If you or a family member is on Medicaid in Vermont and needs a wheelchair ramp, grab bars, or a wider doorway, the state's Choices for Care (CFC) program can help pay for it. Choices for Care is a specialty program within Vermont Medicaid's Global Commitment to Health 1115 waiver. Two state offices share the work: the Department of Disabilities, Aging and Independent Living (DAIL) handles clinical eligibility, and the Department of Vermont Health Access (DVHA) handles financial eligibility. Here is how it works and how to apply.
What Vermont offers#
Choices for Care serves adult Vermonters age 18 and older who are either older adults or have a physical disability and need a nursing home level of care. Once someone qualifies, the program lets that person choose the setting, such as Home-Based care, Flexible Choices (a self-directed budget), Adult Family Care, Enhanced Residential Care, or a nursing facility. Eligibility stays the same across settings; the money follows the person's choice.
Clinical eligibility falls into two main groups, Highest Needs and High Needs, plus a smaller Moderate Needs group. Home modifications are available only through Home-Based options, using funds labeled "Assistive Devices and Home Modifications."
A home modification is a physical adaptation to the home necessary to protect the health, safety, wellbeing, accessibility, and independence of the person, such as ramps, door widening, grab bars, and bathroom modifications. All work must meet Americans with Disabilities Act (ADA) design standards and state and local building codes. This benefit is not available under Adult Family Care, and it is bundled into or excluded from the residential settings.
Amounts and eligibility#
An annual limit on assistive devices and home modifications does apply, but Vermont does not publish the figure. The program manual states only that spending is "not to exceed the rate on file per calendar year," verified against the DAIL Choices for Care manual, July 2026, and your case manager confirms the current amount. Choices for Care is a payer of last resort: Medicare, regular Medicaid State Plan coverage, private insurance, and any other funding source must be checked first.
Vermont does not publish an income figure for Long-Term Care Medicaid; financial eligibility is decided by DVHA, not DAIL. To ask about the current financial rules, call DVHA at 802-476-0100 or toll-free at 1-833-840-0061, and say "Long-Term Care Medicaid," or apply online at dvha.vermont.gov/members.
How to apply in Vermont#
Applying for Choices for Care runs on two tracks at the same time.
- Clinical eligibility. Contact your local DAIL Long-Term Care Clinical Coordinator nurse at 802-241-0294. This nurse reviews whether you meet the nursing home level of care.
- Financial eligibility. Contact DVHA at 802-476-0100 or 1-833-840-0061, or apply online at dvha.vermont.gov/members.
Once you are enrolled in a Home-Based option, a case manager from your local Area Agency on Aging builds your person-centered plan and arranges the purchase and payment for any home modification, after confirming no other source should pay and consulting an occupational therapist (OT) or physical therapist when needed. This takes the paperwork burden off your family. If you prefer more control over your budget, Flexible Choices offers a self-directed alternative.
Vermont partly publishes its waitlist rules: new applicants who meet the High Needs criteria may be placed on a waiting list if state funds are not available at referral, scored by daily-living needs. Active participants who still meet High Needs criteria are not dropped. In practice, the highest-needs cases move fastest, so ask the DAIL clinical coordinator about current status. Vermont delivers Choices for Care through Area Agencies on Aging and Home Health Agencies, not managed care organizations.
For help getting started, the Vermont Senior HelpLine, run by the Area Agencies on Aging, is a good first call at 1-800-642-5119. The federal Eldercare Locator (eldercare.acl.gov, 1-800-677-1116) is a fallback if you need other local aging services.
How it stacks with federal programs#
If the person needing modifications is a veteran, grants from the U.S. Department of Veterans Affairs (VA) may help fund a larger project alongside Vermont Medicaid. See our VA home modification grants guide for details.
Original Medicare does not cover structural home modifications. Some Medicare Advantage (Part C) plans cover extras like grab bars or ramps as a supplemental benefit, but coverage is plan-specific with no standard amount, so ask your plan directly.
Finding a provider who knows this program: Not every contractor has handled Choices for Care paperwork. Adapta Home USA verifies providers' Medicaid Waiver Billing experience, so you can filter for pros who have done this before in Vermont. Find Home Modifications & Remodeling providers in Vermont with Medicaid Waiver Billing experience →
For the bigger picture on combining programs, see our national Medicaid HCBS waiver guide and our full guide to paying for home modifications. HCBS stands for home and community-based services.
FAQ#
Does Vermont Medicaid pay for home modifications like wheelchair ramps or grab bars?#
Yes. Through the Home-Based options of Choices for Care, participants can use Assistive Devices and Home Modifications funds for ramps, door widening, grab bars, and bathroom modifications, as long as the work meets ADA standards and local building codes.
What is Choices for Care and who is eligible?#
Choices for Care is Vermont's specialty program under the Global Commitment to Health 1115 waiver. It serves adults age 18 and older who are older adults or have a physical disability, are Medicaid-eligible, and need a nursing home level of care.
Is there a dollar limit on home modifications through Choices for Care?#
An annual limit does apply, but Vermont does not publish the figure. The manual sets spending at "the rate on file per calendar year," so your case manager confirms the current amount. Choices for Care also pays only after other sources, such as Medicare or insurance, are checked first.
How do I apply for Choices for Care in Vermont?#
Apply on two tracks at once. For clinical eligibility, call the DAIL Long-Term Care Clinical Coordinator at 802-241-0294. For financial eligibility, call DVHA at 802-476-0100 or 1-833-840-0061, or apply online at dvha.vermont.gov/members.
Find a verified provider near you#
Adapta Home USA's directory lets you search Home Modifications & Remodeling providers in Vermont and filter for Medicaid Waiver Billing experience. Our wheelchair ramp cost guide can help you budget while your case manager arranges the work.
This article is for general educational purposes only and does not constitute medical, legal, or financial advice. Consult a qualified professional about your specific situation.
Program amounts, eligibility rules, and application procedures change. Figures on this page were verified against official government sources on the date shown, but you should confirm current details at VA.gov or with the administering agency before making decisions. Adapta Home USA is not affiliated with the U.S. Department of Veterans Affairs or any government agency.