Rhode Island Health Insurance Guide 2025

Medicaid in Rhode Island

Rhode Island expanded Medicaid in 2014, providing comprehensive coverage to low-income adults across the state. Rhode Island Medicaid includes RIte Care, the state's managed care program for families and children, offering robust health benefits.

Who Qualifies for Rhode Island Medicaid?

• Adults ages 19-64 with income up to 138% FPL ($20,783/year for individuals)
• Pregnant women with income up to 253% FPL
• Children under 19 with income up to 261% FPL (RIte Care)
• Seniors and people with disabilities meeting income requirements
• Parents/caretakers meeting income requirements

Rhode Island Medicaid Benefits

• Preventive care and wellness visits
• Doctor visits and specialist care
• Hospital inpatient and outpatient services
• Prescription drug coverage
• Mental health and substance abuse treatment
• Dental services
• Vision care
• Laboratory and X-ray services
• Home and community-based services

How to Apply

You can apply for Rhode Island Medicaid through:

• Online at healthyrhode.ri.gov
• By phone: 1-855-840-4774
• Through HealthSource RI at healthsourceri.com
• In person at the Department of Human Services
• Through a certified navigator or enrollment counselor

Health Insurance Marketplace

Rhode Island operates its own state-based marketplace, HealthSource RI. The marketplace provides a streamlined experience for comparing qualified health plans and checking Medicaid eligibility in one place.

Available Plan Types

• Bronze: Lower premiums, higher out-of-pocket costs (60% coverage)
• Silver: Moderate premiums and costs (70% coverage) - best for subsidies
• Gold: Higher premiums, lower out-of-pocket costs (80% coverage)
• Platinum: Highest premiums, lowest out-of-pocket costs (90% coverage)
• Catastrophic: Available for under-30 or hardship exemption

Enrollment Periods

Open Enrollment: November 1, 2024 - January 31, 2025 (extended deadline)

Rhode Island has an extended enrollment period compared to the federal marketplace. RI Medicaid accepts applications year-round. You can also qualify for a Special Enrollment Period if you have a qualifying life event.

Average Costs in Rhode Island

Health insurance costs in Rhode Island vary based on your age, plan type, and tobacco use. As a small state, pricing is fairly consistent across all regions.