Memory Care in Vermont
Vermont has a relatively large senior population, as they comprise 20.8% of the state’s 646,972 residents. Compared to younger individuals, seniors are more likely to develop dementia, including Alzheimer’s disease, leading to a need for dementia care. Fortunately, in Vermont, the number of Alzheimer’s-related deaths is trending downward. The CDC reports that those deaths fell from 411 in 2016 to 391 in 2020, which represents a decrease of 4.87%.
Memory care communities provide supportive environments for seniors with Alzheimer’s and other memory-related conditions. They provide residents with 24/7 access to staff who are trained in supporting and communicating with individuals with memory loss. This guide supplies readers with data on the cost of memory care in Vermont, the state’s senior-friendly offerings and resources to help older Vermont residents and their families.
The Cost of Memory Care in Vermont
Note: In most cases, memory care is provided in assisted living facilities at rates that are 20-30% above standard assisted living care. While there’s no national database to track memory care costs in the U.S., the Genworth Cost of Care Survey tracks the cost for assisted living on an annual basis. We used the assisted living rates provided by Genworth for 2021 and added 25% to estimate those charged for memory care.
The cost of memory care in Vermont remains on the lower end when compared with other surrounding states. While New York ($5,725) is less expensive, seniors in New Hampshire ($7,566) and Massachusetts ($8,125) can expect to pay more for memory care.
While memory care costs in Burlington are more expensive than in other cities neighboring Vermont at $7,964 per month, seniors in Manchester, New Hampshire ($10,076) should expect to pay considerably more. To the west of Vermont, memory care costs considerably less at $5,313 per month in Glens Falls, New York and $5,270 in Albany, New York. Meanwhile, to the east in Pittsfield, Massachusetts, seniors currently pay $2,065 per month.
Seniors who don’t require memory support should also consider opting for other types of long-term care, many of which are more affordable than memory care. Adult Day Health Care is the least expensive option, averaging at $3,224 per month, while assisted living provides a slightly lower level of residential care and costs $5,250 per month. Those who continue to live in their own homes can pay $5,720 per month for home care or home health care. Otherwise, those who need 24-hour medically-focused care may require a nursing home, which costs an average of $10,585 per month for a semiprivate room or $11,102 for a private room.
Does Medicaid Cover Memory Care in Vermont?
Note: For the purposes of this guide, when we say “Memory Care” we are referring to memory care provided in a “social setting,” such as an Assisted Living Facility. This is the most common way to receive Memory Care and is the best fit for all but the frailest seniors. Sometimes the actual service of memory care can be provided in a Nursing Home (“medical setting”), so the financial assistance options will be very different. To learn more about the financial assistance options available for memory care provided in a nursing home, read our guide to Nursing Home Care in Vermont.
Although Medicaid doesn’t directly pay for memory care services in Vermont’s assisted living facilities, there are three waiver programs that can pay care costs. They don’t pay for room and board costs, however, which means seniors and their families will need to find alternative sources of funding for this aspect of memory care in a facility.
Choices for Care is for Vermont residents who require nursing home levels of care, but are able to choose where they receive it. This can be in a licensed nursing facility or memory care unit as well as the senior’s home. Enhanced Residential Care covers most care costs in a licensed residential facility, including memory care units. Covered services can include personal care, one hour of nursing services per week, case management and household/laundry services — but not meals or room and utility costs. Assistive Community Care Services covers a wider spectrum of care that includes services offered by the previous two waivers in addition to various therapies and restorative nursing services delivered in either a level 3 residential care home or assisted living.
What Memory Care Services Are Covered by Medicaid in Vermont
Vermont’s Medicaid is consistent in what it will pay for and not. The rule of thumb is it will pay for nursing and personal care services in a licensed facility, but not the senior’s room and board costs. In some cases, it can pay housekeeping and laundry costs, but this is dependent on the waiver the senior qualifies for.
Memory Care Waiver Programs in Vermont
There are three waiver programs families may apply for to help with memory care costs. Although each ultimately provides the same services, the location where these services are delivered and the eligibility criteria are different. Waivers can’t be combined, so the senior will only be eligible for one if they meet the qualifying criteria.
Choices for Care
Applications for this program are processed online. Alternatively, seniors can apply via mail or by faxing their application to (802) 241-0514.
Choices for Care is a Medicaid program for seniors who require long-term care. Those in assisted living and memory care facilities, as well as those who reside at home or in nursing care facilities have access to it.
To qualify, seniors must be 65 or older, Vermont residents and require a nursing level of care. Additionally, applicants must be financially eligible for Medicaid.
Enhanced Residential Care (ERC)
Seniors' long-term care facilities process ERC applications on their behalf.
ERC is a bundled package of services that Medicaid covers for those who live in residential care homes or assisted living residences. Services covered depend on the beneficiary's needs, but can include:
- Personal care
- Nursing overviews
- Medication management
- Recreation and social activities
- Household services and laundry
- 24-hour supervision
- Case management and documentation
This program is only open to active beneficiaries in the Choices for Care program.
Assistive Community Care Services (ACCS)
Applications are processed through Vermont's Area Agencies on Aging.
