Beginning August 1, 2023, the Vermont Medicaid program will discontinue coverage for over-the-counter melatonin, vitamin D, and antihistamine products for Medicaid members ages 21 and older. This coverage change is a result of changes to the State Fiscal Year 2024 Medicaid budget. These items are available for purchase in grocery stores and pharmacies without a prescription. This change also applies to Medicare members enrolled in VPharm.
Coverage of these over-the-counter items will remain in place for Medicaid members under the age of 21, as medically necessary, according to Health Care Administrative Rule 4.106 Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services.