This page provides a plain-English summary of key elder care and estate planning information specific to Vermont residents. It covers Vermont Medicaid limits, estate tax rules, advance directive information, and links to important Vermont agencies and resources.
Information on this page is updated periodically but laws and limits change frequently. Always verify current figures with the relevant agency or a licensed attorney.
Vermont Medicaid — 2026 Eligibility Limits for Long Term Care
Vermont’s Medicaid program is called Green Mountain Care and is administered by the Department of Vermont Health Access — DVHA. Vermont’s entire Medicaid program operates under a comprehensive 1115(a) Global Commitment to Health Waiver giving Vermont significant flexibility in program design. Vermont’s long term care Medicaid program is called Choices for Care. Vermont expanded Medicaid under the Affordable Care Act in 2014 providing coverage to adults up to 138 percent of the federal poverty level.
Income limit — single applicant The income limit for a single Vermont nursing home Medicaid applicant is $2,982 per month in 2026. Vermont is an income cap state meaning applicants whose income exceeds this limit must establish a Qualified Income Trust — also called a Miller Trust or QIT — to qualify.
Asset limit — single applicant A single applicant must generally have $2,000 or less in countable assets. However Vermont has a notable exception — single applicants who own their home and choose home-based care over nursing facility placement may keep up to $5,000 in assets. Exempt assets include the primary residence with equity up to $752,000 if the applicant intends to return home, one vehicle, personal belongings and household furnishings, and irrevocable burial trusts up to $10,000.
IRA and retirement account treatment — favorable rule in Vermont Vermont has a favorable rule for IRAs and 401(k)s. An applicant’s IRA or 401(k) is exempt from the asset limit if it is in payout status — meaning the Required Minimum Distribution is actively being withdrawn. This is more favorable than most states which count retirement accounts as countable assets regardless of payout status.
Choices for Care — three tiers of long term care services Vermont’s Choices for Care program is distinctive in offering three tiers of service based on level of care need.
The High Needs tier provides nursing facility level care for people who need the most intensive support. Services are provided in nursing facilities or in the community.
The Highest Needs tier is Vermont’s highest level of home and community based care for people with very complex needs who would otherwise require nursing facility placement.
The Moderate Needs tier provides a lower level of home and community based services for people who need some support but do not require nursing facility level of care. The Moderate Needs tier has different eligibility rules than the High and Highest Needs tiers — it does not include a Community Spouse Resource Allowance provision.
Married couples — one spouse applying When only one spouse applies for Vermont Choices for Care at the High or Highest Needs level the community spouse — the spouse who remains at home — may retain 50 percent of the couple’s combined countable assets up to a maximum of $162,660. If 50 percent of the couple’s assets is less than $32,532 the community spouse may retain up to $32,532. The applicant spouse retains $2,000.
Monthly Maintenance Needs Allowance The minimum Monthly Maintenance Needs Allowance for the community spouse is $2,644 per month in 2026. The maximum is $4,066.50 per month for community spouses with high housing costs.
Personal needs allowance Vermont nursing home Medicaid recipients are allowed to keep $79.93 per month as a personal needs allowance. The remainder of income is applied toward the cost of care.
Look-back period and divestment penalty Vermont has a 60-month — five year — look-back period for nursing home Medicaid and Choices for Care High and Highest Needs applications. The look-back period does not apply to the Moderate Needs tier. Asset transfers made within 60 months of applying that were for less than fair market value may result in a penalty period of ineligibility. The 2026 divestment penalty divisor in Vermont is based on the statewide average monthly cost of nursing facility care.
Estate recovery Vermont requires Medicaid estate recovery. After a Green Mountain Care recipient dies the state seeks reimbursement from the estate for long term care costs paid. Planning with an elder law attorney can help protect assets from estate recovery.
How to apply for Vermont Green Mountain Care Medicaid Applications can be submitted online through Vermont’s My Vermont portal at myvermont.vermont.gov, by phone at 1-800-250-8427, or in person at your local Vermont Department for Children and Families — DCF — district office.
