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Medicare in Vermont

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Here’s a look at some enrollment statistics for Medicare enrollment in Vermont (as of 2015*). As you can see, not all beneficiaries have prescription drug coverage.

  • Number of Medicare beneficiaries: 130,581
  • Number of beneficiaries enrolled in stand-alone Medicare Part D Prescription Drug Plans or Medicare Advantage Prescription Drug plans: 94,501
  • Number of beneficiaries enrolled in Medicare Part D Prescription Drug Plans specifically: 86,007

Original Medicare is the federal health insurance program for eligible American citizens and legal permanent residents of at least five continuous years who qualify by age or disability. Most people are eligible for Medicare when they turn 65, but you can also qualify at any age through disability or having end-stage renal disease or amyotrophic lateral sclerosis (Lou Gehrig’s disease). Original Medicare is divided into two categories, or “parts:” Part A (hospital insurance) and Part B (medical insurance).

In Vermont and nationwide, many Medicare beneficiaries are enrolled into the program automatically. Most people pay a monthly premium for Medicare Part B, but many receive Part A for free. To get premium-free Medicare Part A, you must have worked at least 10 years (40 quarters) while paying Medicare taxes.

Original Medicare doesn’t cover most of the prescription medications you take at home, so if you want help paying for your prescriptions, you might want to look into Medicare Part D Prescription Drug Plan.

There’s another way to get your Medicare benefits. You can enroll in a Medicare Advantage plan, which provides your Original Medicare benefits. The exception is hospice care, which is still covered under Medicare Part A instead of through a Medicare Advantage plan. Available from private insurance companies approved by Medicare’s approval, these plans often include other benefits as well, such as prescription drug coverage and fitness programs. When you’re enrolled in a Medicare Advantage plan, you’re still in the Medicare program and must continue paying your monthly Medicare Part B premium.

Medicare resources in Vermont

Medicare Savings Programs in Vermont: Beneficiaries that live in Vermont and have an income that falls below a certain limit might qualify for programs that help cover medical bills. See the Vermont Agency of Human Services for more information.

Vermont State Health Insurance Counseling and Assistance Program (SHIP): The Vermont State Health Insurance Assistance Program provides answers to questions and addresses concerns about Medicare-related issues.

* Statistical data from the Centers for Medicare & Medicaid Services, “On its 50th anniversary, more than 55 million Americans covered by Medicare” as of July 28, 2015.

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