Rhode Island Medicaid

Last verified: June 2026

What is Rhode Island Medicaid?

Rhode Island Medicaid is administered by the Executive Office of Health and Human Services (EOHHS). Rhode Island expanded Medicaid under the ACA and operates one of the most distinctive state Medicaid programs in the country: a Section 1115 Global Waiver, approved by CMS and renewed multiple times, that gives Rhode Island broad flexibility to coordinate Medicaid with other health and human services programs under a global spending cap.

As of 2025, approximately 340,000 Rhode Islanders are enrolled in Medicaid — a significant share of the state's 1.1 million population. Rhode Island delivers Medicaid through managed care organizations (MCOs): Aetna Better Health of Rhode Island, Neighborhood Health Plan of Rhode Island, and UnitedHealthcare Community Plan of Rhode Island. Most Medicaid members select one of these MCOs as their primary plan.

Rhode Island Medicaid covers doctor visits, hospital care, prescriptions, behavioral health, dental care, and long-term services. The Global Waiver structure allows Rhode Island to fund services that would otherwise not be available under standard federal Medicaid rules — including expanded home-based care for members who might otherwise need institutional care.

Who qualifies for Rhode Island Medicaid?

Rhode Island's income limits are among the more generous in the region for children and pregnant women. Adults qualify through ACA expansion at the standard 138% FPL threshold.

• Adults ages 19–64 (ACA expansion): at or below 138% FPL — approximately $20,783/year for a single person in 2026
• Children under age 19: up to 261% FPL through Medicaid or RIte Care CHIP
• Pregnant women: up to 253% FPL
• Seniors and people with disabilities: income and asset rules vary by program
• Parents and caretaker relatives: varies by household composition
• Medicare Savings Programs: help low-income Medicare beneficiaries pay premiums and cost-sharing

Source: Rhode Island EOHHS; HealthSource RI eligibility information. Verify current limits at healthyrhode.ri.gov or by calling 1-855-697-4347.

Rhode Island's Global Waiver: what makes it distinctive

Rhode Island's Section 1115 demonstration waiver — one of the broadest state Medicaid waivers in the country — allows the state to operate all of its Medicaid and Children's Health Insurance Programs under a single global framework with a negotiated spending cap. Under this structure, Rhode Island can redirect savings toward services not typically covered by Medicaid and integrate services across health, behavioral health, and social supports.

CMS most recently renewed Rhode Island's Global Waiver in 2023. The waiver has been in place in various forms since 2009 and has served as a national model for states seeking flexibility in how they structure and deliver Medicaid services.

Managed care in Rhode Island: choosing your health plan

Most Rhode Island Medicaid members are enrolled in one of three MCOs. When you enroll in Medicaid, you will be asked to choose a health plan. If you do not choose, the state will assign you to one. Each MCO maintains its own provider network, member services line, and care management programs. Neighborhood Health Plan of Rhode Island is a local nonprofit that includes dental coverage in its standard plan. Compare plan options at healthyrhode.ri.gov.

Rhode Island Medicaid topics

What does Rhode Island Medicaid cover?

Medicaid covers a broad range of health services. Federal law mandates certain benefits — inpatient and outpatient hospital care, physician services, lab work, X-rays, and nursing facility services, among others. States add optional services on top of those. Dental, vision, and long-term home care coverage vary by state.

The national benefits overview lists required and commonly optional services. Check the Rhode Island Medicaid website for the current state-specific benefit package.

How to apply

Most people can apply online through Rhode Island's Medicaid portal, by phone, or in person at a local eligibility office. The how to apply page walks through each method, what documents you'll need, and what to expect during the review period.

Under 42 CFR 435.912, states must process most standard Medicaid applications within 45 days (90 days for disability-based applications). Rhode Island must follow that federal timeline.