Vermont's best Medicare Advantage plans come from Humana, the state's only carrier for 2026. Humana's PPO plans cost $0 monthly with a $6,500 maximum out-of-pocket limit and 3.83-star CMS rating. HMO and HMO-POS options aren't available statewide. Most other insurers discontinued their plans for 2026, forcing many Vermont beneficiaries to switch to Original Medicare or Medicare Supplement coverage.
Best Medicare Advantage Plans in Vermont (2026)
Updated: January 29, 2026
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Key Takeaways
Humana stands alone in Vermont's Medicare Advantage market with just two PPO plans, both charging zero monthly premiums. HMO and HMO-POS networks are unavailable across the Green Mountain State.
Without competition in Vermont, Humana's PPO plans carry 3.83-star ratings and $6,500 out-of-pocket maximums, representing the only choice for Medicare Advantage coverage statewide.
Both Humana plans cover the same providers and medications, so your choice depends solely on which specific benefits package better fits your health care situation.
Best Medicare Advantage Companies in Vermont
| PPO | Humana | 3.83 | $0 | $6500 | HumanaChoice Giveback H7617-046 (PPO) |
Medicare Advantage plans bundle hospital stays, doctor visits and prescription drugs into comprehensive packages that often include extra benefits like dental and vision coverage. These private insurance alternatives to Original Medicare must cover everything traditional Medicare does while typically adding wellness programs and hearing aids.
- CMS Star Ratings: Plans earn ratings from 1 to 5 stars based on care quality, customer service and member satisfaction, with 4-star and 5-star plans delivering superior performance.
- Monthly premiums: You'll pay your standard Part B premium plus any plan-specific premium, though many Medicare Advantage plans charge no additional monthly fees beyond Part B costs.
- Maximum out-of-pocket (MOOP) limits: These annual spending caps protect you from high medical expenses, and once you reach your limit, the plan pays 100% of covered services.
- Drug coverage: Most plans include prescription drug benefits with specific medication lists called formularies that determine which drugs are covered and any usage restrictions.
Humana
MoneyGeek Rating
5/ 5
5/5Affordability
5/5Quality
5/5Availability
CMS Star Rating
3.83Plan Types
PPO
WHY CHOOSE HUMANA PPO PLAN?
PPO Medicare Advantage plans in Vermont cost more than HMO options but require zero referrals. See any Medicare-approved doctor directly and use out-of-network specialists when needed. Out-of-network visits cost more, so you'll save by staying in-network for routine care. This works if your orthopedist practices across the state line in New Hampshire or you need treatment while visiting family out of state.
How to Choose the Best Vermont Medicare Advantage Plan
Picking Medicare Advantage coverage in Vermont means choosing between two Humana PPO plans. Networks and drug coverage match between them, so your decision depends on supplemental benefits.
- 1Confirm Your Doctors and Hospitals Are In-Network
Vermont's Humana PPO plans let you see any provider accepting Medicare without referrals. Call your doctors anyway to confirm they accept Humana Medicare Advantage specifically.
- 2Compare Total Costs, Not Just Premiums
Zero monthly premiums apply to Vermont's two Humana plans beyond your Part B costs. Your actual spending depends entirely on health care usage frequency throughout the year. Copays at each doctor visit, specialist appointment and pharmacy refill determine your real annual costs.
- 3Check Prescription Drug Coverage
Humana uses the same formulary for its Vermont plans with identical drug lists and tier pricing across both options. Verify your medications appear on this shared formulary before enrolling. Prior authorization requirements affect certain drugs regardless of which Humana plan you select.
- 4Compare Different Plan Types
PPO health insurance plan structures represent Vermont's only option through Humana for 2026. Referrals aren't required under PPO plans, letting you book specialists directly, though out-of-network care costs more than staying in-network.
- 5Review Star Ratings and Quality Metrics
Humana's Vermont plans carry average of 3.83-star ratings from Medicare measuring claims processing, customer service and health outcomes. Higher-rated options don't exist in Vermont for 2026. Other insurers discontinued coverage statewide, leaving these ratings as your only quality benchmark.
- 6Compare Extra Benefits
Supplemental benefits separate Vermont's two Humana plans since provider networks and medication coverage match identically. Dental, vision, fitness and over-the-counter allowances vary between plans. Match extras to your actual health care habits rather than selecting benefits you'll never use.
- 7Check Out-of-Pocket Maximums
Annual spending caps at $6,500 apply to Vermont's Medicare Advantage options from Humana. Once you reach this out-of-pocket maximum, remaining covered expenses fall entirely on the plan through December. This limit stays consistent across Vermont's available plans for 2026.
How Much Does Medicare Advantage Cost in Vermont?
Vermont Medicare Advantage plans follow a different pattern than most states. PPO plans are the only option here with $0 median and average monthly premiums. Your main cost consideration centers on the $6,500 average out-of-pocket maximum. Budget for copays, coinsurance and deductibles throughout the year even with $0 premiums.
| PPO | $0 | $0 | $6,500 |
Best Vermont Medicare Advantage: FAQ
Get answers about how to enroll in Medicare Advantage, what's covered and enrollment timing for Vermont residents.
How do you get a Medicare Advantage plan in Vermont?
Enroll during the Annual Enrollment Period (October 15 to December 7) or when first eligible for Medicare. Compare plans at Medicare.gov, contact insurers directly, or work with a licensed agent. Coverage begins January 1 or during other qualifying periods.
What does Medicare Advantage cover?
Medicare Advantage plans cover everything Original Medicare does plus prescription drugs, with many Vermont plans adding dental, vision, and fitness benefits.
What's the difference between Medicare Advantage and Medicare Supplement?
Medicare Advantage replaces Original Medicare with bundled coverage from private insurers, while Medicare Supplement (Medigap) works alongside Original Medicare to help cover deductibles and copays.
When is open enrollment for Medicare Advantage in Vermont
Vermont offers multiple Medicare Advantage enrollment periods: the Annual Enrollment Period from October 15 to December 7, plus January 1 to March 31 for current enrollees.
Our Methodology: How We Ranked Vermont's Best Medicare Advantage Plans
Our analysis of Medicare Advantage plans in Vermont uses a weighted approach focusing on affordability and quality. We evaluate three key factors to help you find plans that offer the best value for your health care needs. These factors include affordability at 50%, star ratings at 40%, and availability at 10%.
- Affordability (50%): Cost accounts for half of our overall score because it affects your budget. We evaluated monthly premiums for Part C and Part D coverage combined (30% weight) and in-network maximum out-of-pocket limits (20% weight). Plans with lower premiums and MOOP amounts score higher since they reduce your total annual health care spending.
- Star Ratings (40%): CMS star ratings measure plan quality across categories like care effectiveness, customer service and member satisfaction. The Overall Star Rating combines both Part C (medical coverage) and Part D (prescription drug) ratings on a scale from 1 to 5 stars. Plans with higher ratings earn better scores in our analysis.
- Availability (10%): We score providers based on how many states they operate in, including Washington, D.C. Providers with broader geographic availability score higher because they're more likely to maintain coverage if you move and often have more resources for customer support and plan improvements.
This scoring system helps you compare plans objectively while accounting for what matters most: what you'll pay and the quality of care you'll receive.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.