Vermont Medicare beneficiaries have access to a range of coverage options, state-specific protections, and free counseling services. This comprehensive Vermont Medicare guide covers your SHIP office contacts, Medigap plan availability, birthday rule protections, Medicare Savings Program eligibility, Medicare Advantage options, and how to compare plans. Whether you are turning 65, helping a parent navigate Medicare, or re-evaluating your coverage, understanding Vermont Medicare rules is essential for making informed decisions.
All information in this guide has been verified against official state sources, CMS data, and NAIC reports as of April 2026.
In This Vermont Medicare Guide:
Vermont SHIP — Free Medicare Counseling
Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased Medicare counseling. Vermont’s SHIP program can help you understand your coverage options, compare plans, resolve billing issues, and navigate enrollment periods at no cost.
| SHIP Program | State Health Insurance Program (SHIP), administered by the Adult Services Division |
| Phone | 1-800-642-5119 |
| Website | https://asd.vermont.gov/services/ship |
SHIP counselors are trained volunteers and staff who are not affiliated with any insurance company. They do not sell plans. Contact your Vermont SHIP office before making any major Medicare decisions.
Vermont Medigap (Medicare Supplement) Plans
Medigap plans in Vermont help cover out-of-pocket costs not paid by Original Medicare, including the Part A deductible, Part B coinsurance, and skilled nursing facility copays. Medigap plans are standardized by federal law, meaning Plan G from one carrier covers the same benefits as Plan G from another carrier. The difference is premium cost.
Plans available in Vermont: A, B, C, F, G, K, L, N
Most popular plan: Plan G is the most popular Medigap plan in Vermont. Plan G covers all gaps in Original Medicare except the annual Part B deductible ($240 in 2026). Plan N is the most popular lower-premium alternative, with small copays for some doctor visits and ER visits.
Pricing method: Vermont uses community-rated Medigap pricing. This is the most favorable method for consumers because premiums are the same regardless of age. Your premium will not increase simply because you get older.
The average monthly Plan G premium for a 65-year-old in Vermont is approximately $190. Plan N averages approximately $147 per month. Actual premiums vary by carrier, age, gender, tobacco use, and zip code. Always compare quotes from at least three carriers.
Vermont Medigap Switching Rights
Vermont does not have a Medigap birthday rule. Your primary opportunity to buy or switch Medigap plans without medical underwriting is during your initial Medigap Open Enrollment Period, which lasts 6 months starting when you first enroll in Medicare Part B at age 65 or older.
After your initial OEP closes, you may face medical underwriting if you apply for a new Medigap policy. However, federal law provides guaranteed issue rights in specific situations, such as losing employer coverage or leaving a Medicare Advantage plan during your first year.
Vermont guaranteed issue protections: Vermont requires year-round guaranteed issue for Medigap plans. Medicare beneficiaries can purchase or switch Medigap plans any day of the year without medical underwriting. This goes far beyond the federal 6-month initial enrollment period. Vermont also requires insurers to sell Medigap to Medicare-eligible individuals under 65 (due to disability), though coverage for those under 65 due to end-stage renal disease may be excluded. When a Medicare Advantage plan terminates, enrollees have a 63-day guaranteed issue period from the date of plan termination notice.
Vermont Medicare Advantage (Part C)
Approximately 165412 people in Vermont are enrolled in Medicare. About Approximately 31% in 2025, expected to drop sharply in 2026 due to UnitedHealthcare and Vermont Blue Advantage exiting the market. Only Humana remains, serving 5 counties. of Vermont Medicare beneficiaries choose Medicare Advantage plans, with the remainder on Original Medicare with or without Medigap supplement coverage.
Medicare Advantage plans in Vermont are offered by private insurers as an alternative to Original Medicare. Most MA plans include prescription drug coverage (Part D) and often add dental, vision, and hearing benefits. However, MA plans use provider networks, which can limit your choice of doctors and hospitals.
