Frequently Asked Questions
Get the answers you need.
There’s plenty to know about us, and plenty more to know about healthcare. Check below for some simple answers to common questions. Don’t see your question here? Just contact one of our experts for more information.
General FAQs
What is HealthSource RI?
HealthSource RI is a unique resource that connects Rhode Islanders to a range of health insurance options.
Whether you need insurance for yourself or your family, you’ll find everything you need to weigh your options and choose a plan right here. Our Savings Tool lets you compare your coverage options side-by-side—in simple language. And our experts are available to help you with any questions, concerns, or issues.
Whichever plan you choose, you’ll get essential health benefits, including doctor visits, hospitalizations, maternity care, ER visits, and prescriptions. You may also qualify for financial help to pay for your monthly bill or your medical care.
What does HealthSource RI offer?
HealthSource RI helps you compare your health insurance options, purchase health insurance, and find out if you are eligible for financial help to pay for your coverage.
Who can use HealthSource RI?
People who do not receive affordable insurance through their jobs and employers with 50 or less full-time employees.
I’m ready to enroll. What documents do I need?
These documents are helpful to have if you’re signing up for health insurance:
For all members of your family:
- Last 4 weeks of pay stubs
- Social Security Number(s)
- Immigration documents
- Most recent Tax Return
For you or the primary applicant:
- Photo ID (driver’s license or passport)
- Your HealthSource RI username and password if you’ve already created an account
- Any recent HealthSource RI or Medicaid notices that you have receive
How do I cancel my coverage?
If you or someone in your household wants to disenroll from health insurance you purchased through HealthSource RI, there are several ways to do so:
Option 1: Click on the “Disenroll” button on your HealthSource RI account dashboard. This will allow you to withdraw the request for health coverage for any, or all, members in your account.
Option 2: Contact a Navigator near you to set up an appointment for in-person assistance.You can find a Navigator using our online directory.
Do I qualify for a tax credit?
Tax credits are based on your income and the size of your family.
To learn more, watch this video.
When you’re ready to compare plan costs, our Savings Tool to find out if you’re eligible for a tax credit.
If I’m enrolled in a Veterans Health Administration (VA) health care program, do I meet the requirement for health care coverage?
Yes. you’re considered “covered” If you are enrolled in any of these VA programs:
- Veteran’s health care program
- Civilian Health and Medical program (CHAMPVA)
- Spina bifida health care program
- Children of Women Vietnam Veterans program
Click here for more FAQs about Veterans and health insurance.
What is a health savings account?
Health Savings Accounts (HSAs) let you put tax free money in a bank account to pay for certain medical expenses.
How it works
- Enroll in a high deductible health plan that’s eligible for a Health Savings Account (HSA).
- Open and activate an HSA with an IRS-qualified trustee. Be sure to find out if your trustee has a minimum balance requirement.
- Make contributions to your HSA as you see fit—without exceeding your annual contribution limit.
- Use your trustee’s preferred payment method—such as a debit card and/or checks—to pay for qualified medical expenses.
- Save all your receipts and complete the necessary tax forms to claim your deductions.
Want to know more? Check out our Health Savings Accounts FAQs
Do I have to pay more insurance if I’m sick or have a pre-existing condition?
No. The Affordable Care Act makes it illegal for insurance companies to charge you more because you’re sick or have had a health problem in the past. Your health insurance prices are based on your age, family size and household income. That’s it.
What other programs are available?
Through this website, you can access programs offered by HealthSource RI, the Rhode Island Executive Office of Health and Human Services (EOHHS), and the Rhode Island Department of Human Services (DHS).
Visit our “other programs” page to learn more.
What are some things I should consider before I pick a plan?
First, decide if you’d rather pay more per month, or more when you need medical care.
Sometimes the answer is easy, for example, if you go to the doctor a lot or take medications regularly, then a plan with a higher monthly bill that pays for more of your medical expenses is probably right for you.
If not, you might save money if you pick a plan that has a lower monthly bill but pays for less of your medical care. Just be aware- you’re making a bet. Because if you do have an accident and end up in the emergency room, or suddenly need more medical care, you’ll face a bigger price tag.
Here are a few other things to consider:
- Have a favorite doctor? Make sure he or she accepts this health insurance.
- Do you see a therapist or a psychologist? Look for a plan with low co-pays for mental health visits.
- Are you athletic or accident prone? Look for a plan that charges less for physical therapy visit and trips to the ER.
- Do you take particular medications? Make sure they’re covered by your plan.
Do I get preventive care for free? What counts as preventive care?
No matter which plan you choose, there are certain medical services you can receive for free, including:
- Blood pressure screening
- Breast cancer screening and mammography
- Cervical cancer screening (pap test)
- Cholesterol screening
- Colorectal cancer screening
- Depression screening
- Obesity screening and counseling
- Adult immunizations (such as flu shots, Hepatitis A and B, and pneumonia vaccines)
Take a moment to review a complete list of free medical services.
What is a cost sharing reduction plan?
Depending on your income, you might qualify to pay less when you do things like visit the doctor or fill a prescription. This financial help is called a “Cost Sharing Reduction.” You can only get these Cost Sharing Reductions if you buy what’s known as a Silver plan.
If you select a Silver plan, your cost-sharing reductions will be automatically applied when you use your health insurance. For instance, when you go to see your doctor, the price of the visit will automatically cost less.
What does my health insurance cover?
All health plans must cover the same basic set of healthcare services. These include:
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity care
- Newborn care
- Mental health and substance use treatment services (including counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services
- Chronic disease management
- Pediatric services
Your particular plan might cover more services as well. Each plan has a different approach to
Are oral and dental care covered?
