Medicaid Affordable Healthcare Coverage
For Adults19 - 64 years old
Adults between the ages of 19 and 64 may be eligible for affordable health coverage. If your your income is at or below 138% of the federal poverty level, you may qualify for comprehensive health coverage paid for by RI Medicaid. To be eligible, you must be:
- A Rhode Island resident;
- A citizen of the United States or a legally present non-citizen who has been in the US for five years or meets certain exemptions;
- Not pregnant;
- Not otherwise eligible for Medicaid or Medicare part A or B benefits; and
- Living alone or as part of a household with income at or below 133% of the federal poverty level
How to Apply
· 1. Apply Online - at healthyrhode.ri.gov There are step-by-step questions that guide you through the application process. When you apply online, you will find out if you are eligible and will be able to view your health plan options.
2. Apply by Phone Call Healthsource RI at 1-855-609-3304 if you need help finding a place to apply or if you'd like to complete the application by phone.
· 3. Apply in Person You can apply in person or by mail at one of the Department of Human Services Offices or at HealthSource RI.
4. Apply by Mail - For a copy of the application, download it here.
When to Apply
You can start the application process anytime by setting up an account online at healthyrhode.ri.gov or by working with a DHS or Healthsource RI representative. Once you set up your account, you have 90 days to complete and submit your application. If you don't submit your application in the 90 days, don't worry. You can restart the process and apply at anytime.
What You Need to Apply
Whether applying online or using a paper application in person or by mail, you will be asked to answer questions about your age, household/family size, U.S. tax filing status, residency and citizenship. To help make the process go along as smoothly as possible, you should have the following information at hand when you apply:
- Social Security Numbers
- Birth Dates
- Passport or other immigration numbers
- Tax return from the previous year.
- Information about any health coverage available to you or your family including any information you have about the health insurance your current employer offers even if you are not covered by your employer’s insurance plan.
- W-2 forms with salary and wage information if you work for an employer
- 1099 forms, if you are self-employed
In most cases, you will not need to submit documents containing this information. The online application will guide you through a series of questions.
We will check the information you provide on the application using electronic matches whenever possible. For example, we use our direct connections with federal data hubs to verify social security numbers. We can verify your income through State salary and wage data bases and your federal income tax information through our electronic data matches with the U.S. Internal Revenue Service.
We will also accept your word through an “attestation” by having you sign that all information you provide is truthful at the time you completed the application. If we need additional information we will let you know immediately if you are applying online or by letter if you are applying in-person. If additional documents are needed, you will have the option of uploading them directly to the website, calling by telephone, faxing, mailing or bringing the information in person.
After Completing the Application
Once your application is complete, you will be notified about your health coverage options. You will know right away if you apply online and within 30 days if you apply using a paper application.
· Medicaid Funded Coverage
- If you qualify for Medicaid you will be enrolled in Rhody Health Partners, a Medicaid health plan, through UnitedHealthcare Community Plan or Neighborhood Health Plan of RI.
- If you do not qualify for Medicaid under this eligibility, you may still qualify for Medicaid under a different eligibility path. Contact a DHS representative or a navigator for help.
· Other Affordable Coverage Options
- If you do not qualify for Medicaid and your income is at or below 400% of the FPL, you may be eligible for federal subsidies (through a tax credit) that makes health coverage more affordable. After you apply, you will see a list of health plan options and costs for each plan, including any subsidies. Apply for tax credits on line at healthyrhode.ri.gov