Help Your Aging Parent With Medicare Costs in Vermont
The Programs That Can Help
If your parent lives in Vermont on a fixed income and Medicare premiums are eating into their Social Security check, there are three state and federal programs that can reduce or eliminate those costs. Most families do not know all three exist, and even fewer know how they work together.
Medicare Savings Programs (QMB and QI) pay some or all of your parent's Medicare premiums. QMB covers Part A and Part B premiums plus all deductibles and copays for Medicare-covered services. QI covers just the Part B premium. Vermont expanded QMB to 150% of the Federal Poverty Level in January 2026, which means a single person earning up to $1,995 per month qualifies.
Extra Help (Low-Income Subsidy) is the federal program that reduces Part D prescription drug costs — the monthly premium, the deductible, and per-prescription copays. If your parent qualifies for QMB or QI, they are automatically deemed eligible for Extra Help without a separate application.
VPharm is Vermont's own prescription assistance program. It wraps around Part D and Extra Help to bring prescription copays down to $1 to $2 per medication. VPharm has three income tiers covering individuals up to 225% FPL ($2,993 per month).
Quick Eligibility Check
Vermont eliminated the asset test for QMB, QI, and VPharm. Your parent's savings account, home, car, and retirement funds do not count as assets for these programs. Countable income and the other eligibility rules still apply.
| Program | Single Income Limit | Couple Income Limit | What It Covers |
|---|---|---|---|
| QMB | $1,995/month | $2,707/month | Part A + B premiums, deductibles, copays |
| QI | $2,685/month | $3,645/month | Part B premium ($202.90/month in 2026) |
| VPharm Tier 1 | $1,995/month | $2,707/month | Prescription copays to $1–$2 ($15/mo member premium) |
| VPharm Tier 2 | $2,328/month | $3,158/month | Prescription copays to $1–$2 ($20/mo member premium) |
| VPharm Tier 3 | $2,993/month | $4,060/month | Prescription copays to $1–$2 ($50/mo member premium) |
The income figures use the gross Social Security amount — the number before Medicare Part B premiums are deducted. Look at the Social Security award letter, not the deposit amount.
Where to Start
Step 1: Pull your parent's most recent Social Security award letter. This shows gross monthly income before deductions.
Step 2: Add any other income — pensions, part-time wages, VA benefits (non-service-connected). Vermont applies a $20 general income disregard, so the first $20 of unearned income does not count.
Step 3: Compare the total against the table above. If your parent falls under any threshold, they likely qualify.
Step 4: Apply using Form 201P through Green Mountain Care. You can submit online via the Document Uploader at my.vermont.gov, by mail to 280 State Drive, NOB 1 South, Waterbury, VT 05671-1500, or by phone at 1-800-250-8427.
If you are not sure which programs fit, Vermont's SHIP counselors (through your regional Area Agency on Aging) provide free one-on-one guidance. During peak enrollment periods, wait times can stretch to several weeks for an appointment.
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What to Expect After Applying
DVHA processes applications within 45 days for age-based requests. If your parent is approved for QMB, the Part B premium deduction from their Social Security check stops — but it takes SSA 30 to 90 days to process the state's buy-in record. During that gap, premiums keep coming out. SSA issues a retroactive refund once the update goes through.
VPharm wraps around the member's Part D coverage once enrollment is active; check the approval notice or ask Green Mountain Care when the pharmacy can process it. Extra Help is automatically deemed through QMB or QI, but the Part D plan's records may not reflect the status immediately. If the pharmacy charges more than expected during that gap, the QMB or QI approval notice can serve as Best Available Evidence; ask the pharmacist to contact the Vermont Medicaid Pharmacy Help Desk or use the state eligibility printout.
Get the Complete Walkthrough
The Vermont Medicare Savings Programs guide covers every step from the initial eligibility check through application, approval, premium refund tracking, and annual renewal — plus standalone worksheets to calculate income, track agency interactions, and handle billing disputes.
Get Your Free Vermont — Medicare Savings Program Eligibility Checklist
Download the Vermont — Medicare Savings Program Eligibility Checklist — a printable guide with checklists, scripts, and action plans you can start using today.