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Healthy Vermonters & VPharm - Vermont State Pharmaceutical Assistance Programs

Page Reviewed / Updated - Apr. 2019

Table of Contents


Program Description

The state of Vermont currently offers two different pharmaceutical assistance programs: Healthy Vermonters and VPharm. VPharm requires participating seniors to be enrolled in Medicare Part D, while Healthy Vermonters does not. Healthy Vermonters offers discounted prescription medications without monthly premiums, and VPharm charges monthly premiums, but offers steeper discounts on medications. 

Program Confusion - In past years, VT offered several other prescription assistance programs.  Information about these programs can still be found on many websites.  These programs were Vermont Health Access Plan (VHAP-Pharmacy), VSCRIPT and VSCRIPT Expanded. However, they are no longer relevant.

Eligibility Guidelines

To be eligible for these programs, seniors must meet the following criteria:

Healthy Vermonters

  • Be a Vermont resident. There is no length of residency clause.
  • Have no prescription insurance coverage or have maxed out their coverage benefit for the year.
  • Have an annual income of less than 400% of the Federal Poverty Level (FPL) if enrolled in Medicare Part D. In 2019, this is no greater than $49,960 if unmarried, widowed, or otherwise single, and $67,640 if married or a two-person household. For those that are not enrolled in Medicare Part D, the income limit is 350% of the FPL. In 2019, this means an individual can have an annual income up to $43,715, and a married couple, up to $59,185. Make note, there is no resource (asset) limit.

VPharm

  • Be a Vermont resident. There is no length of residency clause.
  • Be a minimum of 65 years old OR be disabled.
  • Must have Medicare Part D, but cannot have other prescription drug insurance.
  • Have an annual income of less than 225% of the FPL. In 2019, this is less than $28,104 if single, and $38,052 if married. As with Healthy Vermonters, there are no restrictions on resources.

Benefits and Services

VPharm pays for Medicare Part D plan premiums and prescription co-pays. Remember, there is a monthly premium for VPharm. As of 2019, there are three levels of coverage ($15/month, $20/month, and $50/month). Healthy Vermonters offers discounted prescriptions without monthly premiums.

How to Apply / Learn More

These programs are administered by the Department for Children and Families, Agency of Human Services. To apply or learn more, visit their webpage or call 800-250-8427.  One can also obtain an application here.

Did You Know?  Vermont ranks in the Top 5 healthiest states for aging.  Go Green.
The state of Illinois has two programs designed to provide financial assistance to the elderly to help them purchase their prescription drugs.  Rx Basic is for individuals without Medicare insurance and the Rx Plus is designed for those on Medicare.

 

Rx Plus is known as a Medicare wraparound program which means the benefits wrap around those benefits provided by a Medicare Part D plan.  When making a prescription purchase, Medicare Part D is the first payer and then this program contributes towards those costs the Part D plan does not cover.