Vermont Medicaid Home Care is the set of Medicaid programs that pay for care in a parent’s own home — or in assisted living — for someone who would otherwise qualify for a nursing home. This Vermont medicaid home care guide names the program, gives the 2026 financial limits, explains the level-of-care test and the waitlist reality, and shows where the application starts.
The financial figures come from the state Medicaid agency and CMS and reset on their own calendars; where Vermont has not published a figure we say so.
In This Vermont Medicaid Home Care Guide:
Vermont Medicaid Home Care at a Glance (2026)
| Program | Vermont’s program is called Choices for Care, run by the Department of Disabilities, Aging and Independent Living (DAIL), Adult Services Division, and authorized under the state’s Global Commitment to Health Section 1115 demonstration rather than a standalone 1915(c) waiver. |
| 2026 income limit (single applicant) | $2,982 |
| 2026 asset limit (single applicant) | $2,000 |
| Assisted living covered? | Partly — Vermont covers services in some assisted living settings; ask There are two doors and you usually need both. which residences participate. |
| Waitlist | Choices for Care is not a single open-ended entitlement. Vermont treats the Highest Needs Group as an entitlement, so people in that group are enrolled and served whether they choose home care or a nursing home. |
| PACE available? | No. PACE, the Program of All-Inclusive Care for the Elderly, does not currently operate anywhere in Vermont, and there is no PACE center in Burlington, Rutland, Montpelier or any other part of the state. |
| Hire your own caregiver? | Yes. Choices for Care includes participant-directed options, so a senior can hire, train, schedule, supervise and dismiss their own caregiver instead of using an agency, and adult children and other relatives may generally be hired. |
The Vermont Program Behind Vermont Medicaid Home Care
Nursing home Medicaid is an entitlement: anyone who qualifies gets it. Home-based care is different. Vermont delivers it through a waiver or a managed long-term care program with its own name, its own enrollment rules and, in many states, a cap on how many people it serves.
The program Vermont runs for people 65 and over is Vermont’s program is called Choices for Care, run by the Department of Disabilities, Aging and Independent Living (DAIL), Adult Services Division, and authorized under the state’s Global Commitment to Health Section 1115 demonstration rather than a standalone 1915(c) waiver..
In the home-based setting, Choices for Care pays for personal care with bathing, dressing, toileting and eating, plus homemaker help with cooking, laundry and cleaning, respite so a family caregiver can rest, companion services for supervision and socialization, adult day services, case management, a personal emergency response system, and assistive devices, assistive technology or home modifications that no other insurance will cover.
The Moderate Needs Group covers a narrower subset: homemaker, adult day, case management and a flexible fund. Home-delivered meals are not part of the waiver package itself; ask your Area Agency on Aging about Older Americans Act meals.
Who Qualifies for Vermont Medicaid Home Care
Three tests, the same as a nursing home: a medical test, an income test and an asset test. Vermont uses the nursing-facility level of care as the medical bar, which means the applicant needs hands-on help with daily activities or supervision because of dementia — not merely help with errands.
Vermont requires that you meet nursing-home level of care, meaning you generally need extensive or total hands-on help every day with activities of daily living, or have cognitive impairment or behaviors that make it unsafe to be alone. DAIL sorts applicants into a Highest Needs Group, a High Needs Group, or the Moderate Needs Group, which is below nursing-home level.
The functional review is done through the Vermont Independent Living Assessment (ILA), an in-person assessment completed by DAIL’s Long-Term Care Clinical Coordinators, who are registered nurses, or by a DAIL-contracted assessor.
Financially, the applicant’s own income is measured against the Vermont medicaid home care limit of $2,982, and countable assets against $2,000. The spouse who stays home is protected by the same spousal impoverishment rules that apply in a nursing home: up to $162,660 in assets in 2026 and a guaranteed income floor.
Waitlists and Enrollment Caps
Choices for Care is not a single open-ended entitlement. Vermont treats the Highest Needs Group as an entitlement, so people in that group are enrolled and served whether they choose home care or a nursing home.
The High Needs Group is served as state funding allows and can be closed to new enrollment, and the Moderate Needs Group is explicitly capped by available funding, so a waiting list forms when the money runs out. DAIL does not publish a guaranteed wait time; ask your regional office where enrollment stands the week you apply.
Two facts hold everywhere: applying for the waiver does not stop you from applying for nursing home Medicaid later, and the level-of-care assessment for one is usually accepted for the other.
What Vermont Medicaid Home Care Pays For
Personal care (bathing, dressing, transfers), homemaker help, adult day programs, respite so the family caregiver can rest, home modifications such as ramps and grab bars, delivered meals, a personal emergency response button, and in many states assisted living services. It does not pay rent, a mortgage or groceries.