Vermont Medicaid administering agency Department of Vermont Health Access — dvha.vermont.gov
Vermont Estate Tax — 2026
Vermont is one of 12 states that imposes its own state estate tax. Vermont’s estate tax has a $5 million exemption and a flat rate of 16 percent — one of the simpler state estate tax structures. Vermont also has a two-year gift clawback rule that is important for estate planning.
Vermont state estate tax — $5 million exemption Vermont imposes a state estate tax on estates exceeding $5,000,000 per individual in 2026. The $5 million exemption has been in place since 2021 and is not indexed for inflation. Vermont’s estate tax rate is a flat 16 percent on the amount of the taxable estate above the exemption — simpler than the graduated rates used by most other estate tax states. The tax is paid by the estate before assets are distributed to beneficiaries.
Two-year gift clawback rule — important planning consideration Vermont includes gifts made within two years of death as part of the taxable estate for Vermont estate tax purposes. This prevents last-minute large transfers to avoid the Vermont estate tax. Gifts made more than two years before death are not included. This is an important consideration for Vermont residents doing estate planning — significant gifts should be made well in advance of anticipated need.
No portability in Vermont — critical planning consideration Vermont’s estate tax exemption is not portable between spouses. Unlike the federal estate tax a surviving spouse cannot use the deceased spouse’s unused $5 million Vermont exemption. Each spouse has a separate $5 million exemption that must be preserved through planning or it is lost. Married couples in Vermont should work with an estate planning attorney to use strategies such as credit shelter trusts to preserve both spouses’ exemptions and protect up to $10 million from Vermont estate tax.
Unlimited marital deduction in Vermont Property left to a surviving spouse — regardless of the amount — can be fully deducted from the Vermont gross estate. This means no Vermont estate tax is owed on assets passing to a surviving spouse at the first spouse’s death. The Vermont estate tax becomes relevant when assets pass to children and other heirs.
Non-residents with Vermont property Non-residents who own real estate or other tangible property located in Vermont — including vacation homes ski properties and agricultural land — may be subject to a Vermont estate tax return filing requirement if the combined federal gross estate plus federal adjusted taxable gifts made within two years of death exceeds $2.75 million.
No Vermont inheritance tax Vermont does not impose an inheritance tax. Once assets are distributed to beneficiaries Vermont does not impose a separate tax on the inheritance received.
Federal estate tax Vermont residents may also be subject to the federal estate tax. The federal estate tax exemption is $15,000,000 per person in 2026 following enactment of the One Big Beautiful Bill Act. The federal exemption is portable between spouses. Because Vermont’s $5 million exemption is below the federal $15 million exemption many Vermont estates owe state estate tax but no federal estate tax — making Vermont-specific estate planning essential.
No Vermont gift tax Vermont does not impose a state gift tax. Federal gift tax rules apply — the annual gift tax exclusion is $19,000 per recipient in 2026. Note that Vermont’s two-year gift clawback rule means gifts within two years of death are added back to the Vermont taxable estate even if no Vermont gift tax applies.
Vermont income tax Vermont has a progressive income tax with rates ranging from 3.35 percent to 8.75 percent — among the higher state income tax rates in the country. Social Security benefits are partially exempt — Vermont exempts Social Security income for taxpayers with adjusted gross income below $65,000 for single filers or $90,000 for joint filers. Pension income and IRA and 401(k) distributions are taxable in Vermont.
Vermont property taxes — higher than average Vermont has an effective property tax rate of approximately 1.59 percent — among the higher rates in the country. Vermont funds public education through a statewide property tax system which contributes to higher property tax bills.
Vermont Advance Directives
Vermont law recognizes the following advance directive documents:
Vermont Advance Directive for Health Care Vermont uses a combined Advance Directive for Health Care that includes both the appointment of a healthcare agent and treatment instructions. Must be signed and witnessed by two adults or notarized.
Vermont POLST — Physician Orders for Life-Sustaining Treatment Vermont uses a POLST form for seriously ill patients that documents specific medical orders regarding CPR hospitalization and artificial nutrition. Must be signed by a physician or nurse practitioner.
