Rhode Island covers more residents through Medicaid than many states because it expanded the program under the Affordable Care Act in 2014. As of 2026, roughly 309,000 Rhode Islanders receive coverage through Medicaid and CHIP. If your household income falls below a certain percentage of the federal poverty level (FPL), you may qualify for free or low-cost health coverage with no premiums and minimal out-of-pocket costs.
This guide covers every major Rhode Island Medicaid category, current 2026 income limits by household size, asset rules, and step-by-step instructions for applying.
Who Qualifies for Rhode Island Medicaid in 2026
Rhode Island Medicaid covers several distinct groups, each with its own income rules:
- Adults ages 19 to 64 (Medicaid expansion)
- Children and teens under age 19 (RIte Care/CHIP)
- Pregnant women
- Adults 65 and older with low income
- People with disabilities
- Adults needing long-term care or nursing home services
Residency and citizenship status apply to all categories. You must live in Rhode Island and be a U.S. citizen or a legally present non-citizen in a qualifying immigration status.
2026 Income Limits by Program Category
Adults Ages 19 to 64 (Medicaid Expansion)
Rhode Island covers non-disabled adults up to 138% of the federal poverty level. There is no asset or resource test for this group, meaning savings accounts and property do not affect eligibility.
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|
| 1 | $22,025 | $1,835 |
| 2 | $29,863 | $2,489 |
| 3 | $37,702 | $3,142 |
| 4 | $45,540 | $3,795 |
| 5 | $53,378 | $4,448 |
| 6 | $61,217 | $5,101 |
Income above these thresholds may still qualify for subsidized coverage through HealthSource RI, Rhode Island's marketplace. Adults between 139% and 400% FPL can receive premium tax credits.
Children Under Age 19
Children qualify at significantly higher income levels than adults. Rhode Island covers children up to 266% of the FPL through a combination of Medicaid and the Children's Health Insurance Program (CHIP), known locally as RIte Care.
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|
| 1 | $42,454 | $3,538 |
| 2 | $57,562 | $4,797 |
| 3 | $72,671 | $6,056 |
| 4 | $87,780 | $7,315 |
| 5 | $102,888 | $8,574 |
Children in households above this limit may still qualify for CHIP at reduced premium rates depending on income.
Pregnant Women
Pregnant women qualify up to 258% of the FPL. Coverage begins the month the pregnancy is verified and typically continues through 60 days postpartum.
| Household Size | Annual Income Limit | Monthly Income Limit |
|---|
| 1 | $41,177 | $3,431 |
| 2 | $55,831 | $4,653 |
| 3 | $70,486 | $5,874 |
| 4 | $85,140 | $7,095 |
| 5 | $99,795 | $8,316 |
Adults 65 and Older and People with Disabilities
Seniors and people with disabilities who do not qualify for long-term care may access Medicaid through the Low Income Aged and Disabled (LIAD) program. In 2026, the monthly income limit is approximately $1,330 for a single individual and $1,803 for a couple.
This program does have an asset test. Countable assets must not exceed $4,000 for an individual or $8,000 for a couple.
Long-Term Care and Nursing Home Medicaid
Rhode Island's long-term care Medicaid covers nursing home stays, assisted living, and home and community-based services for eligible seniors and people with disabilities.
Income Limit (2026):
- Single applicant: $2,982 per month
- Married couple (both applying): $5,964 per month combined
Asset Limit (2026):
- Single applicant: $4,000 in countable assets
- Married couple (both applying): $8,000 combined
- Married couple (one applying): The applicant may keep up to $4,000; the non-applicant spouse is protected up to $162,660 under spousal impoverishment rules
Rhode Island also offers a Medicaid Spend-Down program for people whose income exceeds the limit. You can reduce your "countable income" by subtracting medical expenses until you reach the medically needy income limit of approximately $1,200 per month for an individual. Once you hit that threshold, coverage kicks in for the rest of the month.
What Medicaid Covers in Rhode Island
Rhode Island Medicaid covers a comprehensive set of services for eligible members:
- Doctor visits and specialist care
- Emergency room and hospital stays
- Prescription drugs
- Mental health and substance use treatment
- Dental care (adults and children)
- Vision care and eyeglasses
- Preventive care and vaccinations
- Maternity care and newborn coverage
- Home health services
- Long-term care in nursing facilities
Children enrolled in RIte Care also receive Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, which cover developmental screenings, hearing tests, and other preventive services not always available to adults.
How to Apply for Rhode Island Medicaid in 2026
Rhode Island consolidated most benefit applications through the HealthyRhode system. Here is how to apply.
Step 1: Gather your documents
Before you start your application, collect:
- Social Security numbers for all household members
- Birth certificates or proof of age
- Proof of Rhode Island residency (utility bill, lease, or bank statement)
- Proof of income for the past 30 days (pay stubs, award letters, tax returns)
- Immigration documents if applicable
- For long-term care applications: bank statements, property records, and medical records
Step 2: Choose your application method
- Online: Apply at HealthyRhode.ri.gov. You can create an account, complete your application, and upload documents all in one place.
- By phone: Call 1-855-697-4347. A benefits counselor will walk you through the application.