ACCS helps those living in residential care homes or assisted living residences access on-site therapies, personal care and case management services.
This program is only available to those living in Vermont who are age 65 or older. Beneficiaries must qualify for both Medicaid and Social Security Income first.
How to Know if You’re Eligible for Medicaid in Vermont
To be eligible for Medicaid in Vermont, the applicant must satisfy strict criteria relating to their income and assets. This criteria isn’t fixed, as the senior’s individual circumstances are taken into account. For example, a single applicant can have an annual income of up to $15,192 if they live within Chittenden County, but the figure for those elsewhere in Vermont is $13,992.
Assets are also counted, such as cash savings and checking accounts. These cannot exceed $2,000 for a single applicant, but can be up to $3,000 if one or both people in a two-person household apply. The Agency of Human Services will scrutinize the applicant’s previous 60 months’ financial history to ensure assets weren’t gifted or undersold in anticipation of a Medicaid application.
2022 Medicaid Income Limits for Seniors in Vermont
Single Applicant
$15,192*
$13,992**
$2,000
Two-Person Household
(Only One Person Applying)
$15,192*
$13,992**
$3,000
Two-Person Household
(Both People Applying)
$15,192*
$13,992**
$3,000
*Within Chittenden County
**Outside Chittenden County
As well as meeting the income and asset guidelines, applicants will also need to provide evidence of certain other criteria. They include being:
- A U.S. citizen or legal resident
- A Vermont resident
- Age 65 or older
- Blind or permanently disabled (if under 65)
- In need of skilled nursing care
How to Apply for Medicaid in Vermont
Seniors have four options when applying for Medicaid. Although all are equally valid, online and phone options are typically processed more quickly due to fewer delays in receiving the necessary information.
- Phone: Call the Customer Support Center at (855) 899-9600
- In-Person: Contact the Assister for your county
- Online: Visit Vermont Health Connect
- Mail: Download a paper application and mail a completed copy to Vermont Health Connect, 280 State Drive, Waterbury, VT, 05671-8100
Information You Will Need
In addition to passing the income and asset guidelines, you will need to satisfy other criteria that will be reviewed annually. You’ll need documents as evidence you meet the additional eligibility criteria. For example:
- Proof of U.S. citizenship (a passport or permanent resident card)
- Proof of Vermont residency (a utility bill)
- Proof of age (a birth certificate)
- Proof you meet the clinical criteria, which will be determined by the Department of Disabilities, Aging and Independent Living
How to Get Help Applying for Medicaid
Applying for Medicaid can be confusing for some applicants, while others may want more information before submitting their applications. The following organizations provide assistance free of charge.
(800) 250-8427
This federal website holds a wealth of information about Medicaid in Vermont, as well as other government benefits. It provides an overview of Medicaid and the requirements for eligibility. There’s also information on how to apply, with associated links. Additionally, applicants can call directly to speak to an advisor.
(800) 250-8427
Green Mountain Care is Vermont’s Medicaid program. It’s staffed by trained advisors who can answer queries directly by phone during normal working hours on weekdays. This includes guiding seniors through their applications.
Online Only
Medicaid experts across the country contribute free content to the American Council on Aging’s website. It’s a potentially useful resource for people who like to self-research. It also includes some useful tools, such as the “Spend Down Calculator,” which can help applicants whose assets exceed the threshold learn how to safely reduce them.
Does Medicare Cover Memory Care in Vermont?
The short answer is that no, Medicare does not cover the cost of memory care in Vermont. As was mentioned above, this doesn’t apply to Memory Care received in a Nursing Home. Since it is the most common to receive memory care in a “social setting” (such as an assisted living facility), Medicare won’t be a viable financial assistance option for most seniors who need Memory Care. However, Medicare will still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.
For more information about when Medicare can be used to pay for Memory Care in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Vermont.
Other Financial Assistance Options for Memory Care in Vermont
Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Memory Care affordable.
Aid and Attendance
Learn more and apply online at va.gov.
Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Memory Care.
Reverse Mortgages
Learn more about your options and how to apply at ftc.gov
If you own a home, you may be able to use a reverse mortgage to help pay for Memory Care. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.
Long-Term Care (LTC) Insurance
Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.
Seniors who already have long-term care insurance may be able to use it to pay for Memory Care. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Memory Care will not typically be eligible to sign up for a LTC insurance policy.
Free and Low-Cost Resources for Seniors in Vermont
The resources listed in the table below exist to help seniors in Vermont access the supportive services and benefits they need to enjoy the highest possible quality of life. While some resources are focused on health and long-term care, others provide seniors with necessities such as food and transportation, enabling them to enjoy a rich and full life, even with memory loss conditions.
1-800-642-5119
Area Agencies on Aging are located throughout Vermont and provide seniors with many supportive services, including medical transportation, health insurance counseling, advocacy and housing search support. Agencies also help seniors connect with government programs that may help pay for care, as well as other local resources as needed.
Contact via website
Vermont's Rx Card helps seniors and other Vermont residents save on necessary prescription medications. Using their Rx card, seniors can save as much as 80% on medications at participating pharmacies throughout the state.
