Applying for Medicaid in Rhode Island does not have to be complicated. Rhode Island is a Medicaid expansion state, which means more residents qualify for free or low-cost health coverage than in many other states. Whether you are an adult, a parent, pregnant, or applying on behalf of a child, this guide walks you through every step of the process so you can get covered as quickly as possible. You can also use our free benefits screener to check your eligibility in just a few minutes.
For a broader look at all assistance programs available in the state, visit our Rhode Island Benefits Overview.
Who Qualifies for Medicaid in Rhode Island?
Rhode Island expanded Medicaid under the Affordable Care Act, opening coverage to most adults ages 19 to 64 with household incomes up to 138% of the Federal Poverty Level (FPL). Children, pregnant women, seniors, and people with disabilities each have their own eligibility categories with different income thresholds.
Rhode Island operates several Medicaid programs under different names:
- RIte Care covers families with children, pregnant women, and children under 19
- Medicaid for Adults covers adults ages 19 to 64 under the expansion
- Medicaid for Elders and Adults with Disabilities (EAD) serves seniors and people with qualifying disabilities
- Katie Beckett provides coverage for children with special health care needs
- Sherlock Plan is Medicaid for working individuals with disabilities
Rhode Island Medicaid Income Limits (2026)
Income limits are based on the Federal Poverty Level. Below are the current FPL thresholds and the income limits for each major eligibility group.
2026 Federal Poverty Level by Household Size
| Household Size | 100% FPL (Annual) | 100% FPL (Monthly) |
|---|---|---|
| 1 | $15,960 | $1,330 |
| 2 | $21,640 | $1,803 |
| 3 | $27,320 | $2,277 |
| 4 | $33,000 | $2,750 |
| Each additional person | +$5,680 | +$473 |
Medicaid Income Limits by Category
| Eligibility Group | Income Limit (% FPL) | Monthly Income (Individual) |
|---|---|---|
| Adults ages 19 to 64 | 138% FPL | $1,835 |
| Parents with children under 18 | 133% FPL | $1,769 |
| Pregnant women | 253% FPL | $3,365 |
| Children under 19 (RIte Care/CHIP) | 261% FPL | $3,472 |
| Seniors and adults with disabilities | Varies by program | Contact DHS |
These income figures are for Modified Adjusted Gross Income (MAGI), which includes wages, self-employment income, Social Security benefits, and other taxable income. Asset limits generally do not apply for MAGI-based Medicaid, though the EAD program may have additional financial criteria.
How to Apply for Medicaid in Rhode Island: Step by Step
You can apply for Rhode Island Medicaid through several methods. The state uses a single application that determines your eligibility for both Medicaid and marketplace health insurance through HealthSource RI.
Step 1: Gather Your Documents
Before you start, collect the following:
- Proof of identity such as a driver's license, state ID, or passport
- Social Security numbers for everyone in your household who is applying
- Proof of income including recent pay stubs, tax returns, or a letter from your employer
- Proof of Rhode Island residency such as a utility bill, lease agreement, or bank statement
- Immigration documents if applicable (lawfully present immigrants may qualify)
- Proof of pregnancy if applying under the pregnant women category
- Information about current health insurance if you have any
Step 2: Choose Your Application Method
Rhode Island offers four ways to apply:
Online (Recommended) Apply through the HealthyRhode portal at healthyrhode.ri.gov. This is the fastest method. The online system is available 24 hours a day, 7 days a week. You can save your application and return to it later if needed.
By Phone Call the DHS Call Center at 1-855-697-4347 or HealthSource RI at 1-855-840-4774 (Monday through Friday, 8 AM to 6 PM). A representative can walk you through the application over the phone.
In Person Visit your local Department of Human Services (DHS) office. You can find office locations at dhs.ri.gov. Staff can help you complete and submit your application on the spot.
By Mail Download a paper application from the DHS website or request one by phone. Paper applications are available in English, Spanish, and Portuguese. Mail the completed form to your local DHS office.
Step 3: Complete the Application
The application asks for information about:
- Your household members and their relationships
- Your household income from all sources
- Your current employment status
- Whether anyone in the household is pregnant, has a disability, or needs long-term care
- Any current health insurance coverage
Be thorough and accurate. Incomplete applications may be delayed or denied.
