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: June 9, 2026
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Key Takeaways
Humana is the only Medicare Advantage insurer in Vermont, offering two PPO plans with $0 monthly premiums. HMO and HMO-POS options aren't available in the state.
Humana's PPO plans carry an average 3.83-star rating and a $6,500 out-of-pocket maximum.
Both Humana plans cover the same providers and medications. Your choice depends on which benefits package better fits your health needs.
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 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. Plans with 4 or 5 stars offer superior performance.
- Monthly premiums: You'll pay the 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 bills. Once you reach your limit, the plan covers 100% of eligible services.
- Drug coverage: Most plans include prescription drug benefits with specific medication lists called formularies. These 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.
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. 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.
- 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.
- 5Review Star Ratings and Quality Metrics
Humana's Vermont plans carry an 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.
- 6Compare Extra Benefits
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.
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 (Oct. 15 to Dec. 7) or when you first become eligible for Medicare. Compare plans at Medicare.gov, contact insurers directly, or work with a licensed agent. Coverage starts Jan. 1 or at the beginning of 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 a bundled package of coverage from private insurers. Medicare Supplement (Medigap) works alongside Original Medicare to help cover out-of-pocket costs like 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
Vermont's Medicare Advantage market has limited options, so our scoring focused on cost and quality. We weighted three factors: affordability (50%), star ratings (40%) and availability (10%), to identify plans with the best value for your health care needs.
- Affordability (50%): Cost accounts for half of our overall score because it directly affects your budget. Monthly premiums for combined Part C and Part D coverage carry 30% weight; in-network MOOP limits carry the remaining 20%. Plans with lower premiums and MOOP amounts score higher because they reduce total annual health care spending.
- Star Ratings (40%): CMS star ratings measure plan quality across care effectiveness, customer service and member satisfaction. The Overall Star Rating combines Part C (medical coverage) and Part D (prescription drug) ratings on a 1-to-5-star scale. Higher-rated plans earn better scores in our analysis.
- Availability (10%): We score providers on how many states they serve, including Washington, D.C. Broader geographic reach scores higher because a plan's coverage is more likely to transfer if you move, and larger providers tend to have more resources for customer support and plan improvements.
This scoring lets you compare plans objectively, balancing what you'll pay against the quality of care you'll receive.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty (P&C) Insurance Producer in Connecticut, is MoneyGeek's resident insurance expert. He has spent nearly a decade analyzing the market, first at LendingTree and now at MoneyGeek, where he produces original research on hundreds of carriers and millions of rates across auto, home, renters, health and life insurance.
He covers economics and insurance at MoneyGeek, and his work has been featured in The Washington Post, The New York Times and NPR, among other outlets.
Like all MoneyGeek analysts, he draws on independent cost and consumer experience data. No insurance company partnership influences his recommendations.
Fitzpatrick earned his degrees from Johns Hopkins University (M.A. Economics and International Relations) and Boston College (B.A.). His career began in financial risk management at State Street. He's also a five-time “Jeopardy!” champion.