Medicaid

What is Medicaid?

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. In Rhode Island, we offer plans from Neighborhood Health Plan of Rhode Island, Tufts Health Plan, UnitedHealthcare and RIte Smiles.

Who is eligible for 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.

What is the difference between Medicaid and HealthSource RI?

HealthSource RI is the state’s marketplace for buying and comparing health insurance plans. Individuals apply for health coverage through HSRI and depending upon their income, they may be eligible for Medicaid or eligible to purchase an insurance plan (possibly with financial assistance). Your application through HSRI will determine your options.

Health plans available through Medicaid and HealthSource RI both offer a similar set of important benefits, called essential health benefits.

If you were recently or are about to be terminated from Medicaid, please visit HealthSourceRI.com/transitions. If are looking for more information about the Medicaid renewals process, please visit staycovered.ri.gov. 

How can I apply for Medicaid?

You can apply online on HealthSourceRI.com. This single application will let you know if you qualify for free or low-cost Medicaid or for affordable commercial coverage through HealthSource RI. You can also apply in person at your local Department of Human Services (DHS) office or by phone by calling HealthSource RI at 1-855-840-4774.

If you need help applying or have questions, you can Find Help for free. Find a certified enroller in your area.

After applying

You will receive a notice from the Department of Human Services letting you know if you were approved, denied or if they require more information in order to make a determination.  It is very important for you to respond if information is requested.

If you are no longer eligible for Medicaid, contact HealthSource RI.

If you get a Medicaid notice telling you that you or a member of your household no longer qualify for Medicaid due to changes in income or your household, you may be eligible to enroll in a health plan through HealthSource RI, but you must act fast.

You only have 60 days from the date listed in the Medicaid notice to enroll in HealthSource RI during your Special Enrollment Period. To avoid a gap in your health coverage, let us help you pick a new plan before your Medicaid coverage ends. We can also tell you if you qualify for financial help to lower your costs.

Call 1-855-840-4774 to speak to an enrollment specialist or find a certified enroller in your area.

Not eligible for Medicaid or HealthSource RI?

If you are uninsured and are not eligible for Medicaid or coverage through HealthSource RI, you may qualify for health services through The Rhode Island Free Clinic or Clínica Esperanza.

You might also qualify for free or “charity care” from one of our local hospitals. To learn more, call or visit the financial services office at any hospital in Rhode Island, call the Department of Health at 401-222-5960, or read more about the program.

Find a Medicaid Provider

Now that you are enrolled in Medicaid, use EOHHS’s Provider Search to find doctors or other health care professionals who are designated as Medicaid Providers. PLEASE NOTE: this provider search does not guarantee that the Medicaid provider is currently accepting new patients. If you are enrolled in a health plan, please contact your health plan’s Member Services department for participating providers.