Key Medicare Advantage considerations in Vermont:
- Networks matter: HMO plans require you to use in-network providers except in emergencies. PPO plans allow out-of-network care at higher cost.
- $0 premium plans: Many Vermont MA plans have $0 monthly premiums (you still pay your Part B premium).
- Maximum Out-of-Pocket (MOOP): MA plans cap your annual spending, unlike Original Medicare which has no cap.
- Star ratings: CMS rates MA plans 1-5 stars. Higher-rated plans often have lower costs and better coverage.
Top Medicare Advantage carriers in Vermont by enrollment:
- Humana (only remaining carrier for 2026). Prior to 2026: UnitedHealthcare
- Vermont Blue Advantage (BCBSVT)
- Humana. UnitedHealthcare and Vermont Blue Advantage exited the market effective January 1
- 2026.
Vermont Medicare Financial Help Programs
Vermont offers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay for premiums, deductibles, and copays. The four programs are:
- QMB (Qualified Medicare Beneficiary): Pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premiums only.
- QI (Qualifying Individual): Pays Part B premiums (limited funding, first-come first-served).
- QDWI (Qualified Disabled Working Individual): Pays Part A premiums for disabled workers.
Vermont MSP eligibility: QMB: up to 150% FPL (expanded from 100% effective January 1, 2026). SLMB: eliminated as of December 31, 2025 — former SLMB enrollees transitioned to QMB. QI: 151%-202% FPL (Part B premium assistance only). Vermont expanded QMB eligibility significantly in 2026 under H.721.
Apply through your local SHIP office or your state Medicaid agency for free help determining eligibility.
Top Medicare Insurance Companies in Vermont
Top Medigap carriers in Vermont:
- Blue Cross Blue Shield of Vermont
- Humana
- Medco Containment
- State Farm
- AFLAC
When comparing carriers, focus on premium cost (for identical standardized Medigap plans, benefits are the same — only price differs), financial strength ratings from AM Best (A or higher), customer satisfaction ratings, and claims processing speed.
Vermont Medicare Enrollment Periods
Understanding Medicare enrollment deadlines prevents costly late enrollment penalties:
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, birthday month, 3 months after). Enroll in Parts A and B during this period.
- Medigap Open Enrollment: Year-round. Vermont state law requires continuous open enrollment for Medigap plans — beneficiaries can enroll or switch at any time without medical underwriting, regardless of when they first enrolled in Part B.. During this period, insurance companies cannot deny you Medigap coverage or charge higher premiums based on health conditions.
- Annual Enrollment Period (AEP): October 15 through December 7 each year. Switch between Original Medicare and Medicare Advantage, change MA plans, or add/change Part D drug plans.
- Medicare Advantage Open Enrollment Period (OEP): January 1 through March 31. Switch MA plans or return to Original Medicare (and add a Medigap plan, subject to underwriting).
- Special Enrollment Periods (SEP): Available when you lose employer coverage, move, or qualify for other life events.
Additional Vermont Medicare protections: Vermont has among the strongest Medigap consumer protections in the nation: (1) Year-round open enrollment — beneficiaries can buy or switch Medigap plans any day of the year without medical underwriting; (2) Community-rated premiums required — insurers cannot charge more based on age or health status (two pools: under-65 and 65+); (3) Medigap access for under-65 disabled Medicare beneficiaries is required; (4) Expanded QMB eligibility to 150% FPL effective 2026; (5) 63-day guaranteed issue period when a Medicare Advantage plan terminates.
Compare Vermont Medicare Plans
Ready to compare Medicare options in Vermont? Use the official Medicare Plan Finder or contact your local SHIP counselor for free, unbiased help.
Official Sources & Resources
- Medicare.gov: medicare.gov
- Vermont Department of Financial Regulation: https://dfr.vermont.gov/
- State Health Insurance Program (SHIP), administered by the Adult Services Division: https://asd.vermont.gov/services/ship
- CMS.gov: cms.gov
- NAIC: naic.org
This Vermont Medicare guide was last verified against official sources in April 2026. If you notice outdated information, please contact us.