Key threshold: If your income is below $22,025 (individual) or $45,540 (family of 4), you likely qualify for Green Mountain Care / Vermont Medicaid with free or very low-cost coverage. No premiums, no deductibles.
Vermont Medicaid Income Limits 2026
The following table shows the key income thresholds for Vermont in 2026:
| Household Size | 100% FPL | 138% FPL (Medicaid Limit) | 400% FPL (Subsidy Limit) |
|---|---|---|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
If your household income falls below the 138% FPL column, you qualify for Green Mountain Care / Vermont Medicaid. If your income is between 138% and 400% FPL, you qualify for ACA marketplace subsidies to help pay for private insurance.
About Green Mountain Care / Vermont Medicaid
Who Qualifies for Green Mountain Care / Vermont Medicaid
If you're a Vermont resident wondering about your health coverage options, Green Mountain Care, Vermont's Medicaid program, is a crucial starting point. It provides comprehensive health insurance for eligible individuals and families. Adults can qualify with incomes up to 138% of the Federal Poverty Level (FPL). For a single person, this means an annual income of approximately $20,120, and for a household of three, it's around $34,307 in 2024. Children in Vermont have higher income thresholds, qualifying up to 317% of the FPL, and pregnant women up to 213% FPL. Green Mountain Care is a significant program in the state, with approximately 176,300 Vermonters, or 27.2% of the population, enrolled in Medicaid in 2024. This demonstrates it's a widely utilized and essential program for many residents.
If You're Near the Income Line
If your income is slightly above the Green Mountain Care threshold, you'll likely transition to exploring health plans through Vermont Health Connect, the state's health insurance marketplace. Here, you may be eligible for subsidies to help make your coverage affordable. For example, with a benchmark Silver plan costing around $680 per month in Vermont, which is higher than the national average, subsidies can significantly reduce your out-of-pocket premium. It's important to remember that your eligibility for either Green Mountain Care or marketplace subsidies can change with your income. If you experienced a loss of Medicaid coverage during the recent unwinding period, you can reapply at any time if your circumstances change and you believe you now qualify.
What Green Mountain Care / Vermont Medicaid Covers
Green Mountain Care offers robust benefits with minimal to no cost-sharing, meaning you generally won't pay deductibles, co-pays, or co-insurance for covered services. Vermont's Medicaid program operates under an 1115 demonstration waiver called "Global Commitment to Health," which gives the state flexibility in covering health services and populations. Unique aspects include the "Choices for Care" waiver, which helps older residents needing moderate to high levels of care remain in their homes or communities, even allowing family members (excluding spouses and legal guardians) to be hired as care providers. Vermont Medicaid also covers telehealth services, including audio-only telephone calls, at the same reimbursement rate as in-person services for medically necessary care.
Tips for Applying
When navigating Green Mountain Care, be aware that while Vermont's uninsured rate is low at 3.4% compared to the national average of 8.2%, some residents still face challenges. Recent changes due to federal law will impact Medicaid eligibility for certain immigrants starting October 1, 2026, and more frequent renewals for some adult populations are expected in 2027. While Vermont has maintained many flexibilities beyond the federal Public Health Emergency, some waivers related to asset tests and telephone signatures expired in 2023. To ensure you have the most accurate and up-to-date information for your specific situation, your best action step is to contact Vermont Health Connect directly to discuss your eligibility and application.
Marketplace Insurance in Vermont
Vermont residents who do not qualify for Medicaid can purchase private health insurance through Vermont Health Connect. The average benchmark (second-lowest cost Silver) plan in Vermont costs approximately $680/month for a 40-year-old in 2026.
Premium tax credits (subsidies) are available for households with income between 100% and 400% FPL. Here is what a 40-year-old individual in Vermont might pay for a Silver plan after subsidies, based on the $680/month benchmark:
| Income Level | Annual Income | Your Cost | Monthly Subsidy |
|---|---|---|---|
| 150% FPL | $23,940 | ~$80/mo | $600/mo |
| 200% FPL | $31,920 | ~$173/mo | $507/mo |
| 250% FPL | $39,900 | ~$277/mo | $403/mo |
| 300% FPL | $47,880 | ~$392/mo | $288/mo |
| 400% FPL | $63,840 | ~$523/mo | $157/mo |
These estimates are for a 40-year-old individual on a benchmark Silver plan in Vermont. Actual premiums depend on your age, household size, tobacco use, and plan choice. Households with income between 100-250% FPL also qualify for cost-sharing reductions (CSR) on Silver plans, which lower deductibles and copays. Vermont runs its own marketplace through Vermont Health Connect.
How to Apply for Green Mountain Care / Vermont Medicaid
Medicaid enrollment is open year-round — there's no deadline. You can apply through any of these channels:
- Online: Apply through Vermont Health Connect — the system automatically checks your Green Mountain Care / Vermont Medicaid eligibility when you enter your income.
- Phone: Call Vermont's Medicaid helpline for guided help with your application.
- In person: Visit your local human services office or a certified application counselor.
You'll need proof of income (pay stubs or tax returns), proof of Vermont residency, and Social Security numbers for household members.
Calculate Your Subsidy in Vermont
Enter your income, age, and household size to see if you qualify for Medicaid or marketplace subsidies in Vermont.
Frequently Asked Questions
How much can I earn and still qualify for Green Mountain Care / Vermont Medicaid?
In 2026, the Medicaid income limit in Vermont is 138% of the federal poverty level: $22,025 per year for an individual, $29,863 for a household of 2, $37,702 for 3, and $45,540 for a family of 4.
Has Vermont expanded Medicaid under the ACA?
Yes, Vermont has expanded Medicaid under the ACA. Adults aged 19-64 earning up to 138% of the federal poverty level qualify for Green Mountain Care / Vermont Medicaid.
Am I eligible for health insurance subsidies in Vermont?
Vermont residents with household income between 100% and 400% FPL ($15,960 to $63,840 for an individual in 2026) qualify for premium tax credits that reduce the cost of marketplace health insurance. Apply through Vermont Health Connect.
What is the Vermont Medicaid program called?
Vermont's Medicaid program is known as Green Mountain Care / Vermont Medicaid. It provides health coverage for eligible low-income residents including children, pregnant women, seniors, and adults up to 138% FPL.
What happens if I lose Medicaid coverage in Vermont?
If your Green Mountain Care / Vermont Medicaid coverage ends due to income changes or redetermination, you qualify for a Special Enrollment Period on the marketplace. This gives you 60 days to sign up for a private plan through Vermont Health Connect. If your income is between 100-400% FPL, you'll likely qualify for subsidies to help cover the cost.
Am I eligible for Green Mountain Care / Vermont Medicaid if I'm employed?
Yes. Medicaid eligibility in Vermont is based on your Modified Adjusted Gross Income (MAGI), not your employment status. If your household income is at or below 138% FPL ($22,025 for an individual), you qualify for Green Mountain Care / Vermont Medicaid even if you work full-time. Many Green Mountain Care / Vermont Medicaid enrollees are working adults.
What's the difference between Medicaid and marketplace insurance in Vermont?
Medicaid (Green Mountain Care / Vermont Medicaid) is free or very low-cost with no premiums or deductibles. Marketplace plans in Vermont average $680/month before subsidies — among the highest in the country. If you qualify for Medicaid, it will almost always be the better financial choice. If your income is just above the Medicaid limit, subsidies can still make marketplace coverage affordable.