Rhode Island Medicaid Application Guide

Medicaid is a program that offers free or low-cost health coverage for people with limited income and resources. If you qualify, you can enroll in Medicaid at any time. Rhode Island embraced the provision to expand Medicaid in 2014 under the Affordable Care Act (ACA). Federal funding covered the full cost of expansion through 2016, after which the state began to pay part of the cost.

Adults with income up to 138% of poverty, pregnant women with income up to 253% of poverty, and children with incomes up to 261% of poverty are eligible for Rhode Island Medicaid. Medicaid covers low-income adults, children, seniors, persons with disabilities, pregnant women, children in foster care and former foster youth up to age 26. You must be a resident of Rhode Island to apply and be able to prove that you are a citizen or a legally present non-citizen who is in a status that qualifies you for publicly funded health coverage.

Rhode Island Medicaid provides comprehensive healthcare coverage including doctor visits, hospital care, prescription drugs, preventive services, mental health and substance abuse treatment, and long-term care services. In Rhode Island, we offer plans from Neighborhood Health Plan of Rhode Island, Tufts Health Plan, UnitedHealthcare and RIte Smiles. Rhode Island uses a Medicaid managed care model to provide coverage. RIte Care and Rhody Health Partners (UnitedHealthcare) are the managed care programs in the state. RIte Care is for pregnant women and children, and utilizes UnitedHealthcare Community Plan of New England, Tufts, or Neighborhood Health Plan of RI to provide coverage.

When applying for Rhode Island Medicaid, fill out applications as honestly and completely as possible. Depending on the benefit(s) or program(s) you are applying for, additional documentation may be needed such as proof of identity, income, assets/resources and expenses. In Rhode Island (and most other states), the application process involves a 60 month (5 years) "Lookback Rule," which means that the state will review any transfers or gifts given within five years of your application and take those into account for long-term care applicants. Approval typically takes several weeks, and you'll receive notification from DHS regarding your application status.