1-800-889-2047
Vermont's Long-Term Care Ombudsman Project supports the dignity and independence of seniors who live in long-term care residences. It accepts complaints regarding care, and is authorized to mediate complaints and develop positive outcomes.
(802) 316-3839
The Alzheimer's Association helps seniors living with dementia to access support groups, medical help and other resources specific to those living with the disease. It also provides caregiver training and helps those who need it to schedule respite care.
Contact local transportation provider
The Vermont Public Transit Association helps seniors aged 60 and older access transportation to and from medical appointments, adult day care and personal appointments at no cost.
COVID-19 Rules for Memory Care in Vermont
The following information is based on research done on several government websites, including healthvermont.gov/covid-19. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visitation Policies
Are loved ones allowed to visit to provide emotional support?
Are relatives allowed to visit for end-of-life care?
Are residents required to quarantine after visiting with a loved one?
Are visitors required to wear PPE (including masks) in order to visit residents?
Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?
Are visitors checked for elevated temperatures?
Are visitors required to answer questions about health, travel, and potential virus contact?
Outings & Social Activities
Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?
Are residents who leave required to quarantine when they return?
Are senior living communities required to cancel all group outings?
Are residents allowed to eat meals together in a common area?
Are residents allowed to gather in common areas for group activites?
COVID-19 Safety Measures for Staff and Residents
Are staff members regularly required to do a temperature check?
Are staff members regularly tested for COVID-19?
Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?
Are residents regularly screened for COVID-19 symptoms?
Are residents regularly checked for elevated temperatures?
Are residents regularly tested for COVID-19?
Memory Care Laws and Regulations in Vermont
Through the Department of Disabilities, Aging and Independent Living, the State of Vermont has specific licensing regulations for assisted living residences (ALRs) and residential care homes (RCHs). These facilities include those with designated memory care units, as well as those that are exclusively for memory care. For assisted living facilities, Vermont’s ALR regulations must be used in conjunction with the RCH regulations.
Scope of Care
ALR’s uniform consumer disclosure shall describe all its service packages, tiers and rates. It must also include a statement that rates are subject to change due to changing care needs and other situations that should be described. This disclosure shall be available to the public upon request and noted of its availability in the facility’s marketing and other written materials.
Care Plans
An ALR or RCF must coordinate with the resident and/or the client’s legal representative in developing a care plan based on the resident’s assessment. Using an assessment instrument provided by the licensing agency, assessments must be done within 14 days after a resident’s admission and submitted to the agency annually or as requested. Care plan reviews must be done at least annually and whenever necessary due to a resident’s changes in condition or circumstances.
Medication Management
The administration of specific medications must be delegated by a registered nurse to designated staff for designated residents. The registered nurse is responsible for teaching unlicensed staff with proper medication administration techniques and the medication’s potential side effects with respect to the resident’s condition. Non-RN staff members can only perform insulin injections if they have received additional training and upon delegation by a registered nurse.
Staffing
For RCH or ALR with more than 15 residents, there must be at least one awake staff member on duty at all times. The licensing agency may require a specific staffing level to meet the residents’ needs. Facilities with special care units such as those for memory care shall provide specialized training to staff members who have direct care responsibilities for residents with Alzheimer’s or dementia.
Medicaid Coverage
While Vermont’s Medicaid programs do not cover room and board costs, residents who are ERC and/or ACCS recipients benefit from subsidized supportive services provided by participating ALRs and RCHs. These participating facilities include those with memory care units that have either or both ERC and ACCS certifications.
Reporting Abuse
Any ALR or RCH staff member can report any case of suspected abuse, neglect or exploitation to the Adult Protective Services (APS) unit of DAIL. APS reports should be made within 48 hours of learning the alleged incident. This may be done online or by calling 1-800-564-1612 toll-free.
Frequently Asked Questions
How much does memory care cost in Vermont?
Vermont’s monthly average memory care cost is $6,673. Although memory care facilities usually charge 20 to 30% more than standard assisted living facilities, memory care in Vermont is estimated to be 60% more affordable than nursing home care.
Does Green Mountain Care pay for memory care?
Yes. Applicable Medicaid programs include the Enhanced Residential Care (ERC) option under the Choices for Care waiver and the Medicaid State Plan’s Assistive Community Care Services (ACCS). Eligible seniors may qualify for either or both programs and must be residents of participating ERC and/or ACCS providers.
Does Medicare pay for memory care?
Medicare does not cover memory care or assisted living costs, but it pays for the costs of care planning and cognitive assessments for individuals diagnosed with dementia, as well as hospice care provided in long-term care facilities.
What types of facilities offer memory care?
There are assisted living and residential care facilities that are exclusively for memory care, as well as those that have special care units designated as memory care neighborhoods. Nursing homes and continuing care retirement communities can also have dedicated memory care units.
How Many Memory Care Facilities Are in Vermont?
There are 98 memory care facilities in Vermont. These cater to seniors with dementia conditions such as Alzheimer’s. Memory care services in the state are offered in both independent memory care facilities and in separate wings of communities offering other senior living services and amenities. Read More