find a plan

View our comprehensive guides to coverage in Rhode Island

Individual and Family
Short-term
Medicaid
Medicare
Dental

The American Rescue Plan's premium-cutting subsidies

Find out how the American Rescue Plan will drastically cut marketplace health insurance costs for Rhode Islanders from Providence, to Newport, Warwick and beyond. Enroll through August 15 during a statewide COVID-related special enrollment period.

Calculate your subsidy savings!
Individual and Family

Short-term coverage in Rhode Island

The sale of short-term health insurance plans is not banned in Rhode Island, but due to its strict regulations, no insurers offer short-term health insurance plans in Rhode Island. Learn more about Rhode Island's short-term regulations.

View plan availability in your state.
Short-term

Medicaid in Rhode Island

Rhode Island implemented the Affordable Care Act's Medicaid eligibility expansion in 2014. Since then Rhode Island enrollment in Medicaid/CHIP has grown by 60%.

Learn more.
Medicaid

Medicare enrollment in Rhode Island

As of December 2020, there were 225,803 Rhode Island residents enrolled in Medicare plans. Read more about Medicare coverage in Rhode Island.

Find plans
Medicare

Flexible dental benefits. Fast approval.

Protect yourself from the soaring costs of dental procedures. Compare plan options to see premiums and deductibles that fit your budget.

Compare dental plans.
Dental

Frequently asked questions about health insurance
coverage options in Rhode Island

Rhode Island utilizes a state-run health insurance marketplace – HealthSource RI – which is an active purchaser exchange. That means that the marketplace negotiates directly with insurers, and determines which plans will be made available each year.

The marketplace/exchange is used by individuals and families who need to purchase their own coverage, as well as small businesses buying group health coverage for their employees. People who purchase their own health coverage include the self-employed, early retirees who aren’t yet eligible for Medicare, and people employed by a small business that doesn’t offer health benefits for employees. Depending on household income, they can also qualify for premium subsidies and cost-sharing reductions through HealthSourceRI, which reduce premium costs and out-of-pocket costs for eligible enrollees.

In most states, enrollments outside of the open enrollment period (ie, during a special enrollment period) must be completed by the 15th of the month in order to have coverage effective the first of the following month. But Rhode Island is one of just two states where the deadline is the 23rd of the month.

Rhode Island is one of a handful of states where there is a tax penalty for not having health insurance. The state’s individual mandate took effect in 2020, and the penalty for non-compliance is assessed on state tax returns in Rhode Island starting with the returns filed in early 2021. 

Read our guide to the Rhode Island health insurance marketplace.

Rhode Island’s state-run exchange has followed the lead set by the Biden administration’s COVID-related special enrollment period. Rhode Island’s COVID-related enrollment window continues through August 15, 2021, and is an opportunity for both new and current enrollees to take advantage of the newly enhanced premium subsidies created by the American Rescue Plan.

(Rhode Island had previously announced a COVID-related enrollment period through May 15, but it was limited to uninsured residents; the extension through August 15 notes that the enrollment opportunity is also available to current enrollees who would like to make a plan change).

A qualifying event is not necessary in order to use the COVID-related enrollment window, and coverage selected during this window will be effective the first of the month following the enrollment.

Previously, open enrollment for 2021 health plans via HealthSourceRI will was extended through January 23, 2021. This was more than a month longer than the open enrollment period in states that use HealthCare.gov, and it’s a few weeks longer than the open enrollment period that Rhode Island used for 2020 coverage.

Two health insurance companies – Blue Cross Blue Shield of Rhode Island and Neighborhood Health Plan of Rhode Island — offer 2021 medical insurance through HealthSource RI.

For 2021, Rhode Island marketplace plan rates increased by an average of about 4.2%.

  • Blue Cross Blue Shield of Rhode Island: 3.3% increase
  • Neighborhood Health Plan of Rhode Island: 4.7% increase

For 2021 coverage, 31,174 people selected private individual market plans through HealthSource RI during the open enrollment period. HealthSource RI reported that 30,071 of those enrollees effectuated their coverage by paying the necessary premiums). 

The year before, for 2020 coverage, 34,643 people selected plans during open enrollment, and 32,704 effectuated their coverage. The exchange noted that the decreased enrollment could be mostly attributed to the increase in Medicaid enrollment during the COVID pandemic, and the federal rules (under early COVID relief legislation) that prevent states from disenrolling people from Medicaid during the pandemic emergency period.

Read more about the Rhode Island health insurance marketplace.

With a state-based health insurance marketplace (HealthSource RI) and Medicaid coverage expansion, Rhode Island has fully embraced the Affordable Care Act. And the healthcare reform law has been quite effective for the state. Rhode Island has seen the ninth-largest reduction in the percentage of residents without health insurance since 2013 and now has one of the nation’s lowest uninsured rates.

The Rhode Island exchange enrolled about two and a half times as many people in expanded Medicaid coverage than in private plans during the 2014 open enrollment period, so Medicaid expansion has played a key role in reducing the number of uninsured residents in the state.

In 2010, Rhode Island’s U.S. Senators – Democrats John Reed and Sheldon Whitehouse – both voted yes on the ACA. In the U.S. House, both of the state’s Representatives were also Democrats – Patrick Kennedy and Jim Langevin – and voted yes.