If you want dental insurance, for your whole family you can buy a plan through HealthSource RI. If you just want dental coverage for your children under 18, pediatric dental coverage is already included in any 2018 Individual and Family health plan you purchase from HealthSource RI.
Is vision care covered?
HealthSource RI plans do not offer full vision coverage for adults but they do cover yearly medical exams and vision coverage and eyeglasses for children.
What do these terms mean?
Visit our Glossary to learn more about specific health insurance terms that may be confusing.
What is the Individual Mandate?
Did you know that health insurance is required in the state of Rhode Island? If you go without continuous health coverage, you might pay a penalty when you file your taxes. To learn more visit our Individual Mandate FAQ page.
Member-Specific FAQs
Once I'm enrolled, how do I use my plan? What do I do next?
Did you know that health insurance is required in the state of Rhode Island? If you go without continuous health coverage, you might pay a penalty when you file your taxes. To learn more visit our Individual Mandate FAQ page.
How do I pay my bill?
You can pay online, in person, or through the mail. Learn more about your options at our “How to make a payment” page.
How do I report a change in my income or household?
You can log on to your HealthyRhode account to safely and securely report your changes. You can also call our contact center at 1-855-840-4774 and an enrollment specialist will help you make the changes in your account.
What do I do if I forgot my password or username?
Go to the login page for your HealthyRhode account and click on “forgot username/password.” You’ll have the option of answering security questions or getting an email to reset your password or get a reminder of your username.
If you can’t access your password/username online, you can always call us for help at 1-855-840-4774.
How do I check to see if a doctor accepts my health insurance?
The only way to guarantee that a particular doctor accepts your health insurance plan is to ask them directly, but you can start by using your health insurance company’s provider directory. You can find a link to all of those directories at our “Find a provider” page.
How do I know if my health insurance covers my medications?
You can look up your medications in your health insurance company’s list of covered prescription drugs. Learn more at our page “Does my plan cover my medications?”
How do I cancel my coverage?
If you or someone in your household wants to disenroll from your coverage through HealthSource RI, you can:
Option 1: Click on the “Disenroll” button on your HealthyRhode account dashboard. This will allow you to withdraw the request for health coverage for any, or all, members in your account.
Option 2: Contact a Navigator near you to set up an appointment for in-person assistance. You can find a Navigator using our online directory.
Option 3: Call the Contact Center at 1-855-840-4774 if you have questions or would like help withdrawing your request for coverage. We’re open Monday – Friday 8 a.m. to 6 p.m.
How do I get help in other languages?
All Rhode Islanders have the right to get help and information in their language at no cost. To talk to an interpreter, call 1-855-840-4774.
Veterans Health FAQs
If I’m enrolled in a Veterans Health Administration (VA) health care program, do I meet the requirement for health care coverage?
Yes. If you are enrolled in any of VA’s programs below, you have coverage under the standards of the Affordable Care Act (health care law):
- Veteran’s health care program
- Civilian Health and Medical program (CHAMPVA)
- Spina bifida health care program
- Children of Women Vietnam Veterans program
How do I enroll in VA health care coverage?
You may apply by visiting www.va.gov/healthbenefits/enroll, calling 1-877-222-VETS (8387), or going in-person to your local VA health care facility.
VA Medical Center  |
||
| Providence: | Providence VA Medical Center830 Chalkstone Avenue Providence, RI 02908
401-273-7100 |
|
| Community Based Outpatient Clinic |
||
| Middletown: | Middletown Outpatient ClinicOne Corporate Place Middletown, RI 02842
Phone: 401-847-6239 |
|
| Vet Center |
||
| Warwick: | Providence Vet Center2038 Warwick Ave Warwick, RI 02889
Phone: 401-739-0167 or 401-739-0167 |
|
Can I continue to use VA health care with other programs, like coverage through HealthSource RI or federal health care programs?
Yes. You can continue to use VA health care coverage for all your health care needs, or complement your VA care with a private health plan through HealthSource RI, a private health plan you buy on your own from an insurance company, or coverage from other federal health care programs if you qualify, including Medicare, Medicaid and TRICARE.
However, your ability to receive VA coverage may prevent you from qualifying for financial help to pay for your health insurance on HealthSource RI.
I am enrolled in a VA health care program. Am I eligible for financial help to buy a health plan through HealthSource RI?
Because VA care meets the standard for health care coverage, you wouldn’t be eligible for financial help through HealthSource RI.
However, you may still purchase private health insurance at full cost through HealthSource RI or directly through a health insurance company to complement your VA health care coverage.
If you are eligible for VA health care but are not enrolled in a VA health care program, you may still receive financial assistance for a plan through HealthSource RI if you are otherwise eligible.
Are my family members (who aren’t eligible for VA or other federal health care programs) eligible for financial help to purchase health insurance?
Your family members who are not enrolled in a VA health care program can apply through HealthSource RI to get coverage.
They may get lower costs on monthly premiums or out-of-pocket costs. They also may be eligible for free coverage through Medicaid or RIte Care.
Where can I get more information on VA health coverage and the Affordable Care Act?
For information on VA health care and the Affordable Care Act, visit VA’s website at www.va.gov/aca, or call 1-877-222-VETS (8387), Mondays through Fridays 8 a.m. to 8 p.m.
For information on HealthSource RI, call our contact center at 1-855-840-4774, or find free, in-person help.
HealthSource RI connects you with health and dental insurance from these companies:
