Having a baby in Vermont

Program

Dr. Dynasaur (Vermont Medicaid)

Agency

Department of Vermont Health Access

Medicaid limit

213% of the poverty level

12-month postpartum coverage since

April 1, 2023

Presumptive eligibility

Not for the pregnancy group, but hospitals can still make presumptive determinations.

Hospitals in every state may make presumptive eligibility determinations.

Vermont has no required paid leave. The voluntary VT FMLI plan pays 60% of wages for up to 6 weeks if your employer buys it or you enroll yourself (enroll in May; benefits start the next January).

Program

Vermont Family and Medical Leave Insurance (VT FMLI), insured and administered by The Hartford

Legal maximum, your own health

6 weeks

Law in effect since

July 1, 2023

Pay

60% of your average weekly wage up to a maximum weekly benefit tied to the Social Security wage base; max $2,128.85/week for 2026 claims under the state-employee plan. The Hartford's individual-plan page still lists $2,031.92. Only if you are enrolled: through an employer that buys VT FMLI, or by buying individual coverage yourself. Employer plans can offer 60-70%.

Job protection

VT FMLI pays benefits only; it does not protect your job. Separate laws may: Vermont's Parental and Family Leave Act (21 V.S.A. § 472) gives up to 12 weeks of unpaid, job-protected parental leave a year (including pregnancy and, since July 1, 2025, recovery from childbirth or miscarriage) at employers with 10+ employees for employees with 1 year at an average of 30+ hours/week; the federal FMLA also applies at employers with 50+ employees.

Who qualifies

Voluntary. State of Vermont employees are covered by the state plan. Employers with a Vermont location and 2+ employees may buy group coverage (they design it: 6-26 weeks, 60-70% pay). Individuals can buy the 6-week individual plan if they live and work in Vermont and their employer doesn't offer FMLI, or if they are a self-employed Vermont resident; one-employee employers also use the individual pool. Annual enrollment is May 1-31; special enrollment within 30 days of losing employer coverage, changing jobs, or moving to Vermont.

Notes

Phase 3 confirmed: the individual purchasing pool opened with enrollment May 1-31, 2025, coverage effective July 1, 2025, and benefits from Jan. 1, 2026 (Governor's release and The Hartford). Earlier phases: state employees (benefits July 1, 2023) and employers with 2+ employees (July 1, 2024). For a pregnant mom buying individually, timing is tight: enrolling in May 2026 means benefits only from Jan. 1, 2027. Weeks are a combined 6 per 52-week benefit year for all leave types under the individual and state-employee plans, so recovery from childbirth plus bonding share the same 6 weeks. Employer group plans can provide more (6-26 weeks). The Hartford lists a $2,128.85 cap for 2026 claims on the state-employee plan, but its individual-plan page still shows the 2025 figure ($2,031.92), so individual buyers should confirm with The Hartford. VT FMLI comes from a governor's initiative and a state contract, not a law. 2026 legislature: Vermont did NOT enact a mandatory paid family leave program. The only leave-related act of the 2025-2026 biennium is Act 32 (H.461, signed May 22, 2025, effective July 1, 2025), which expands UNPAID leave under the Parental and Family Leave Act, and no paid-leave bill appears on the 2026 bills-passed lists.

Voluntary means you're covered only if your employer buys a policy or joins an opt-in plan. The weekly maximum is a ceiling, not a typical benefit. Checked October 2026. Amounts usually change January 1 and July 1, so confirm with the state before you plan.

In Vermont, Medicaid pays for in-home lactation consulting by IBCLCs, who enroll and bill directly.

Who can bill

IBCLC

Where

home

IBCLCs can enroll on their own

Yes

Since

June 1, 2018

Notes

Vermont Medicaid has covered in-home lactation consulting by IBCLCs since June 1, 2018. IBCLCs enroll as their own Vermont Medicaid providers under an IBCLC provider specialty (S54); the billing manual says they must be licensed, enrolled and hold an IBCLC certificate. The October 2026 fee schedule pays S9443 at $120 per session, and no visit limit is stated.

Vermont Medicaid member information

Full-time provider prices before any subsidy, in 2021 dollars. The national median for center infant care was $12,647 a year. The NDCP has no 2022 prices for this state; 2021 is the most recent year with data. 14 county infant center prices were modeled by DOL from statewide survey data rather than reported for the county. 14 county infant center prices were not surveyed in 2021; DOL estimated them from the price trend between other survey years.