VPharm Program Vermont: Tiers, Premiums, and How It Wraps Part D
Your parent is paying $80 a month in Part D copays on top of the plan premium, and the pharmacy bills keep climbing. VPharm — Vermont's own prescription assistance program — can reduce those copays to a few dollars per fill and cover gaps that Part D and Extra Help miss.
What VPharm Does
VPharm is a state-funded program authorized under Vermont law (33 V.S.A. § 2073) and operated through the state's Section 1115 Global Commitment to Health waiver. It wraps around Medicare Part D coverage, picking up costs that Part D leaves behind:
- Subsidizes or eliminates the Part D deductible ($615 standard in 2026)
- Reduces prescription copays at the pharmacy counter
- Covers certain maintenance medications excluded from standard Part D formularies
VPharm is not a replacement for Part D — your parent must be enrolled in a Medicare Part D plan to participate. It layers on top, reducing what Part D doesn't cover.
2026 Income Tiers and Monthly Premiums
VPharm uses three income tiers. Each has a flat monthly member premium and no asset test.
| Tier | Single Income | Couple Income | FPL Range | Monthly Premium |
|---|---|---|---|---|
| VPharm 1 | Up to $1,995 | Up to $2,707 | Up to 150% | $15 |
| VPharm 2 | $1,995.01 – $2,328 | $2,707.01 – $3,158 | 150.01% – 175% | $20 |
| VPharm 3 | $2,328.01 – $2,993 | $3,158.01 – $4,060 | 175.01% – 225% | $50 |
VPharm Tier 1 has the same income ceiling as QMB ($1,995/month single). A senior who qualifies for QMB almost certainly qualifies for VPharm Tier 1 as well.
How VPharm Works With Extra Help
This is where it gets layered — and where the value compounds. A senior enrolled in QMB or QI is automatically deemed eligible for Extra Help (the federal Part D Low-Income Subsidy). Extra Help covers the Part D plan premium up to the regional benchmark and eliminates the Part D deductible.
VPharm then wraps around Extra Help, reducing copays further and covering non-formulary items that neither Part D nor Extra Help touch. For a Tier 1 member already on Extra Help, VPharm handles the remaining prescription cost-sharing that LIS leaves behind.
For seniors between 175% and 225% FPL who don't qualify for any MSP (and therefore don't get automatic Extra Help), VPharm Tier 3 provides standalone prescription relief — the $50/month premium still saves hundreds in annual drug costs for anyone on multiple medications.
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How to Apply
VPharm uses the same Form 201P as the Medicare Savings Programs. Your parent can apply for both MSP and VPharm on a single form. Submit through the Vermont Document Uploader at my.vermont.gov, by mail to Green Mountain Care in Waterbury, or by calling 1-800-250-8427 to apply over the phone.
Required documentation is the same as MSP: Social Security award letter and any pension or income statements. No asset documentation needed.
Keeping VPharm Active
Green Mountain Care sends monthly premium billing statements. The VPharm premium must be paid to maintain coverage — a 60-day grace period applies before termination. Annual renewals follow the same schedule as MSP, with a renewal packet mailed 45 days before the review date.
The Vermont Medicare Savings Programs, Extra Help & VPharm Guide details how VPharm coordinates with Part D plan selection, what happens when tier status changes at renewal, and worked examples showing total out-of-pocket savings across all three tiers.
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.