Kennedy has since been replaced by another Democrat, David Cicilline, who is also supportive of the ACA and has stated that “protecting the programs created through the recent health care reform is one of [his] top priorities in congress.” Thus, the entire U.S. congressional delegation from Rhode Island is Democratic and supportive of healthcare reform.

Rhode Island’s state legislature also has a very strong Democratic majority. Former Gov. Lincoln Chaffee, a Democrat, was an ardent supporter of the law, “fully committed to ensuring that Rhode Island is a national leader in implementing health reform …” Chaffee has since been replaced by Gov. Gina Raimondo, a Democrat who took office in 2015 and is strongly invested in healthcare reform.

The state has been fully on-board with ACA implementation from the get-go, opting for a state-run exchange (HealthSource RI) and agreeing to expand Medicaid to cover all of the state’s legal residents with incomes up to 138% of poverty.

In late spring 2014, there was some talk in the legislature about switching to a federally-facilitated exchange in order to be more cost-effective, but that ultimately did not happen and the state is still running the exchange.

Rhode Island immediately embraced the provision to expand Medicaid coverage under the Affordable Care Act.

Immediately after the Supreme Court ruled in 2012 that Medicaid coverage expansion would be optional for the states, Former Gov. Lincoln Chafee made it clear that Rhode Island would be implementing Medicaid expansion, expanding eligibility for coverage to all non-elderly adults with household income up to 138% of the poverty level.

At the time, Rhode Island estimated that about 40,000 additional people would enroll in Medicaid plans through 2022, with most of them (about 83%) being newly eligible as a result of Medicaid expansion. But the state noted that there was considerable uncertainty in terms of how many people would actually be newly eligible and newly enrolled.

As of November 2020, Medicaid enrollment in Rhode Island was 68% higher than it had been in 2013, and included more than 130,000 additional enrollees. Enrollment has increased considerably since the COVID pandemic began in early 2020.

Since the ACA was implemented, the state has seen a 64% reduction in the uninsured rate, from 11.6% uninsured in 2013 to 4.1% uninsured in 2018 and in 2019.

Read more about Medicaid coverage expansion in Rhode Island.

The sale of short-term health insurance plans is not banned in Rhode Island, but due to its strict regulations, no insurers offer short-term health insurance plans in the state. The state’s restrictions include a mandate that short-term health insurance coverage include essential health benefits, cover pre-existing conditions, and premiums cannot be based on medical history.

No short-term health insurance plans have been approved for sale in the state for several years.

Read more about short-term health insurance plans in Rhode Island.

Medicare is health coverage run by the federal government for people age 65 and older and people with long-term disabilities. As of December 2020, there were 225,803 Rhode Island residents enrolled in Medicare plans. Almost half are enrolled in Medicare Advantage plans, while a little more than half have Original Medicare. Most Medicare beneficiaries in Rhode Island are eligible for Medicare due to age, but 17% are under the age of 65 and eligible for Medicare because of a disability.

Read more about Medicare enrollment in Rhode Island.

Learn more about the Medicare open enrollment period, during which Medicare beneficiaries can change their Part D coverage or Medicare Advantage coverage.

  • HealthSourceRI – The state-run marketplace/exchange in Rhode Island. Provides health insurance options for individuals, families, and small businesses, as well as financial assistance for individuals and families based on household income.
  • Rhode Island Health Center Association – Navigator and Certified Application Counselor services to help people enroll in coverage through HealthSourceRI. Can provide assistance with private plan enrollment and Medicaid/CHIP enrollment, as well as information on applicable financial assistance available to offset costs in private plans.
  • Rhode Island Office of Healthy Aging, Medicare Counseling — The state health insurance assistance program for Medicare beneficiaries; can provide information, assistance, and counseling related to enrollment, eligibility, and claims.
  • Medicare Rights Center — A nationwide service that can provide advice, information, and assistance to Medicare beneficiaries and their caregivers.

In 2018 and 2019, Rhode Island enacted legislation to implement a state-based individual mandate starting in 2020, and to create a reinsurance program to stabilize the state’s individual insurance market. The reinsurance program was subsequently approved by the federal government and took effect in 2020.

When it comes to health insurance in Rhode Island, we’re the voice of experience.

Talking about health insurance since 1994.
Talking about health insurance since 1994.
We’ve been helping Americans understand and navigate the individual health insurance market since 1994. Nearly 2.8 million readers turned to our pages for help in 2019.
Tools for health insurance shoppers.
Tools for health insurance shoppers.
Millions of users have turned to us for a free health insurance quote … and more than 600,000 Americans have utilized our Obamacare Subsidy Calculator.
Partnerships with leading health insurance carriers.
Partnerships with leading health insurance carriers.
We vet our business partners carefully, so our readers can feel confident when using our free health insurance quote tool to compare ACA-compliant plans, short-term medical policies and Medicare plans.
Experts on health reform.
Experts on health reform.
Our insurance experts have been tracking and analyzing health reform efforts – including the Affordable Care Act – since 2008. We’ve earned a reputation as a health insurance industry watchdog.
Answering your burning questions.
Answering your burning questions.
We’re here to answer your burning questions every day. In the past decade, our Frequently Asked Questions section alone has been viewed more than 4 million times.

Our experts and articles referenced in

0
Would love your thoughts, please comment.x
()
x