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Medicare · Montpelier

Medicare in Vermont: 2026 Guide

Vermont Medicare at a Glance

Vermont bans Part B excess charges and has the lowest Medicare Advantage penetration after Alaska.

MetricValue (2026)
Medicare enrollees0.16 million
Medicare Advantage penetration20%
Typical Plan G (65 yo nonsmoker)$175/month
Nursing homes (Medicare-certified)35
5-star nursing homes30%
Median SNF semi-private room$11,800/month
Median assisted living$5,300/month

Your Medicare Choices in Vermont

Every Medicare-eligible resident chooses between two paths:

  • Original Medicare + Medigap + Part D — any-doctor access, stable benefits, higher premium.
  • Medicare Advantage (Part C) — bundled benefits, often $0 premium, but networks and prior auth.

About 20% of Vermont's Medicare enrollees choose Advantage. Your best path depends on your doctors, travel patterns, health, and budget.

Medigap in Vermont

Medigap is federally standardized across all states except Massachusetts, Minnesota, and Wisconsin — so Plan G in Vermont is the same coverage as Plan G anywhere else in the country. What differs is premium and carrier availability.

  • Typical 65-year-old nonsmoker Plan G: $175/month
  • Plan N averages 20–30% less
  • Your one-time Medigap Open Enrollment is the 6 months beginning when you're 65+ AND enrolled in Part B
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Nursing Home Quality in Vermont

Vermont has 35 Medicare-certified nursing homes; 30% carry a 5-star Overall CMS rating. Before choosing a facility, check its Medicare Care Compare listing, read the most recent state inspection report, and visit in person on both a weekday meal and a weekend shift. Oversight agency: Vermont Department of Disabilities, Aging & Independent Living.

  • SHIP (free Medicare counseling): 1-800-642-5119
  • State long-term care ombudsman: 1-800-889-2047

Related Resources

Disclaimer: Figures are approximate 2026 benchmarks. Not affiliated with the U.S. government or the federal Medicare program. Consult a licensed agent or SHIP counselor before making decisions.

Frequently Asked Questions

When can I enroll in Medicare in Vermont?+
Your 7-month Initial Enrollment Period begins 3 months before the month you turn 65 and ends 3 months after. Vermont follows federal Medicare enrollment rules; SHIP counselors at 1-800-642-5119 can walk you through timing.
What is the average Medigap Plan G premium in Vermont?+
A 65-year-old nonsmoker in Vermont typically pays around $175/month for Plan G. Your actual premium depends on carrier, tobacco use, and sometimes ZIP code.
How many nursing homes are in Vermont?+
Vermont has approximately 35 Medicare-certified nursing homes. About 30% carry an Overall 5-star CMS rating.
Who regulates nursing homes in Vermont?+
Vermont Department of Disabilities, Aging & Independent Living conducts state surveys on behalf of CMS. The long-term care ombudsman (1-800-889-2047) advocates for residents.
What is the median nursing home cost in Vermont?+
The median semi-private room runs about $11,800/month; assisted living about $5,300/month (Genworth Cost of Care Survey benchmarks).