Vermont Do Not Resuscitate Order A physician order directing emergency personnel not to perform CPR. Vermont has standardized out-of-hospital DNR protocols.
Vermont Advance Directive Registry Vermont does not maintain a statewide advance directive registry. Copies of your advance directive should be given to your healthcare agent physician and any hospital or care facility where you receive care.
Free Vermont advance directive forms Free Vermont-specific advance directive forms are available at caringinfo.org and from the Vermont Medical Society at vtmd.org.
Vermont Key Agencies and Resources
Department of Vermont Health Access — DVHA Administers Green Mountain Care — Vermont Medicaid — including the Choices for Care long term care program. Website: dvha.vermont.gov My Vermont Portal: myvermont.vermont.gov Phone: 1-800-250-8427
Vermont Department of Disabilities Aging and Independent Living — DAIL Coordinates programs and services for older Vermonters including home care nutrition programs caregiver support and the Vermont SHIP program for free Medicare counseling. Website: dail.vermont.gov Phone: 1-802-871-3019 Vermont SHIP — free Medicare counseling: 1-800-642-5119
Vermont Area Agencies on Aging Vermont is served by 5 Area Agencies on Aging that coordinate local services for older adults and caregivers. Eldercare Locator: 1-800-677-1116 or eldercare.acl.gov
Vermont Long Term Care Ombudsman Program Advocates for the rights of residents of nursing homes and assisted living facilities. Investigates complaints and helps resolve problems free of charge. Website: vtombudsman.org Phone: 1-800-889-2047
Vermont Bar Association Lawyer Referral Service Connects Vermonters with attorneys including those who specialize in elder law and estate planning. Website: vtbar.org Phone: 1-802-223-2020
Vermont Legal Aid Provides free civil legal services to low income Vermonters including seniors on issues related to Medicaid benefits housing and elder law. Website: vtlegalaid.org Phone: 1-800-889-2047
Vermont Veterans Resources
Vermont Office of Veterans Affairs — OVA Provides services and benefits to Vermont veterans and their families including free VA claims assistance and connections to Vermont veterans resources. Website: veterans.vermont.gov Phone: 1-888-666-9844
Vermont Veterans Home Vermont operates a state veterans home providing long term care to eligible veterans and their spouses located in Bennington. Website: veterans.vermont.gov/veterans-home
Vermont Senior Property Tax Benefits
Property Tax Credit — Homestead Declaration Vermont homeowners who occupy their home as their primary residence and file a Homestead Declaration may qualify for a property tax credit based on income. The credit reduces property taxes for qualifying lower and moderate income homeowners including seniors. File using Form HS-122 with your Vermont income tax return by April 15.
Senior Stabilization — Income Sensitivity Adjustment Vermont’s income sensitivity program adjusts property taxes for homeowners whose property tax burden is high relative to their household income. Seniors living on fixed incomes often qualify for meaningful reductions under this program.
Disabled Veteran Property Tax Exemption Vermont veterans who are totally and permanently disabled due to a service-connected disability may qualify for a property tax exemption on their primary residence. Contact your town listers for details.
Finding Elder Law and Estate Planning Attorneys in Vermont
The following resources can help you find a qualified elder law or estate planning attorney in Vermont:
- National Academy of Elder Law Attorneys — NAELA — naela.org — searchable directory by location
- Vermont Bar Association Lawyer Referral Service — vtbar.org — 1-802-223-2020
- Vermont Chapter of NAELA — Vermont has an active NAELA chapter with members throughout the state
- Vermont Legal Aid — vtlegalaid.org — free legal assistance for income-qualifying seniors — 1-800-889-2047
The information on this page is for general informational purposes only and does not constitute legal or financial advice. Vermont Green Mountain Care Medicaid rules estate tax rates and other figures change frequently. Always verify current information with the relevant agency or a licensed attorney. Laws vary and individual circumstances differ significantly.
Last updated: May 2026