Medicare in Vermont

Vermont among states with lowest Medicare Advantage enrollment

Resources for Vermont beneficiaries

State Health Insurance Assistance Programs (SHIPs) provide free, in-depth, one-on-one insurance counseling and assistance to Medicare beneficiaries, their families, friends, and caregivers. SHIPs operate in all 50 states.

Vermont has offices offering SHIP assistance throughout the state. Click or call the one nearest you:

Snapshot of Medicare in Vermont

Total Medicare enrollment in Green Mountain State

In 2009 there were 117,393 Medicare beneficiaries in Vermont, which is 18.7 percent of its total population. That compares with 16 percent of the United States population enrolled in Medicare.

The states with the highest percentage of beneficiaries are West Virginia and Maine with about 21 percent each. Those with the lowest percentage are Alaska (9.5 percent) and Utah (10 percent). In raw numbers, Alaska has the least recipients at 69,301 and California (which has about an eighth of the country’s population within its borders) has the most at a little over 5 million (13 percent of its population).

Read about Medicare’s open enrollment period and other important enrollment deadlines.

Breakdown of the aged vs. disabled

Individuals who qualify by virtue of their age alone make up 80 percent of Vermont Medicare recipients. The balance — 20 percent — are on Medicare as the result of a disability. Kentucky has the highest percent of Medicare recipients listed as disabled (28 percent), followed by Alabama, Mississippi, West Virginia and Arkansas. Hawaii has the smallest percentage at 12 percent, followed by North and South Dakota at 14 percent each.

Medicare spending per recipient

Medicare pays about $8,719 annually per enrollee in Vermont. Growth in per-enrollee spending in Vermont from 1991 to 2009 has been about 6.8 percent.

In terms of spending per recipient, about 20 states spend $10,000 or more per recipient. (Medicare spends the most per beneficiary — $11,903 — in New Jersey and the least per enrollee — $9,576 — in Montana. South Carolina and Nebraska lead in per-enrollee spending growth at 7.4 percent, and Pennsylvania‘s growth per enrollee has been the least at just over 5 percent.

Medicare spending overall

In total spending on Medicare, Vermont ranks #47 with $941 million per year. With the largest and smallest numbers of recipients, itʼs no surprise that California accounts for $50.6 billion of overall Medicare spending while Alaska spends only $553 million. Total Medicare spending for all states and the District of Columbia was $471 billion in 2009 (latest available data).

Medicare Advantage in Vermont

Medicare Advantage offers Americans health benefits through private plans instead of through Original — or traditional — Medicare (the federal government’s fee-for-service program). These plans are one option for consumers who desire additional benefits beyond what Original Medicare offers, but are not considered a wise option by some consumers who are concerned that government spends more per enrollee on the private plans than it does on its own program.

In 2014 in Vermont, 7 percent of all Medicare recipients chose a Medicare Advantage plan. Vermont is in a two-way tie with Delaware for #47 among all states for insureds choosing an Advantage plan. Nationwide, 30 percent of Medicare beneficiaries enrolled in a Medicare Advantage program. A full 32 percent of urban dwellers choose them, compared to only 20 percent of rural dwellers, likely due to less access to plans.

Minnesota is the only state where more than half (51 percent) of Medicare eligibles enrolled in a Medicare Advantage plan. Alaska, with only 22 Advantage enrollees, is the only state to have zero percent enrolled in Medicare Advantage. Five more states have Medicare Advantage enrollment (by percentage of the state’s Medicare enrollees) in the single digits: Wyoming with 3 percent, New Hampshire with 6 percent, Vermont and Delaware (both with 7 percent) and Maryland squeaking in with 9 percent.

Stand-alone Medicare Prescription Drug plans

Vermont has 78,019 in stand-alone prescription drug plans. The state has 31 plans with premiums ranging from $13 to $126 per month. That amounts to 48 percent of all enrollees in Vermont having a stand-alone Rx plan compared to an average of 47 percent nationally. (Florida is highest with 52 percent.)

Medicare prescription drug coverage — called Medicare Part D — was the result of legislation passed in 2003 and signed into law by President George W. Bush in 2006. It is a bit of a controversial program because it was an unfunded liability — meaning that the vast majority of costs fell on taxpayers — and the law also barred Medicare from negotiating lower drug prices with drug makers.

For those under 65 in Vermont

Are you under 65 years of age? We have information on Vermont health insurance and the Vermont health insurance marketplace at our health insurance site.