50-state desk · VT
Vermont
Statutory floorHospitals must provide free care at or below 250% FPL and discounted care on a sliding scale through 400% FPL. Debt sales are restricted. Medical debt is barred from credit reports.
18 V.S.A. § 9482 · compiled September 2026
| Rule | This state |
|---|---|
| Free-care floor | 250% FPL |
| Discount / eligibility floor | 400% FPL |
| Covers insured patients | Yes, if they otherwise qualify |
| Which hospitals | Generally all licensed hospitals |
| Medicaid expansion | Yes — adults to 138% FPL |
| Screen before collections | Yes |
| Credit reports | Statewide ban (FCRA-preemption fights ongoing) |
| Debt sales | Restricted or banned |
| Home liens | Not banned |
| Wage garnishment | Federal CCPA cap (typically 25%) |
| Interest on medical debt | No special cap located |
| Collection hold | No extra state waiting period |
| Lawsuit clock | 6 years · 12 V.S.A. § 511 |
2026 poverty line here
Alaska and Hawaii use their own HHS tables. Everyone else uses the 48-state and D.C. figures, effective January 2026.
| Household | 100% | Free floor | Discount floor |
|---|---|---|---|
| 1 | $15,960 | $39,900 | $63,840 |
| 2 | $21,640 | $54,100 | $86,560 |
| 3 | $27,320 | $68,300 | $109,280 |
| 4 | $33,000 | $82,500 | $132,000 |
| 5 | $38,680 | $96,700 | $154,720 |
| 6 | $44,360 | $110,900 | $177,440 |
What to do
- 01 At or under 250% FPL, Vermont free care is statutory.
- 02 Sliding scale through 400% FPL. Ask for the written determination.
- 03 They should not sell the debt. Medical debt should not be on a Vermont credit report.
- 04 Itemize professional fees; they sometimes bill outside the hospital policy.
Appeals
Federal No Surprises Act.
Insurance: Vermont DFR — external review
Medicaid: DVHA fair hearing (Green Mountain Care).
Medicare is federal regardless of state: redetermination, reconsideration, ALJ, Appeals Council, then district court.
Cite this in a letter
I request hospital financial assistance under 18 V.S.A. § 9482 — free care at or below 250% of FPL and discounted care through 400% of FPL. Please do not sell this debt or furnish it to a credit bureau.
Put a Vermont bill in the machine.
The estimate will use this state’s floors. The letters will cite 18 V.S.A. § 9482.
Start a Vermont caseFederal overlay — every state
501(r)
501(c)(3) hospital organizations must publish a Financial Assistance Policy, a plain-language summary, and generally may not take extraordinary collection actions (selling the debt, reporting it, liens, lawsuits) until they have made reasonable efforts to determine FAP eligibility.
No Surprises Act
Emergency services, air ambulance, and many out-of-network clinicians at in-network facilities cannot balance-bill beyond in-network cost-sharing. Independent dispute resolution is between the plan and the provider — not a reason to pay the sticker rate.
FDCPA
15 U.S.C. § 1692g. Within 30 days of first collector contact, demand validation. Until validated, collection and credit reporting should stop. Partial payment can restart a state’s statute of limitations.
EMTALA
Emergency departments must screen and stabilize regardless of ability to pay. An ER bill is not an agreement that chargemaster rates are the cash price.
Medicare appeals
Five levels: redetermination (MAC, 120 days), reconsideration (QIC), ALJ at OMHA, Medicare Appeals Council, then federal district court. A remaining patient balance is often a claim the provider still needs to work.
Credit bureaus
The CFPB’s 2025 medical-debt reporting rule was vacated in July 2025. Industry practice still generally omits paid medical collections and unpaid balances under $500. Unpaid medical debt over $500 can appear after a delay unless a state ban applies. FCRA-preemption fights over those state bans are ongoing.