Medicare & Medicaid in Vermont (VT)
2026 healthcare costs, coverage, and spending data for Vermont.
$10,273
Spending/Capita
3,007,602
Medicare Enrollees
4,043,470
Medicaid Enrollees
5.6%
Uninsured Rate
Medicare Premiums in Vermont
Part B Premium
$178/mo
Part D Premium (Avg)
$44/mo
Medigap Premium (Avg)
$329/mo
Medicaid Expansion: Yes - Vermont expanded Medicaid under the ACA
Procedure Costs in Vermont
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $204,897 | $163,917 | $40,979 |
| Kidney Transplant | $121,950 | $97,560 | $24,390 |
| Heart Valve Replacement | $78,184 | $62,548 | $15,637 |
| Coronary Artery Bypass Graft (CABG) | $73,215 | $58,572 | $14,643 |
| Spinal Fusion | $60,848 | $48,678 | $12,170 |
| Defibrillator Implantation (ICD) | $46,251 | $37,001 | $9,250 |
| Total Knee Replacement | $33,207 | $26,566 | $6,641 |
| Total Hip Replacement | $31,626 | $25,301 | $6,325 |
| Cardiac Catheterization with Stent | $28,374 | $22,699 | $5,675 |
| Laminectomy | $26,974 | $21,579 | $5,395 |
| Pacemaker Implantation | $24,885 | $19,908 | $4,977 |
| Mastectomy | $24,663 | $19,730 | $4,933 |
| Colectomy | $24,287 | $19,429 | $4,857 |
| Stroke Treatment (Acute) | $21,867 | $17,494 | $4,373 |
| Lumbar Disc Surgery | $21,665 | $17,332 | $4,333 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Lithotripsy (Kidney Stones) | $8,594 | $6,875 | $1,719 |
| Arthroscopic Knee Surgery | $7,178 | $5,743 | $1,436 |
| Endoscopic Sinus Surgery | $6,977 | $5,582 | $1,395 |
| TURP (Prostate) | $6,512 | $5,210 | $1,302 |
| Septoplasty | $6,211 | $4,969 | $1,242 |
| Dialysis Access Surgery | $5,670 | $4,536 | $1,134 |
| Bunionectomy | $5,444 | $4,355 | $1,089 |
| Tonsillectomy | $5,113 | $4,090 | $1,023 |
| Nasal Polyp Removal | $5,092 | $4,074 | $1,018 |
| Pilonidal Cyst Surgery | $4,570 | $3,656 | $914 |
| Hemorrhoid Surgery | $4,297 | $3,437 | $859 |
| Cataract Surgery (Outpatient) | $4,122 | $3,297 | $824 |
| Ganglion Cyst Removal | $4,014 | $3,212 | $803 |
| Adenoidectomy | $3,491 | $2,793 | $698 |
| Bronchoscopy | $3,264 | $2,611 | $653 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $4,007 | $3,205 | $801 |
| MRI Brain | $1,800 | $1,440 | $360 |
| Nuclear Stress Test | $1,680 | $1,344 | $336 |
| CT Scan Abdomen/Pelvis | $1,479 | $1,183 | $296 |
| CT Angiography | $1,448 | $1,158 | $290 |
| MRI Knee | $1,438 | $1,151 | $288 |
| MRI Spine (Lumbar) | $1,391 | $1,113 | $278 |
| MRI Shoulder | $1,391 | $1,113 | $278 |
| MRI Spine (Cervical) | $1,169 | $935 | $234 |
| MRI Hip | $1,077 | $862 | $215 |
| Bone Scan | $841 | $673 | $168 |
| CT Colonography (Virtual) | $830 | $664 | $166 |
| CT Scan Chest | $762 | $610 | $152 |
| CT Scan Head | $618 | $495 | $124 |
| Fluoroscopy | $552 | $441 | $110 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $413 | $331 | $83 |
| Allergy Testing | $317 | $254 | $63 |
| Mammogram (Screening) | $271 | $271 | $0 |
| Office Visit (New Patient) | $239 | $191 | $48 |
| Annual Wellness Visit | $235 | $235 | $0 |
| Psychiatry Visit | $217 | $174 | $43 |
| Mental Health Counseling | $207 | $165 | $41 |
| Wound Care Visit | $204 | $163 | $41 |
| Bone Density Test (DEXA Scan) | $189 | $151 | $38 |
| Skin Cancer Screening | $187 | $149 | $37 |
| Speech Therapy Session | $183 | $146 | $37 |
| Office Visit (Established Patient) | $178 | $143 | $36 |
| Physical Therapy Session | $171 | $137 | $34 |
| Shingles Vaccination | $163 | $163 | $0 |
| EKG (Electrocardiogram) | $154 | $124 | $31 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Blood Culture | $60 | $48 | $12 |
| Vitamin D Level | $54 | $43 | $11 |
| Blood Type and Crossmatch | $51 | $41 | $10 |
| Thyroid Panel (TSH) | $48 | $38 | $10 |
| BNP (Heart Failure Marker) | $47 | $38 | $9 |
| Glucose Tolerance Test | $44 | $35 | $9 |
| Lipid Panel | $42 | $34 | $8 |
| Troponin Level | $41 | $33 | $8 |
| PSA (Prostate-Specific Antigen) | $39 | $31 | $8 |
| Comprehensive Metabolic Panel | $38 | $30 | $8 |
| Urine Drug Screen | $37 | $29 | $7 |
| Pap Smear Lab Processing | $35 | $28 | $7 |
| Iron Studies (Ferritin) | $34 | $27 | $7 |
| Hemoglobin A1C | $33 | $26 | $7 |
| Liver Function Panel | $33 | $26 | $7 |
Compare Vermont With Other States
Frequently Asked Questions
How much does Medicare spend per person in Vermont?
In 2026, the average Medicare spending per beneficiary in Vermont is $10,273.
How many people are enrolled in Medicare in Vermont?
Vermont has approximately 3,007,602 Medicare beneficiaries.
Did Vermont expand Medicaid?
Yes, Vermont expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Vermont?
The uninsured rate in Vermont is 5.6%.
What is the average Medigap premium in Vermont?
The average Medigap (Medicare Supplement) premium in Vermont is $329 per month.