have an application mailed to you. Complete it and mail to:
Vermont Health Connect
Application and Document Processing Center
280 State Drive
Waterbury, VT. 05671-8100
Vermont Medicaid Phone Number
Here’s how to contact the Vermont Medicaid Agency:
For Medicaid Applicant & Member Services
Vermonters who have Medicaid or Dr. Dynasaur:
Call customer service at 1-800-250-8427.
Relay services for the Deaf and hard of hearing: 711
Business hours:
8:00 a.m. to 5:00 p.m. Monday – Friday
Vermont Medicaid Expansion Update
Vermont has fully embraced the Affordable Care Act (ACA), including the expansion of Medicaid.
In 1995, the Vermont legislature authorized the creation of the Vermont Health Access Plan (VHAP) and Dr. Dynasaur, which is still utilized to provide coverage to children and pregnant women.
Vermont’s Medicaid enrollment grew by 11 percent from late 2013 to mid-2016.
In addition, the state’s uninsured rate is among the lowest in the country.
Efforts to impose a Medicaid work requirement failed to advance in Vermont legislature in 2018.
Vermont Medicaid Income Limits Summary
We hope this post on Vermont Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of Vermont, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
Alabama Medicaid Income Limits and How to Apply
Alaska Medicaid Income Limits and Chart