- In person: Visit your local Department of Human Services (DHS) office. Use the DHS office locator at dhs.ri.gov to find the office nearest you.
- By mail or fax: Download a paper application from the EOHHS website, complete it, and mail or fax it to your local DHS office.
Step 3: Submit and await determination
Standard Medicaid applications are typically processed within 45 days. Disability-based applications may take up to 90 days. If you are pregnant, hospitalized, or in urgent need, request expedited processing when you apply.
Step 4: Check for retroactive coverage
If you had qualifying medical expenses in the three months before your application, Rhode Island may retroactively apply Medicaid coverage to those months if you were eligible. Tell the caseworker about any recent medical bills when you apply.
Step 5: Enroll in a managed care plan (if applicable)
Most Medicaid members in Rhode Island receive coverage through a managed care organization (MCO). After approval, you will typically choose from one of the following plans:
- Neighborhood Health Plan of Rhode Island (NHPRI)
- Tufts Health Together
- UnitedHealthcare Community Plan
If you do not choose a plan, one will be assigned to you. You can switch plans once a year or immediately if you have a qualifying reason (such as moving or losing access to your doctor).
Rhode Island Medicaid vs. Other Coverage Options
If your income is above the Medicaid limit, you may still qualify for subsidized coverage through HealthSource RI, the state's official marketplace. Here is a quick comparison:
| Program | Income Range | Cost to You |
|---|
| Medicaid (adults) | Up to 138% FPL | Free (no premiums) |
| HealthSource RI plans | 139% to 400% FPL | Subsidized premiums |
| Full-price marketplace plans | Above 400% FPL | Full premium cost |
| Medicare | Age 65+ or disability | Varies (Part B premiums) |
Some Rhode Islanders qualify for both Medicaid and Medicare, known as dual eligibility. In that case, Medicaid typically covers costs that Medicare does not pay, including copays and long-term care.
Renewing Your Coverage
Rhode Island Medicaid eligibility is not permanent. Most enrollees renew annually. Rhode Island sends renewal notices by mail or through your online HealthyRhode account.
To avoid a gap in coverage:
- Keep your address updated with DHS
- Respond to renewal notices promptly
- Report income or household changes within 30 days, as these can affect your eligibility category
If your income changes during the year and rises above the Medicaid limit, HealthSource RI can help you transition to a subsidized marketplace plan with no gap in coverage.
Check Your Eligibility Now
Not sure whether you qualify? Use the free screener at BenefitsUSA.org/screener to see which programs you may be eligible for based on your household size, income, and situation. The tool checks Medicaid, SNAP, CHIP, and other programs at once, and it is free to use.
For more information about assistance programs available to Rhode Island residents, visit the Rhode Island benefits overview page.
Frequently Asked Questions
What is the income limit for Rhode Island Medicaid for a single adult in 2026?
A single adult ages 19 to 64 qualifies if their annual income is below $22,025, which is 138% of the 2026 federal poverty level. There is no asset test for this group.
Do I need to be a U.S. citizen to qualify for Rhode Island Medicaid?
No. Rhode Island Medicaid covers U.S. citizens and legally present non-citizens in qualifying immigration statuses. Undocumented immigrants are generally not eligible for full Medicaid coverage, though emergency Medicaid may be available for urgent medical situations.
How long does it take to get approved for Rhode Island Medicaid?
Standard applications are processed within 45 days. Disability-related applications take up to 90 days. If you are in an emergency situation or are pregnant, ask for expedited processing when you call or apply.
Can I keep my doctor if I enroll in Medicaid?
That depends on whether your doctor participates in Rhode Island Medicaid's managed care network. When you choose your plan, you can check the plan's provider directory to confirm your current doctors are included.
What is the asset limit for Rhode Island Medicaid long-term care?
For 2026, a single applicant can have no more than $4,000 in countable assets. Married couples where both spouses are applying have a combined limit of $8,000. A protected amount of up to $162,660 is set aside for the spouse not applying for nursing home coverage.
What is RIte Care?
RIte Care is Rhode Island's Medicaid program for children and pregnant women. It operates through managed care plans and provides comprehensive coverage including dental, vision, and behavioral health services. Children qualify up to 266% FPL and pregnant women qualify up to 258% FPL.
What happens if my income is too high for Medicaid?
If your income exceeds 138% FPL as an adult, you can apply for subsidized health insurance through HealthSource RI, the state marketplace. Depending on your income, you may qualify for significant premium tax credits that reduce your monthly cost.
Can I get Medicaid if I am self-employed?
Yes. Self-employed individuals can apply for Medicaid. Income is calculated based on net self-employment earnings after business expenses, not gross revenue. You will need to provide documentation such as a recent tax return or a profit and loss statement.
Does Rhode Island Medicaid cover dental?
Yes. Rhode Island Medicaid covers dental services for both children and adults, including preventive cleanings, fillings, and extractions. Coverage for more extensive dental procedures may vary by managed care plan.
How do I report a change in income or household size?
Log in to your HealthyRhode account at HealthyRhode.ri.gov, call 1-855-697-4347, or visit your local DHS office. Changes should be reported within 30 days of when they occur.
