Most older adults prefer to age in place rather than move into an institutional setting such as a nursing home because remaining at home often supports a seniorâs sense of independence and connection to familiar surroundings and loved ones. While home-based care is often more desirable, it can also be expensive. The good news is that Medicaid may offer financial assistance, but the rules are complex and vary by state. To help provide some clarity, the attorneys at Unsworth LaPlante, PLLC discuss whether Medicaid will cover home health care for seniors in Vermont.
Medicaid Support for Home Health Care Services in Vermont
Medicaid is a collaborative program funded by both state and federal governments that offers medical coverage for individuals who meet certain income and resource limitations. In Vermont, the Medicaid program is administered through the Department of Vermont Health Access and may offers seniors several options that help pay for the high cost of long-term care needs. Among these options are programs that provide in-home care for qualifying elderly residents who prefer to avoid nursing facility placement. The Choices for Care program, for example, operates under a special Medicaid waiver and focuses on enabling seniors to remain at home or in community-based settings. This initiative offers a range of services designed to meet the daily needs of individuals who require a nursing facility level of care but choose to remain at home. Services may include personal care assistance, housekeeping help, meal preparation, and skilled nursing. To qualify for Choices for Care, an individual must meet both clinical and financial eligibility criteria. Clinically, the person must demonstrate a need for services equivalent to what would be provided in a nursing facility. Financially, the applicant must satisfy income and asset requirements consistent with Medicaid eligibility in Vermont. As of 2025, this means that an individual cannot have income that exceeds $2,901 per month and may not own countable resources valued at more than $2,000. Home health services that Medicaid may pay for in Vermont include things such as:
- Personal care tasks such as bathing, dressing, and grooming
- Skilled nursing assistance for tasks such as managing medications or wound care
- Rehabilitative therapies when prescribed by a physician, including speech, occupational, or physical therapy
- Light housekeeping, meal preparation, and assistance with shopping or errands
These services are structured through an individualized care plan, which outlines the specific needs of the recipient and the scope of assistance to be provided. The plan must be approved by Medicaid and is reviewed periodically to ensure the services remain appropriate.
Family Caregivers and Medicaid Compensation
A common concern among families is whether Medicaid will provide payment to a relative who takes on the role of caregiver. In Vermont, Medicaid does allow for some family members to receive compensation for providing in-home care, depending on the circumstances and the structure of the program under which services are delivered.
Under the Choices for Care initiative, individuals may designate a qualified family member or friend to serve as their caregiver. This is often facilitated through what is known as a self-directed option, in which the recipient has control over choosing and managing their care providers. The arrangement must comply with established guidelines and include oversight by a case manager or fiscal intermediary service. While you may be able to receive payment for providing care to a loved one in Vermont, there are some common exclusions, such as:
- Spouses and legal guardians are typically excluded from receiving payment as caregivers due to potential conflicts of interest and regulatory restrictions.
- The chosen caregiver must often complete formal training or certification requirements, which may include receiving a Home Health Aide or Personal Care Assistant credential recognized by the state.
- Compensation is subject to caps on the number of hours that can be billed and the hourly reimbursement rate, which is set by Medicaid and may be lower than private-market rates.
- The care plan must be developed in consultation with a case manager and approved by the relevant Medicaid authorities to ensure that the services align with the recipientâs medical and functional needs.
Do You Have Questions about Medicaid Covering Home Health Care for Seniors in Vermont?
For more information, please attend one of our upcoming FREE seminars. If you have additional questions about Medicaid covering home health care expenses for seniors in Vermont, contact an experienced Essex Junction Medicaid planning attorney at Unsworth LaPlante, PLLC by calling 802-879-7133 to schedule your appointment today.
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