Stay Informed and Protect Your Health.

Provider and Member Communication


**System Maintenance**

The State of Vermont’s Eligibility and Enrollment System for Qualified Health Plans and Medicaid will be Unavailable July 10 – July 21 for Required Maintenance and Upgrades.
The State of Vermont’s eligibility and enrollment system for qualified health plans and Medicaid will be undergoing required system maintenance and upgrades between Friday, July 10th at 5pm and Tuesday, July 21st at 9am. Some programs will not be affected, including Medicaid for the Aged, Blind and Disabled, Long-Term Care Medicaid, Disabled Children’s Home Care (DCHC or Katie Beckett), Medicare Savings Programs, VPharm or Healthy Vermonters programs. These programs use a different enrollment system so the scheduled maintenance will not affect them.

The State began public communications last week to encourage Vermonters who may need to enroll or make a change to their account to do so before the system becomes unavailable on July 10th beginning at 5pm.  During the period of scheduled maintenance and upgrades, affected customers will not have access to their account and will not be able to make changes either online or over the phone.  

The Customer Support Center and the Assister hotline will remain open from 8:00am-4:30pm Monday-Friday during the time the system is undergoing the planned maintenance and upgrades to answer general questions and to assist customers and Assisters who have an urgent access to care need. Customers may still contact the Customer Support Center at 1-855-899-9600 but staff will have very limited capacity to support customers and Assisters during the system upgrade.

The cost of PPE is not eligible for Medicaid reimbursement and any costs associated with the purchase of PPE may not be charged to Medicaid members. PPE are considered supplies that are incidental to a provider’s practice and may not be billed separately. Providers are required to submit claims for all Medicaid covered services and may not request payment from a Medicaid enrolled individual at the time of service. Vermont Medicaid cannot reimburse the member for services. To ensure access to care for Vermont Medicaid members, the Agency of Human Services has offered financial opportunities for providers and has developed a proposal for health care provider stabilization. As more information will be forthcoming, providers should continue to visit this webpage for the most up-to-date information. (6/10/2020)

  • Cost-Sharing:
    Vermont Medicaid has:
    • Eliminated co-payments for hospital outpatient services;
    • Eliminated co-payments for medications that may be used to treat the symptoms of COVID-19.

These changes ensure that no co-payments apply to COVID-19 testing, diagnosis, and treatment services. (3/31/2020)

In order to manage our COVID-19 response, our temporary call center hours for Member Services will be 8:00 AM to 4:30 PM, Monday through Friday. Due to the COVID-19 Emergency, Vermont is facilitating initial and continuous health care enrollment by:

  • Temporarily waiving financial verifications required for those seeking to enroll in health insurance;
  • Extending Medicaid coverage periods (meaning the Department is not processing the annual “reviews” that could result in loss of Medicaid) until after the emergency ends;
  • Not ending Medicaid coverage during the Emergency period unless the customer requests it;
  • See below for more information on how Vermont is implementing these changes for Long-Term Care Medicaid.
  • Temporarily waiving Dr. Dynasaur premiums, beginning with the April bills for the premium due in May;
  • Offering a Special Enrollment Period for those who do not currently have health insurance to enroll in a qualified health plan and receive premium and cost-sharing assistance, if eligible. (Eligible Vermonters can continue to apply for, and enroll in, Medicaid at any time). This Special Enrollment Period is currently open through August 14, 2020.

  • Long-Term Care Medicaid:

For Long-Term Care Medicaid, Vermont is:

  • Accepting self-attestations for current income and resources from applicants for Long-Term Care Medicaid eligibility determinations and suspending transfer of asset rules (60 month look back period) during the Emergency;
  • Extending the review period for Long-Term Care Medicaid members who had a review scheduled for March, April or May until the Emergency ends;
  • Reviews are extended for all Long-Term Care Medicaid members scheduled for those three months whether or not they returned their review application;
  • All Provider questions and concerns should be sent via EMAIL to the DVHA LTC Management Team at:

Department of Vermont Health Access

280 State Drive
Waterbury, Vermont 05671-1010
Phone: 802-879-5900
Fax: 802-241-0260

Contact List for staff email, telephone & fax numbers

Hours of Operation: Monday-Friday (Excluding Holidays) 7:45am - 4:30pm

Public Record Requests
Kelly Provost
DVHA Public Records Officer
Visit the Agency of Administration site for the Public Records Database

Report Medicaid Fraud, Waste, and Abuse