Step 4: Submit and Track Your Application
After submitting your application, you will receive a confirmation. The state typically processes Medicaid applications within 45 days (or 90 days for disability-based applications). You can check the status of your application by:
- Logging into healthyrhode.ri.gov
- Calling DHS at 1-855-697-4347
Step 5: Respond to Any Requests for Information
DHS may contact you to verify information or request additional documents. It is very important that you respond promptly to any requests. Failing to provide requested documentation can result in your application being denied.
Step 6: Receive Your Determination
You will receive a written notice from DHS letting you know whether you have been approved, denied, or if more information is needed. If approved, your notice will include details about your coverage start date and the health plan options available to you.
Choosing a Medicaid Health Plan
Once approved for Rhode Island Medicaid, you can choose from the following managed care plans:
- Neighborhood Health Plan of Rhode Island (1-800-459-6019)
- UnitedHealthcare Community Plan (1-800-587-5187)
- Tufts Health Plan (1-866-738-4116)
If you do not select a plan, one will be assigned to you. You can change your plan during the first 90 days of enrollment or during the annual open enrollment period.
What Medicaid Covers in Rhode Island
Rhode Island Medicaid covers a comprehensive set of benefits, including:
- Doctor visits and preventive care
- Hospital stays (inpatient and outpatient)
- Prescription medications
- Mental health and substance abuse treatment
- Laboratory tests and X-rays
- Maternity and newborn care
- Pediatric services including dental and vision for children
- Emergency services
- Rehabilitative services
- Home health services
- Transportation to medical appointments
Most Medicaid recipients in Rhode Island pay no premiums and have little to no cost-sharing for covered services.
What to Do If You Are Denied
If your Medicaid application is denied, you have the right to appeal. Your denial notice will include instructions on how to request a hearing. Key things to know:
- You typically have 30 days from the date of the denial notice to file an appeal
- You can request a hearing by phone, in writing, or through your DHS caseworker
- Free legal assistance may be available through Rhode Island Legal Services at 401-274-2652
- If you are denied Medicaid due to income, you may still qualify for reduced-cost health insurance through HealthSource RI
Tips for a Faster Application
- Apply online for the quickest processing times
- Submit all documents upfront rather than waiting for DHS to request them
- Double-check your income information since most denials are related to income errors
- Get free help from a certified application counselor. Find one at healthsourceri.com/get-help-community
- Use our screener at /screener to pre-check your eligibility before applying
Medicaid Renewal in Rhode Island
Medicaid coverage in Rhode Island must be renewed annually. DHS will send you a renewal notice before your coverage expires. You can renew online at healthyrhode.ri.gov, by phone, or by mail. For the latest on renewals, visit StayCovered.RI.gov.
If you lose Medicaid coverage due to a change in income, you have 60 days to enroll in a marketplace plan through HealthSource RI during a Special Enrollment Period.
Frequently Asked Questions
How long does it take to get approved for Medicaid in Rhode Island?
Most Medicaid applications are processed within 45 days. Disability-based applications may take up to 90 days. Applying online and submitting all required documents upfront can speed up the process.
Can I apply for Medicaid at any time?
Yes. Unlike marketplace health insurance, Medicaid has no open enrollment period. You can apply any time of year, and if you qualify, your coverage can begin as early as the date of your application.
Does Rhode Island Medicaid cover dental and vision?
Medicaid covers dental and vision services for children. Adult dental coverage is limited but does include emergency dental services. Check with your managed care plan for details on adult dental and vision benefits.
Can immigrants apply for Medicaid in Rhode Island?
Lawfully present immigrants may qualify for Medicaid in Rhode Island. Undocumented immigrants are generally not eligible for full Medicaid but may qualify for emergency Medicaid services. Children and pregnant women who are lawfully present have expanded eligibility.
What if my income changes after I am approved?
You are required to report income changes to DHS. If your income increases above the limit, you may lose Medicaid but could qualify for subsidized marketplace coverage through HealthSource RI. Report changes through the HealthyRhode portal or by calling 1-855-697-4347.
Is there a cost for Rhode Island Medicaid?
Most Medicaid recipients in Rhode Island pay no monthly premium and have minimal or no copayments for covered services.
Can I apply for Medicaid and other benefits at the same time?
Yes. The HealthyRhode portal allows you to apply for Medicaid, SNAP (food assistance), and other programs through one integrated application. Use our benefits screener to see all the programs you may qualify for.
Get Started Today
Applying for Medicaid in Rhode Island is free and can be done in under 30 minutes online. Start by checking your eligibility with our free benefits screener, then head to healthyrhode.ri.gov to submit your application. If you need help at any point, call HealthSource RI at 1-855-840-4774 or visit a local DHS office.
