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Vermont Medicare and Health Plans for Seniors (VT)

The total number of Medicare beneficiaries in Vermont is 104,460 or 17% of its total population as of July 2008, not far from the national average of 15%. As of 2007, Medical Advantage penetration was 2%, (about 2,000 Medicare Advantage plans, of which only 10 are eligible for switching as of 2007) significantly low compared to the national average of 19%.

Medicare Advantage Plans are supplementary health insurance for Medicare beneficiaries who have both Part A (hospital) and B (optional medical insurance). In principle, Medical Advantage enrollees get extended benefits and have smaller out-of-pocket expenses than would typically occur with the original Medicare system, although it may require the use of provider network services such as accredited physicians.

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The above statistics seem to indicate that Vermonters feel less need to procure additional health coverage by enrolling in supplemental Medicare plans, certainly in the case of Medicare Advantage plans. With an average annual Medicare spending of $6,028 compared to a national average of $7,439, it may be deduced that Vermonters either prefer to pay out-of-pocket health costs rather than pay monthly insurance premiums or have a smaller Medicare "coverage gap" than residents in most other states.

Vermont's Lack of Medicare Advantage Plans

The fact that Vermont seniors prefer out-of-pocket costs may account for the relatively small number (20) of Medicare Advantage plans offered in parts or the whole of Vermont. Among the Medicare Advantage plans that also provide prescription drug coverage* at no monthly premium are:

  • AARP MedicareComplete Choice [R7444 - 001]
  • SecureHorizons MedicareDirect Rx Plan 56 [H5435 - 025]
  • SecurityChoice Plus [H0540 - 020]

If Vermont residents are as healthy as they appear in statistics, the lack of penetration for Medicare Advantage plan providers may be offset by the infrequency of the required payouts for medical needs.

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Providers for Medicare plans available in VT1

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* You may be able to get extra help to pay for your prescription drug premiums and costs. To see if you qualify for getting extra help, call:

1-800-MEDICARE (1-800-633-4227). TTY/TDD users should call 1-877-486-2048, 24 hours a day/7 days a week;

The Social Security Administration at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY/TDD users should call, 1-800-325-0778; or Your State Medicaid Office

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