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Version 4 Updated 07/13/2026
1 | P a g e 2026 STANDARDS CHANGE FOR HEALTHCARE
Effective January 1, 2026 the following healthcare standards change: • Protected income levels (PILs) for Medicaid for the Aged, Blind, and Disabled • QMB, QI, and QDWI income maximums • SLMB program is sunsetting 1/1/2026 due to QMB program expansion • SSI/AABD payment levels and federal SSI payment maximums • MABD maximum allocation for ineligible child • Substantial Gainful Activity (SGA) limit • Pickle deduction percentage chart o NOTE: This document has been republished since 1/1/2026. All amounts are the same as previously published except for the maximum income amounts for households of one which are based on the Federal Poverty Level (FPL). These new income amounts, indicated by an asterisk (*) in the charts below, are effective 4/1/2026. The following Long-Term Care (LTC) Medicaid standards change on January 1, 2026: • Institutional income standard (IIS) • Community spouse resource allocation maximum (CSRA) • Substantial Home Equity limit • Home upkeep deduction • Allocations to community spouse- maximum, standard income allocation and shelter standard • Allocation to each dependent family member living with a community spouse • Community maintenance allowance (CMA) for the home-and-community-based waiver programs • Medicare Part A co-payment for nursing home care
Eligibility maximums for Medicaid for the Aged, Blind and Disabled (MABD) and waiver programs, effective 4/1/26 Household Size Coverage Groups Rule % FPL 1 2 3 4 5 6 7 8 PIL outside Chittenden County § 29.14 N/A 1,375 1,375 N/A N/A N/A N/A N/A N/A PIL inside Chittenden County § 29.14 N/A 1,483 1,483 N/A N/A N/A N/A N/A N/A VPharm 1 § 5441 150% 1,995* 2,707 3,419 4,132 4,844 5,557 6,269 6,982 VPharm 2 § 5441 175% 2,328* 3,158 3,989 4,820 5,652 6,483 7,314 8,145 VPharm 3 § 5441 225% 2,993* 4,060 5,129 6,197 7,266 8,335 9,404 10,472 Medicaid for working people with disabilities (MWPD) § 8.05d 250% 3,325* 4,511 N/A N/A N/A N/A N/A N/A Healthy Vermonters (aged, disabled) § 5724 400% 5,320* 7,217 9,117 11,017 12,917 14,817 16,717 18,617