HomeCareAtlas Team · Updated September 2026
Researched from primary state regulatory sources.
How to Start a Home Care Agency in Vermont
Starting a home care agency in Vermont costs roughly $40,000 - $70,000 and takes 1-3 months. Here's every step, fee, and deadline — sourced directly from None for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board..
Vermont does not license non-medical home care agencies. You can offer personal care, companionship, and homemaker services without a state home care license. You still need to form a business, get workers' comp, and follow state and federal business rules. Skilled home health is different. Offering home health services needs a Certificate of Need from the Green Mountain Care Board (18 V.S.A. § 9434). If you want Medicaid clients, you can apply to DAIL to become a Choices for Care provider. DAIL announced this for non-medical home care agencies on October 25, 2024. Vermont has one of the oldest populations in the U.S.
Vermont does not require a state license to operate a non-medical home care agency. You can begin operations after completing standard business formation (LLC, EIN, business license) and obtaining insurance. Total startup costs range from $40,000 - $70,000, and you can be operational within 1-3 months. No state license for non-medical care. Background checks are not required for private-pay agencies, but we suggest them. Since October 2024, non-medical agencies can apply to DAIL to become Choices for Care Medicaid providers.
- License Required
- No — Business license only
- Regulatory Body
- None for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board.
- Application Fee
- $0 (no state license fee)
- Timeline
- 1-3 months (typical timeline)
- Total Startup Cost
- $40,000 - $70,000
- Key Requirement
- No state license for non-medical care. Background checks are not required for private-pay agencies, but we suggest them. Since October 2024, non-medical agencies can apply to DAIL to become Choices for Care Medicaid providers.
- Last Verified
- September 2026 against None for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board. regulations
Typical timeline
This is our best guess. Check with the None for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board..
Residents Age 70+
Moderate Opportunity
How Vermont compares to neighboring states
| State | License Fee | Timeline | Startup Cost |
|---|---|---|---|
| Vermont ← | $0 (no license) | 1-3 months | $40,000 - $70,000 |
| New Hampshire | $250 | 30-90 Days | $35,000 - $70,000 |
| New York | $2,000 | 9-18 Months | $100,000 - $200,000 |
| Massachusetts | $0 (no license) | 4-8 Weeks | $55,000 - $100,000 (our estimate) |
Vermont Licensing Overview
The None for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board. oversees all non-medical agencies.Vermont does not license non-medical home care agencies. You can offer personal care, companionship, and homemaker services without a state home care license. You still need to form a business, get workers' comp, and follow state and federal business rules. Skilled home health is different. Offering home health services needs a Certificate of Need from the Green Mountain Care Board (18 V.S.A. § 9434). If you want Medicaid clients, you can apply to DAIL to become a Choices for Care provider. DAIL announced this for non-medical home care agencies on October 25, 2024. Vermont has one of the oldest populations in the U.S.
No State License for Non-Medical Care
Vermont has no license for non-medical home care agencies. You can provide personal care, companionship, and homemaker services after you form your business and get insurance. Many other states make you wait months for a license.
Business Registration Required
Register your LLC or corporation with the Vermont Secretary of State. Get an EIN from the IRS, register for a state tax account with the Vermont Department of Taxes, and meet any local business licensing or zoning rules.
Background & Registry Checks
State law does not make private-pay agencies run checks. But the law lets employers check the Adult Abuse Registry (33 V.S.A. § 6911). You can also get Vermont Crime Information Center (VCIC) records. We suggest you check every caregiver before they see a client. Choices for Care providers must follow the DAIL Background Check Policy.
Insurance & Workers' Comp
Vermont law requires workers' comp for employees (21 V.S.A. § 687). No state rule sets a liability amount for private-pay agencies. Ask your insurance agent. Our estimate is that many agencies carry about $1,000,000 in general liability plus professional liability. No surety bond is required.
Choices for Care (Medicaid)
Since October 2024, non-medical home care agencies can apply to DAIL's Adult Services Division to become Choices for Care providers. This covers personal care, respite, and companionship. Before that, only designated home health agencies could. You also must enroll as a Vermont Medicaid provider.