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Assisted living: Partly — Vermont covers services in some assisted living settings; ask There are two doors and you usually need both. which residences participate.
PACE: No. PACE, the Program of All-Inclusive Care for the Elderly, does not currently operate anywhere in Vermont, and there is no PACE center in Burlington, Rutland, Montpelier or any other part of the state. Vermont is one of the states that has never established a PACE program under its Medicaid agreement with CMS.
Can a Family Member Be the Paid Caregiver?
Yes. Choices for Care includes participant-directed options, so a senior can hire, train, schedule, supervise and dismiss their own caregiver instead of using an agency, and adult children and other relatives may generally be hired.
The formal cash-and-counseling option is called Flexible Choices, which converts the home-based service plan into a cash allowance that the participant, or a designated surrogate such as a relative or friend, manages with help from a consultant. A fiscal intermediary such as ARIS Solutions handles background checks, payroll and taxes. Legal guardians and spouses face restrictions on being paid.
The full picture — who may be paid, how the pay is set and how to enroll — is in our companion guide to Vermont family caregiver pay.
How to Apply for Vermont Medicaid Home Care
Where: There are two doors and you usually need both. — start here.
Ask for two things on the first call: the functional assessment and a Medicaid financial application. Doing both at once shortens the timeline by weeks. Bring the same five years of financial records a nursing home application needs; the look-back rule applies to waivers too.
What Happens on Assessment Day
The assessment is a visit, usually at the parent’s home, by a nurse or social worker who walks through the day: getting out of bed, bathing, dressing, using the toilet, eating, moving from room to room, taking medication, and whether the person can be left alone safely. Answer for the worst day, not the best one. Families who describe a good morning talk their parent out of Vermont medicaid home care without meaning to.
Bring the medication list, the diagnoses, recent hospital paperwork and any dementia evaluation. If a doctor has written that the person needs supervision or hands-on help, bring that letter; it is often the single document that tips the level-of-care decision.
The Care Plan That Follows
Approval produces a written care plan: which services, how many hours, and who delivers them. The plan is the budget. Hours outside it are not paid, and hours inside it that go unused are not banked. A plan can be revised when the parent’s condition changes — after a fall, a hospital stay or a new diagnosis — so keep the case manager’s number and call when something changes rather than waiting for the annual review.
Mistakes That Cost Families Months
- Waiting for the crisis. Waiver slots and assessments take weeks; the application should start when the family first notices the parent needs daily help.
- Giving money away first. The five-year look-back applies to the waiver as well as the nursing home, so a gift meant to “get under the limit” creates a penalty period instead.
- Spending the spouse’s protected share. Ask for the resource assessment before paying anything down.
- Assuming Medicare covers it. Medicare pays for short-term skilled care after a hospital stay, never for ongoing daily help. Vermont Medicaid Home Care is the program that does.
Where to Get Help Free
Two free doors exist in every state: the Vermont SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For a Vermont medicaid home care question involving a house, a spouse at home or a recent gift, a local elder law attorney or legal aid office is the next call.
Key Takeaways: Vermont Medicaid Home Care
- Same tests as a nursing home: Vermont medicaid home care requires nursing-facility level of care plus the income and asset tests.
- Not an entitlement: Vermont medicaid home care runs through a waiver that can have a waitlist, so apply before the crisis.
- The assessment travels: the level-of-care finding for Vermont medicaid home care is usually accepted for nursing home coverage later.
- Room and board are never covered: Vermont medicaid home care pays for care services, not rent, even in assisted living.
- Family can be the caregiver: most Vermont medicaid home care programs let the participant hire and direct a relative.
Official Sources
- Vermont’s program is called Choices for Care, run by the Department of Disabilities, Aging and Independent Living (DAIL), Adult Services Division, and authorized under the state’s Global Commitment to Health Section 1115 demonstration rather than a standalone 1915(c) waiver.: https://asd.vermont.gov/services/choices-for-care-program
- There are two doors and you usually need both.: https://asd.vermont.gov/services/choices-for-care-program is the state page that walks you through starting a Choices for Care application, and the financial application is the Application for Long-Term Care Medicaid, form 202LTC, published by the Department of Vermont Health Access at https://dvha.vermont.gov/sites/dvha/files/doc_library/202LTC_2.pdf. Completed paper applications go to Green Mountain Care, Application and Document Processing Center, 280 State Drive, Waterbury, Vermont. You can also review long-term care Medicaid basics at https://dvha.vermont.gov/members/long-term-care before you file.
- Medicaid.gov spousal impoverishment standards: medicaid.gov
- Medicare.gov Medicare Savings Programs: medicare.gov
This Vermont medicaid home care guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.