Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – September 29, 2022

Reviewed by Dr. Brindusa Vanta, MD

Medicare is a health insurance program that helps pay for some medical costs for those aged 65 and older and for people with certain disabilities. 

Original Medicare consists of two parts: Part A and Part B. Part A covers the costs of inpatient hospital care, skilled nursing care in a nursing home, hospice care and home healthcare. Individuals who paid Medicare payroll tax for a minimum number of years receive this coverage for free. Through Part B, Medicare recipients get help paying for some of the costs of outpatient medical care, durable medical equipment, mental health services, ambulance and other services and. Medicare recipients pay a monthly premium for Part B coverage. In 2022, the cost is $170.10.

Medicare recipients may choose to receive coverage through Medicare Advantage or Medicare Part C provided by a private insurer rather than to participate in Original Medicare. Prescription drug coverage is available to both Original Medicare and Medicare Part C enrollees through Medicare Part D. Most Medicare Part C plans include Part D, and therefore seniors enrolled in this plan do not need to apply separately for drug coverage. 

In Vermont, 154,684 individuals are enrolled in Medicare in 2022; almost 24% of the state’s more than 645,000 residents are participating in this program. About 82% of Medicare beneficiaries in Vermont received coverage under traditional Medicare, with the remaining 18% covered by Medicare Advantage plans in 2021. This puts Vermont’s share of Medicare Advantage recipients well below the nationwide rate which was 42% in the same year. This guide reviews the options for Medicare coverage in Vermont to help those eligible for Medicare make important decisions regarding their health coverage.

Options for Medicare Coverage in Vermont

Vermonters have choices when it comes to Medicare. Residents of the state may opt to receive Original Medicare or a Medicare Advantage plan through a private health insurance company. Add-on coverage for prescription drugs is available to all Medicare beneficiaries through Part D plans offered by private insurers. In addition, Original Medicare recipients may add Medicare Supplement insurance to lower their out-of-pocket costs.

Original Medicare (Parts A & B)

Original Medicare is administered by the Centers for Medicare & Medicaid Services (CMS) and is open to seniors aged 65 and over, along with those under 65 years old, but with certain disabilities or end-stage kidney disease. Part A covers inpatient hospital care, nursing home and skilled nursing care, hospice and home health care. Part B, or medical coverage, pays for medically necessary goods and services such as durable medical equipment, mental health services and emergency medical transportation. 

Unlike most private Medicare plans, Original Medicare’s provider network isn’t limited to the beneficiary’s geographic region, making it easier to obtain services while traveling within the country. In most cases, Medicare doesn’t pay for health services the individual receives outside the United States. 

Under this program, seniors pay for services as they receive them. They must pay an annual deductible, which is $1,556 for Part A and $233 for Part B in 2022. After they’ve paid this amount, Medicare covers all eligible services at 80%. Beneficiaries pay the remaining 20% out of pocket.

Who Should Consider Original Medicare

Original Medicare may be a good option for those who:

  • Travel frequently within the United States
  • Don’t need extra benefits such as home-delivered meals and coverage for over-the-counter medication
  • Want to choose their own prescription drug coverage

Medicare Advantage (Part C)

Medicare Advantage plans are an alternative to Original Medicare offered through private insurance companies. Laws require Medicare Advantage plans to cover as much as Original Medicare covers (except hospice care which remains covered by Medicare Part A), but to give insurers the option to provide additional benefits.

Vermonters who opt for a Medicare Advantage plan may receive access to coverage for vision and dental care, prescription drugs and other services that Original Medicare usually won’t pay for. Instead of paying 20% coinsurance for outpatient services, most plans require enrollees to pay a copay, which may result in lower out-of-pocket costs.

Four main types of Medicare Advantage plans are available: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Private Fee For Service (PFFS) plans and Special Needs Plans (SNPs).

Who Should Consider Medicare Advantage

Medicare Advantage may be a good choice for individuals who:

  • Wish to have more control over what medical expenses they pay for out of pocket
  • Want additional benefits like prescription drug, dental and vision coverage
  • Are in overall good health and may qualify for lower premiums
  • Are comfortable with managed care

The Top 10 Medicare Advantage Plans in Vermont

The table below lists the 10 most popular Medicare Advantage plans (by enrollment) in Vermont. Most Medicare Part C insurance providers offer more than one plan, so cost information includes a range, while enrollment numbers reflect the total number of Vermonters enrolled in all of the insurer’s Medicare Advantage plans as of April 2022. Learn more about Medicare Advantage plans here.


Total Enrollment

Star Rating

Min Cost

Max Cost

Plan Types







Vermont Blue Advantage


















Aetna Medicare


















Anthem Blue Cross and Blue Shield






Highmark Inc.






Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t pay for most prescription drugs through Part A or B coverage. Instead, Original Medicare users purchase separate prescription drug policies, also called Part D coverage. Part D is already included in most Advantage plans. Medicare contracts with private health insurance companies to provide this coverage. There are multiple plans to choose from with varying monthly premiums, which beneficiaries pay in addition to their Original Medicare premiums. While seniors don’t have to purchase prescription drug coverage when they’re first eligible for Medicare, not obtaining this coverage at this time may result in late enrollment penalties they pay for as long as they have Medicare if they enroll later.