Estimated Startup Costs (2026)
Budget for $40,000 - $70,000 to ensure 3-6 months of runway.
| Category | Low Est. | High Est. |
|---|---|---|
| Business formation & legal | $500 | $2,000 |
| Business registration & fees | $0 | $500 |
| General liability insurance | $1,500 | $4,000 |
| Professional liability insurance | $1,000 | $3,000 |
| Workers' comp insurance | $1,500 | $4,000 |
| Office space & setup | $2,000 | $6,000 |
| Background & registry checks (VCIC, Adult Abuse Registry) | $300 | $1,000 |
| Training & onboarding | $1,000 | $3,000 |
| Technology & software | $1,000 | $3,000 |
| Marketing & branding | $2,000 | $6,000 |
| Working capital (3-6 months) | $15,000 | $35,000 |
We map every cost and file your Vermont license for you.
Vermont Startup Timeline
1-2 weeks
Register your business & define services
Decide if you are offering non-medical care (homemaker, companion, personal care). Register your LLC or corporation with the Vermont Secretary of State. Get your EIN from the IRS and register for a state tax account with the Vermont Department of Taxes.
2-4 weeks
Develop policies, procedures & compliance framework
Write policies on client rights, privacy, emergencies, hiring, and abuse reporting. Your caregivers are mandated reporters under Vermont law. These policies matter even though no state license is required.
2-3 weeks
Get insurance & complete registrations
Get general liability, professional liability, and workers' compensation insurance. Register with the Vermont Department of Labor for unemployment insurance. Complete any local business registrations.
2-3 weeks
Set up operations & technology
Set up your office (home office or small professional space). Pick home care management software for scheduling, billing, and EVV. Create client intake and assessment processes.
2-4 weeks
Recruit, hire & train staff
Start recruiting caregivers. We suggest VCIC and Adult Abuse Registry checks before each caregiver sees a client. Complete an I-9 for every hire. Train on safety, privacy, dementia care, and your policies. Many agencies add CPR and first aid.
2-4 weeks
Launch & build referral network
Start marketing to referral sources -- hospitals, home health agencies, senior centers, area agencies on aging, and VA offices. Build relationships with discharge planners. If you want Medicaid clients, send the Home Care Provider Application to DAIL's Adult Services Division ([email protected]). You also must enroll as a Vermont Medicaid provider. DAIL certification requires an active Medicaid provider number.
We can do all of them for you in Vermont.
New 2026 Legal Mandates
Background & Registry Checks
Ongoing - Private-pay agencies are not required to run checks. Employers may check the Adult Abuse Registry (33 V.S.A. § 6911). You can also get VCIC criminal records. Choices for Care providers must follow the DAIL Background Check Policy (Home Care Provider Standards 1.16.2).
Privacy and HIPAA
Ongoing - HIPAA covers health care providers that bill health plans, like Medicaid, electronically (45 CFR 160.103). A private-pay-only agency may not be covered. If you bill Medicaid, you must follow HIPAA. Either way, keep client records private and train staff on privacy.
Mandated Reporter Status
Ongoing - Vermont law says workers who give caregiving to adults must report suspected abuse, neglect, or exploitation of a vulnerable adult. They must report within two business days (33 V.S.A. § 6903). Train staff on how to report to Adult Protective Services.
Vermont Labor Law Compliance
Ongoing - Follow Vermont and federal wage and overtime rules. Pay caregivers for travel time between clients (federal rule). Register with the Vermont Department of Labor for unemployment insurance. Workers' comp is required for employees (21 V.S.A. § 687).
Our Vermont licensing team tracks the law so you do not have to.
Caregiver Mandates
Important Warning
Finding caregivers is the biggest challenge in Vermont. DAIL said Vermont's workforce shortages are why it opened Choices for Care to more agencies (DAIL ASD notice, Oct. 25, 2024). Rural drives are long. Plan for travel time and mileage in your prices.
- VCIC & Adult Abuse Registry checks: Not required for private-pay agencies, but we suggest both before a caregiver sees a client. Choices for Care providers must follow DAIL rules.
- Workers' compensation: Required for employees (21 V.S.A. § 687).
- CPR & first aid training: Not required by the state for private-pay agencies. Many agencies add it to onboarding.
- Privacy training: Train every worker on keeping client information private. If you bill Medicaid, HIPAA training is required.
- Scope of practice training: Clear training on what caregivers are NOT allowed to do (no medical advice, no medication administration, no wound care). Crossing this line creates huge liability risks.
