Home Care in Vermont

The 2021 Genworth Cost of Care Survey shows that Vermont’s average in-home care and home health care costs are $5,720 per month. Factors that can affect your care costs include where you reside and the number of hours per week that you need help. In-home care services don’t include medical treatment, while licensed medical professionals perform home health care services. An in-home care provider can assist you with chores, meals, day-to-day routines and transportation, while a home health care service offers light medical care, such as wound treatment and insulin shots.

Compared to its neighbors, Vermont is in the middle of the road for care expenses. New Hampshire costs more at $6,006 per month for in-home care and $6,197 per month for home health care. In Massachusetts, both services are $5,911 per month, while New York’s monthly fees for in-home care are $5,339 and $5,529 for home health care. Connecticut’s monthly costs are $5,243 for in-home care and $5,339 for home health care. The national average is $4,957 for in-home care and $5,148 for home health care.

While aging in place can save you money compared to nursing home care, it’s more expensive than the state’s other care types. Adult day care costs $3,224 each month, while an assisted living facility’s monthly fees are $5,250. Semi-private nursing home care is $10,585 per month. Most people choose to age in place because they want more control over their treatment and wish to remain active in their communities. They may be willing to pay a little more for their autonomy.

Vermont Medicaid only pays for medical treatment and in-home care services that it might consider medically necessary. While Medicaid covers medical treatments and services, such as transportation, to help reduce your care cost, it doesn’t cover assistance with daily routines and other in-home services. Fortunately, two waivers are available that cover home health care for Vermont residents.

Global Commitment to Health Waiver

The Global Commitment to Health program offers several different waivers for residents who require long-term care and are over 65 years of age. The waiver can cover the cost of modifying your home if you have a disability, companion care, transportation, adult day care services, assistive medical technology, emergency care and personal care. To qualify, you must have a disability or medical condition that requires long-term care.

For more information about this program or to enroll, you may call (855) 899-9600 or apply online through the Vermont Health Connect website.

Choices for Care Waiver

The Choices for Care program gives Vermont residents more autonomy over their treatment and care plan, which includes the option to receive care at home. It offers home-based case management and personal care services, emergency response coverage, companion care and adult day care services. The Choices for Care program also has a respite and support program for uncompensated family caregivers.

To be eligible, you must be over the age of 65 or have a physical disability. You must also qualify for Medicaid. You can obtain the application online and then mail it to:

Green Mountain Care
Application and Document Processing Center
280 State Drive
Waterbury, VT 05671-1500

If you need assistance applying, you can call or visit your local Department of Disabilities, Aging and Independent Living.

Medicaid is available for seniors and adults with disabilities who meet certain income requirements. Income limits vary based on whether you live alone or with a spouse. For an individual, your income can’t exceed $30,276 per year, and you can’t have more than $2,000 in sellable assets to pay for care. For married couples, annual income limits are $30,276 for one applicant with a $2,000 cap on assets. It’s $60,552 for two applicants with no more than $4,000 in assets.

To apply for Vermont Medicaid, you can visit the Vermont Health Connect website and enroll during the open enrollment period from November 1 to January 15. You may qualify for a special enrollment period if you meet certain criteria such as losing your insurance, recently moving or other qualifying life events. You can also call (855) 899-9600.

What Information You Will Need

• Proof of Vermont residency
• U.S. citizenship or legal resident status
• Valid birth certificate
• State-issued ID
• Medical records
• Financial statements such as income, bank records and retirement accounts

How to Get Help Applying for Medicaid

Navigating the application process can be frustrating, and any errors on your form can cause delays in receiving coverage. There are several organizations you can contact to help you process the application and file it correctly for free.

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

If you’re aging in place, there are free and low-cost programs available on the state and local levels to help you find what you need to live a good quality of life at home. Below are some programs where seniors living home can get assistive medical devices, meal delivery and find social groups.

Per the Centers for Medicare & Medicaid Services (CMS) mandate, Vermont required full COVID-19 vaccination for its home health care providers by February 28, 2022. Many home health providers have chosen to go beyond mandated measures to protect patients. They may decide to use personal protective equipment, masks and social distancing to protect seniors from the virus spread.

This information is current as of April 2022. However, federal and state mandates continue to evolve, so it’s important to stay informed. Check with your local and state health authority for the latest information to know what measures it requires to protect your loved ones.

The Vermont Agency of Human Services regulates how home health care providers may conduct business in the state. All in-home care providers and home health care agencies must abide by these rules.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

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