Each prescription drug plan has its own formulary, or list of covered drugs. Formularies are typically split up into tiers. The tier a medication is in determines how much the insurance company pays and how much the beneficiary pays for it. Lower-level tiers are usually made up of generic and low-cost brand name drugs, while higher tiers are composed of more expensive brand name and specialty drugs. In most cases, the lower the tier, the lower the policyholder’s cost-sharing responsibility.

Who Should Consider Medicare Prescription Drug Coverage

Seniors who may benefit from prescription drug coverage include those who:

  • Currently take prescription medication or expect to in the future
  • Want to avoid late enrollment penalties
  • Want to reduce out-of-pocket prescription drug expenses

Medicare Supplement Insurance (Medigap)

While Original Medicare provides coverage for many medical costs, seniors may still have significant out-of-pocket expenses. These may include copays, coinsurance and deductibles. Seniors may be able to reduce their cost-sharing obligations by purchasing a Medigap plan. These plans can only be used with Original Medicare. It’s illegal for private insurance companies to sell Medigap plans to those with Medicare Advantage plans.

For more information on Medigap plans, seniors can refer to the Best Medicare Supplement Companies of 2022 page.

Who Should Consider Medicare Supplement Insurance

Good candidates for Medigap may be those who:

  • Have ongoing health issues and expenses
  • Travel overseas often
  • Want to access an expanded network of health care providers
  • Expect to need health services not covered by Original Medicare

Medicare Resources in Vermont

Vermonters have a wealth of options when it comes to Medicare coverage. While that means that seniors and those with disabilities are free to choose the type of health insurance that fits their budgets and suits their medical needs, it can also make it difficult to know which plans to choose. Fortunately, resources are available to provide free advice and assistance so that people eligible for Medicare can make informed choices.

Vermont State Health Insurance Program

Sponsored by Vermont’s Area Agencies on Aging, the Vermont State Health Insurance Program provides free advice to anyone eligible for Medicare. Family members and caregivers may also receive assistance through the program. Knowledgeable counselors are available to answer questions about Original Medicare, Medicare Advantage plans, Medicare drug plans and Medicare Supplement insurance to provide individualized advice regarding which plans may be the best fit for their needs. The free service can also share information about Medicaid and VPharm programs that can lower the cost of healthcare for low-income individuals.

Contact Info

The Vermont State Health Insurance Program is available by phone at 800-642-5119 or by contacting a local office of the Vermont’ Association of Area Agencies on Aging.

Visit Website
Vermont Legal Help

A nonprofit organization, Vermont Legal Help offers free legal advice and counseling for all residents of Vermont. Seniors and their families can contact the helpline to get answers to questions regarding state and federal Medicare laws. The organization’s website also offers detailed information about Medicare and serves as a valuable reference for those trying to choose coverage or resolve a dispute with Medicare or their private insurer.

Contact Info

Vermont Legal Help provides assistance via the toll-free number 800-917-7787. The official website also provides a Legal Help Tool for quick answers to common questions. Individuals can also fill out the Legal Help Request Form to get help.

Visit Website
Vermont Health Connect

Administered by the Department of Vermont Health Access, Vermont Health Connect is the state’s health insurance marketplace. Although Medicare health plans aren’t available through the program, its website provides detailed information regarding Medicare eligibility. In addition, seniors and individuals with disabilities who fail to meet the eligibility requirements to qualify for Medicare can receive financial help to cover some of the costs of health care through the program. Those who are eligible for both Medicare and Medicaid can get advice about which of the state’s plans are the right fit for their needs.

Contact Info

Vermont Health Connect is reachable via phone at 855-899-9600. Seniors, individuals with disabilities and their family members can browse official websites for more information.

Visit Website
Central Vermont Council on Aging

The Central Vermont Council on Aging serves older adults living in the greater Montpelier area. Residents of the region can receive free Medicare enrollment and plan selection counseling in person, by phone and remotely via Zoom. All Vermonters can access valuable information regarding Medicare rules and guidelines on the agency’s website. Throughout the year, the agency also hosts online video conference workshops to introduce seniors and their families to Medicare. Anyone living in Vermont can participate in one of these sessions.

Contact Info

To schedule an appointment or seek advice, seniors can call 802-479-0531 or send an email to the Director at [email protected]

Visit Website
Green Mountain Care

Green Mountain Care provides services for residents of Vermont with demonstrated financial need. The agency administers the state’s Medicaid program and offers detailed information about eligibility and enrollment on its website. Medicare enrollees who need help paying for prescription drugs can apply for assistance through the agency. Those interested in applying can download an application to begin the process or call to receive the form in the mail.

Contact Info

On weekdays, seniors can call Green Mountain Care at 1-800-250-8427 for assistance. The hotline has relay support for those with hearing impairments. The website also has numerous resources for seniors.

Visit Website
Office of the State Treasurer

Seniors who find it difficult to navigate the official Medicare website can find quick answers to common questions through the Office of the State Treasurer. The department’s site provides links to key pages on the Medicare website for easy review. On the site, individuals who work for state and municipal government agencies or for Vermont public school districts can also find information about planning for retirement and pension funds. As a result, the site is an excellent resource for many Vermonters who are approaching the age of Medicare eligibility.

Contact Info

The Treasurer’s Office advises that the fastest way to receive assistance is to email [email protected] Staff fields questions about retirement planning at 802- 828-2305, and the website offers free information 23/7.

Visit Website