- Ongoing education: Regular in-service training on client safety, fall prevention, infection control, dementia care, and your agency's policies and values.
Regional Billing Snapshots
*Regional rates vary by specialized care needs (Dementia, Parkinson's) and local competition.*
We launch Vermont home care agencies start to finish.
Regional Market Opportunities
Vermont has about 645,000 people. About 24.1% are 65 or older (Census 2025 estimate). That is one of the highest shares in the U.S. Rural drives and hiring are the biggest challenges. The billing rates below are our estimates, not official numbers.
Burlington-South Burlington
Largest metro area in Vermont with the highest concentration of seniors, hospitals, and referral sources.
Key: Best starting market. Strong hospital and senior center referral networks. Most competitive area but also most demand.
Rutland / Central Vermont
Steady senior population with limited home care providers. Good mix of small-town communities.
Key: Underserved market with good potential. Build relationships with local providers and area agencies on aging.
Brattleboro / Southern Vermont
Border area with Massachusetts and New Hampshire. Growing retiree population drawn to the rural lifestyle.
Key: Retirees moving in from other states often have long-term care insurance, creating private-pay opportunity.
Barre-Montpelier (Capital Region)
State capital area with government retirees and a stable senior population.
Key: State employee retirees with good benefits create steady demand. Smaller market but very limited competition.
Rural Vermont (NEK, Lamoille, etc.)
Significant unmet demand in the Northeast Kingdom and other rural areas. Severe provider shortages.
Key: Huge need but challenging logistics. Travel time eats into margins. Focus on tight geographic clusters and plan for winter operations.
Cost of care in Vermont
What agencies charge clients vs. what caregivers earn in Vermont. The difference is the agency's gross margin per billable hour — before overhead like insurance, admin, marketing, and compliance costs.
$40
Avg. hourly rate charged to clients
$21.28
Avg. caregiver hourly wage
$18.72
Gross margin per hour
47%
Gross margin %
What this means for agency owners
In Vermont, agencies keep roughly $18.72 per billable hour after paying the caregiver. That's a 47% gross margin.
This is a strong margin that gives you room to cover overhead costs (insurance, admin, marketing, compliance) and still run a profitable agency.
Sources: Avg. hourly rate from CareYaya and CareScout 2025 surveys (averaged). Caregiver wage from Care.com. Gross margin is before overhead costs like insurance, admin, marketing, and compliance.
Vermont Medicaid Programs
Choices for Care
Vermont's main Medicaid program for long-term care. Choices for Care pays for help at home so older adults and people with disabilities can stay home. DAIL's Adult Services Division runs it. A case manager works with each person on a care plan.
Agency Angle: Since October 2024, non-medical home care agencies can apply to DAIL to provide personal care, respite, and companionship under Choices for Care. Before that, only designated home health agencies could. Send the Home Care Provider Application to DAIL. You also need a Vermont Medicaid provider number. You must be ready for EVV. Start early. It takes time.
VA Aid & Attendance Benefits
Many Vermont veterans and their spouses qualify for VA Aid & Attendance benefits that can pay for non-medical home care services.
Agency Angle: Learn how VA benefits work. Then you can help families use them to pay for care.
Becoming a Provider
Essential 2026 Tech Stack for Owners
Tiles outlined in teal are areas HomeCareAtlas covers in our platform.
Vermont Licensing FAQ
Do I need a license to start a home care agency in Vermont?
No. Vermont does not license non-medical home care agencies that provide personal care, companionship, and homemaker services. You still need to register your business with the Secretary of State, get an EIN, and carry workers' comp. We suggest background checks on all staff. If you want Medicaid clients, apply to DAIL to become a Choices for Care provider.
Do I need a Certificate of Need in Vermont?
Not for non-medical home care. A Certificate of Need from the Green Mountain Care Board is required to offer home health services (18 V.S.A. § 9434). That applies to skilled home health agencies, not to personal care or companion agencies.
How much does it cost to start a home care agency in Vermont?
We estimate $40,000 to $70,000. There is no state license fee. Your main costs are insurance, office setup, technology, training, marketing, and working capital.
How long does it take to start a home care agency in Vermont?
There is no license to wait for. We estimate 1-3 months to get running. It depends on how fast you finish business setup, insurance, policies, hiring, and training. Choices for Care enrollment takes extra time.
