Medicaid Work Requirements

You do not have a work requirement if you are under age 19.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check if this situation applied to you for at least one month during the “look-back” period. (Read about the look-back period above.)
• Example: Charlie applies for Medicaid for Adults in March 2027. He turned 19 last month. Since he is a new applicant, VHC will “look back” one month to see if Charlie met an exception. Since he was under 19 years old during the look back period (February), he does not have a work requirement.

Your Medicaid will not end for failing to meet the work requirements if you are the parent or caretaker relative of a child under age 19*.

The reason will be based on your child’s age and your household income. No matter the reason, parents should never have their Medicaid terminated for failing to meet work requirements. You still need to meet all the other Medicaid eligibility and renewal requirements.

What to know

• Parents may have to renew their Medicaid every 6 or 12 months. The rules are different based on your household income.
  • VHC will tell you if you must renew every 6 months. You will get your renewal paperwork about 7 weeks before it is due.
• Always open your mail from Vermont Health Connect and respond right away!

Definitions

• A child is age 0 – 19.
  • *If your child is age 18, they must be in school full-time and expected to graduate before age 19.
• A caretaker relative is a relative by blood, adoption or marriage who assumes primary responsibility for the child; or an adult not related by blood, adoption or marriage, but who lives with the child and assumes primary responsibility for the child.

You do not have a work requirement if you are age 65 or older.

What to know

Vermont Health Connect will check this in the month you apply or renew Medicaid.  

You do not have a work requirement if you are on Medicare or eligible to get Medicare Part A.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check if this situation applied to you for at least one month during the “look-back” period. (Read about the look-back period above.)

You do not have a work requirement if you are pregnant or in the post-partum period (the 12 months after the pregnancy ends).

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.) 
• Call VHC to report a pregnancy and update them with your estimated due date: 1-855-899-9600.
• Learn more about Dr. Dynasaur — Vermont’s Medicaid program for pregnant people and kids.

You do not have a work requirement if you are age 19 - 26 and were in foster care when you turned 18.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.) 
• If you are on Medicaid when you turn 27, VHC will see if you qualify for other coverage. If VHC finds you eligible for Medicaid for Adults, you will not have work requirements at this renewal. This is because you were a former foster youth in the look-back period.

You do not have a work requirement if you are a member of a federally recognized American Indian or Alaska Native tribe (AI/AN).

What to know

• Vermont Health Connect will check this in the month you apply or renew Medicaid.
• Fill out Appendix B: American Indian or Alaska Native Family Member at the end of the 205ALLMED application.
• You will receive a 12-month coverage period instead of a 6-month coverage period.

You do not have a work requirement if you are the parent, guardian, caretaker relative or family caregiver for a dependent child under age 14 or a person with a disability (any age).

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.) 
• Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.

Definitions

• A dependent child is under age 14 through the month they turn 14.
• A person with a disability must meet the Americans with Disabilities Act definition but does not need to be classified as disabled by Medicaid or Medicare.
• A guardian is an adult appointed by a court to care for and make personal decisions for the dependent child or person with a disability.
• A caretaker relative is a relative by blood, adoption or marriage who assumes primary responsibility for the child or person with disability. There are different relationships that qualify for a dependent child and a person with a disability.
• A family caregiver is an adult family member or other individual that has a significant relationship with and provides care to the dependent child or person with a disability. This relationship is not limited to legally recognized relatives or members of the same household.

You do not have a work requirement if you have a serious health condition or disability and it stops you from meeting the work requirements.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.)
• In 2027: Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.
• In 2028: You may need more proof. We will update this webpage.

Examples of serious health conditions or disabilities

• A substance use disorder (SUD)
• A disabling mental disorder
• A physical, intellectual or developmental disability that significantly impairs your ability to perform one or more activities of daily living
• A serious or complex medical condition
• Blindness or disability (as defined in section 1614 of the Social Security Act).

You do not have a work requirement if you are a veteran with a total disability rating (100%) from the Dept. of Veterans Affairs (VA).

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.)
• Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.
• Learn about disability compensation on the VA website.

You do not have another work requirement if your household already meets the work requirements for 3SquaresVT or Reach Up.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.)
• Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.

You do not have work requirements if you participate in a drug or alcohol rehabilitation and treatment program.

What to know

• You only need to have the situation for one month to not have a work requirement.
• Vermont Health Connect will check the month you apply / renew your Medicaid and during your look-back period. (Read about the look-back period above.)
• The program must be a private, nonprofit organization or a publicly operated community health center. It can be inpatient or outpatient.
• Examples: The Brattleboro Retreat, designated agencies, federally qualified health centers, etc.
• Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.

You do not have a work requirement if you are in jail or prison now or in the past three months.

What to know

• Vermont Health Connect will check if this situation applied to you for at least one month during the “look-back” period. (Read about the look-back period above.)
• Fill out Appendix D: Work Requirements at the end of the 205ALLMED application.

A person who meets a short-term hardship will not have a work requirement. There are two short-term hardships that you must request:

• Traveling outside your community for care related to a serious or complex condition for yourself or your dependent.
• Spending part of all of a month in an inpatient hospital, nursing home, ICF/IID, inpatient psychiatric hospital services or other services of similar acuity.

To ask for a hardship: Fill out Appendix D: Work Requirements at the end of the 205ALLMED application. Or call Vermont Health Connect: 1-855-899-9600.