More than 150,000 people in Vermont rely on Medicare for healthcare coverage. Of those beneficiaries, 130,000 have Original Medicare, while only 20,000 residents benefit from a Medicare Advantage plan. Here, you’ll learn the basics about your Vermont Medicare plan and how you can supplement it.

Vermont Medicare Facts and Figures

  • Over 116,000 residents have both Medicare Part A and Part B plans
  • Out of that number, 98,000 have aged into Medicare Parts A and B
  • 18,000 people have Medicare Parts A and B due to some disability
  • Almost 20,000 beneficiaries enrolled in a Medicare Advantage plan
  • Nearly 106,000 Vermont residents utilize a stand-alone Medicare Part D plan

Medicare Costs in Vermont for 2023

With a Vermont Medicare Part A and B plan, you can expect coverage for most medical services and expenses. Part A is known as “hospital insurance” because it will cover your inpatient hospital stay.

Healthcare professionals sometimes call Medicare Part B “medical insurance”—it helps cover health care expenses like outpatient hospital care, surgery, rehab, and checkups.

Medicare Part A Costs in 2023 Medicare Part B Costs in 2023
  • Part A is premium-free for most
  • Part A deductible is $1,600 per benefit period
  • Inpatient hospital stay days 61-90 is $400
  • The standard Part B premium is $164.90
  • The annual deductible for Part B is $226
  • Medicare pays 80%, you pay 20% out-of-pocket

Original Medicare Coverage

Most senior citizens enrolled in Medicare Part B also have a Part A plan to cover inpatient benefits. Part B has nearly 117,000 beneficiaries, with 18,000 enrolled because of a disability and 98,000 by age.

The number one reason people have Original Medicare in Vermont is their age, although disability is also a reason.

Medicare Part A (Hospital Coverage)

  • Inpatient care in hospitals
  • Skilled nursing facility care
  • Hospice care
  • Home health care
Medicare Part B (Medical Insurance)

  • Services from doctors and health providers
  • Outpatient care
  • Home health care
  • Durable medical equipment
  • Some preventive services

Supplemental Medicare Plans in Vermont

Vermont Medicare covers most of the medical bills and treatments you can expect as you grow older. However, it doesn’t cover everything. You’ll want to ensure you fill in the gaps and have comprehensive coverage for all your healthcare needs.

After enrolling in Medicare Parts A and B, you should consider adding a supplemental plan for more coverage options and an extra layer of protection. Medicare Supplement plans save you from paying healthcare costs out of pocket. Also known as Medigap plans, these policies work like sealant for your Original Medicare structure, covering any gaps in Parts A and B.

Enrolling in Medicare Advantage plans (also called Part C plans) is another recommended way to supplement Medicare Parts A and B. No matter where you live, you can expect the same benefits from Medicare Part C, including a Maximum-Out-of-Pocket (MOOP) to limit your medical service costs. There are several types of available Medicare Advantage plans:

  • Preferred Provider Organization (PPO)
  • Medicare Advantage Prescription Drug (MAPD)
  • Health Maintenance Organization – Point of Service (HMO-POS)
  • Health Maintenance Organization (HMO)
  • Private Fee-for-Service (PFFS)
  • Special Needs Plans (SNPs)

Medicare Parts A and B, Medicare Supplement plans, and many Medicare Advantage policies won’t cover your prescriptions. You’ll need to enroll in a Part D plan for prescription drug coverage. Here’s some of what you can expect with a Medicare Part D plan:

  • Enrollment through private insurance companies like Cigna and Humana
  • Low monthly premiums that vary from state to state
  • An annual deductible of $505, depending on your location
  • Prescription medication coverage
  • Prescription drug tiers that help organize costs

Original Medicare covers most of your healthcare needs, but not all of them. You’ll want to enhance your Vermont Medicare coverage with Medicare Supplement/Medigap, Medicare Advantage Part C, and Medicare Part D. These plans help beneficiaries cover healthcare costs and avoid blindsiding medical expenses.

Vermont Medicare Resources

Do you need guidance managing your Vermont Medicare plan? Know that you’re not alone.

The State Health Insurance Assistance Program (SHIP) in Vermont has plenty of resources to help you navigate Medicare. You can also find low-cost and even paid-for healthcare solutions with Vermont Medicaid programs. Visit the Community of Vermont Elders (COVE) to get education and advocacy for your healthcare journey.

Are you uncomfortable choosing a Medicare plan by yourself? We at Medigap.com are here to help you through the process.

FAQs

Why does Medicare in Vermont ask for your ZIP code?

If you’re looking to enroll in Vermont Medicare, you may wonder why it requires your ZIP code. ZIP codes help identify your location and let you know which Medicare Advantage plans are available in your area.

Do you automatically get Medicare with Social Security in Vermont?

Having Social Security doesn’t necessarily mean you get Medicare. However, two years after you receive Social Security Disability Benefits (SSDI), you can automatically enroll in Medicare. Vermont Medicare is also available after you turn 65.

How much does Medicare deduct from Social Security in Vermont?

Medicare doesn’t deduct any standard amount from your Social Security check. The amount deducted depends on several factors and specific parts of your Medicare plan. In addition, because Medicare Part C and Part D plans come from private insurers, premium rates may vary considerably.

How common are the Medicare Part B excess charges in Vermont?

Medicare Part B excess charges aren’t common, as only about 3% of healthcare providers will charge these extra costs. To calculate possible excess charges, subtract your Medicare coverage from the doctor’s overall expenses.

If your doctor doesn’t find Medicare coverage sufficient, they may charge 15% more than the approved rate.

What is the Medicare deduction from Social Security in Vermont?

Medicare beneficiaries can expect monthly premium deductions from their Social Security in Vermont. This automatic deduction helps cover Part B, “medical insurance” for outpatient services such as doctor visits, rehab, and hospital care.

With Part D prescription drug coverage, you must give your consent before Medicare deducts any amount from your Social Security check.

How to Sign Up for Supplemental Medicare in Vermont

Supplementing your Original Medicare plan provides more comprehensive medical coverage. With a Medicare Supplement, Medicare Advantage Part C, or Medicare Part D plan, you can rest easy knowing you’ve filled all the gaps. To find the right plan for your needs, we recommend the following:

  • Researching different policies
  • Comparing premiums and coverage options
  • Talking to friends and family
  • Contacting your local Medicare Supplement provider

You have many ways to supplement your Vermont Medicare. Our healthcare experts can help you better understand Original Medicare, summarize supplemental policies, and make an informed next step.

Call us today or fill out our convenient online rate form to get connected with the best rates in your area of Vermont.

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.