What insurance is required in Vermont?
Workers' comp is required for employees (21 V.S.A. § 687). The state sets no liability amount for private-pay agencies. Ask your insurance agent. Our estimate is that many agencies carry about $1,000,000 in general liability plus professional liability. No surety bond is required. Cyber insurance can help if you keep records online.
Can my non-medical agency get Medicaid clients in Vermont?
Yes. On October 25, 2024, DAIL announced it was opening Choices for Care enrollment to non-medical home care providers for personal care, respite, and companionship. Before that, only designated home health agencies could bill for these. Send the Home Care Provider Application to DAIL's Adult Services Division. After approval, enroll with the Medicaid fiscal agent.
What are the biggest challenges of starting a home care agency in Vermont?
The biggest challenge is finding and keeping caregivers. Other challenges: long rural drives, winter weather, and billing long-term care insurance and VA benefits.
Is Vermont a good market for home care agencies?
Vermont has about 155,000 adults age 65+. That is 24.1% of the population (Census 2025 estimate), one of the highest shares in the U.S. There is no state license, and Choices for Care is now open to non-medical agencies. The state is small, so plan for a small client base.
Can I operate a home care agency from home in Vermont?
Yes. A home office is common for non-medical home care agencies in Vermont. Make sure you comply with local zoning laws and have a professional setup for business operations, caregiver training, and any client or family meetings.
Starting in a Nearby State?
Licensing requirements vary a lot between states. Compare your options:
New Hampshire
$250 fee · 30-90 Days
New York
$2,000 fee · 9-18 Months
Massachusetts
No state license required · 4-8 Weeks
Want us to handle your Vermont licensing?
We take care of the whole process. You fill in your details, we handle the rest.
See how we help in VermontHave questions? Book a free 15-minute call. We'll answer them, even if you never hire us.
Sizing up the competition? See the 175 home care agencies already operating in Vermont →
Home care agencies in Vermont
Want to see the competition up close? Look at who is already open, city by city.
- Home care agencies in Burlington
- Home care agencies in Mendon
- Home care agencies in Shelburne
- Home care agencies in Barre
- Home care agencies in Castleton
Looking for care for a family member? Find agencies near you
Considering other states?
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Carolina
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Where our numbers come from
We check each fact against Vermont's own rules. Tap a source to read it yourself.
- License needed?No18 V.S.A. §9402(11)· Oct 2026
- Who oversees itNone for non-medical home care. Medicaid enrollment: Vermont Department of Disabilities, Aging, and Independent Living (DAIL), Adult Services Division. Home health agencies: DAIL Division of Licensing and Protection and the Green Mountain Care Board.DAIL Division of Licensing and Protection; 18 V.S.A. §9434· Oct 2026
- License name—18 V.S.A. §9402(11)· Oct 2026
- The rules—18 V.S.A. §9402(11)· Oct 2026
- First license feeno fee18 V.S.A. §9402(11)· Oct 2026
- License lasts—18 V.S.A. §9402(11)· Oct 2026
- BondNone18 V.S.A. §9402(11)· Oct 2026
- Owner/manager trainingNo state minimum18 V.S.A. §9402(11)· Oct 2026
- Caregiver trainingNo state minimum18 V.S.A. §9402(11)· Oct 2026
- Background checksNo state mandate for private-pay agencies; employers may check the Adult Abuse Registry (33 V.S.A. §6911) and VCIC criminal records33 V.S.A. §6911(d)(1)(C)· Oct 2026
- How long it takes1-3 monthsBest guess — not confirmed yet
See something wrong? Email us at [email protected]. We fix mistakes fast.
Ready to start your agency in Vermont?
Get a free 15-minute call. We'll walk through your Vermont licensing path, a realistic timeline, and a budget that fits — even if you never hire us.
Free · 15 minutes · No obligation. Prefer to read first? Grab the free step-by-step Vermont guide.
This guide is for informational purposes only and does not constitute legal, regulatory, or business advice. Licensing requirements, fees, and regulations change frequently. Always verify current requirements with your state's licensing agency before making business decisions. HomeCareAtlas is not responsible for the accuracy or completeness of this information.
Researched and reviewed by
John Helmy, Founder of HomeCareAtlasBuilding tools and resources to help home care agency owners navigate licensing, compliance, and growth.