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THE RHODE ISLAND CANCER COUNCIL, INC.
What Is Medicaid?
Medicaid is a federal program that provides medical assistance to certain
individuals and families with low incomes and limited resources. The
Rhode Island Medical Assistance Program is also known as Medicaid, and
its provisions can be found in Title 27-Insurance of Rhode Island General
In Rhode Island there are two categories of eligibility for medical assistance.
1.Categorically Needy: includes individuals who are eligible or receiving
cash assistance from the Supplemental Social Security Income Program
(SSI), or the Family Independence Program (FIP).
2.Medically Needy: includes individuals who are under the income and
resource limit or if they have large medical expenses.
To be eligible in Rhode Island you must:
1.Be a Rhode Island resident;
2.Have an income less than approximately $795 each month;
3.Have resources (savings) of less than $4,000 for an individual or $6,000
for a couple.
It is important to note that the house you live in and term life insurance
policies (below a certain face value) are not counted as resources when
Characteristics of Medicaid Coverage
Retired or disabled individuals who have low incomes and are enrolled in
Medicare may also qualify for medical assistance from Medicaid.
If your income is too high to qualify for Medicaid coverage and you are
having trouble affording Medicare coverage, there are five programs offered
by Medicaid that will provide you medical assistance:
1.The Qualified Medicare Beneficiary Program (QMB) will pay your
Medicare monthly premium and your Medicare deductibles and coinsurance
if your household income is less than $798 for an individual, $1,070 for a
2.The Specified Low-Income Medicare Beneficiary Program (SLMB) will
pay for your monthly Medicare premiums if an individual has an income
under $957. Married couples' combined income must be under $1,283 per
month to qualify.
3.The Qualifying Individuals-1 Program (QI-1) will pay your Medicare Part
B premium if an individual has an income under $1,077 per month. Married
couples' combined income must be under $1,444 per month to qualify.
4.The Qualified Disabled and Working Individuals Program (QDWI) may
pay for your Medicare Part A premium if your income is below $1,695 a
month with resources under $4000 and you are currently working. For a
couple, the income must be below $2245 a month with resources below
RIteCare and RIteShare
RIteCare is Rhode Island’s Medicaid managed care program that provides
families on the Family Independence Program (FIP) and eligible uninsured
pregnant women, parents, and children up to age 19 with comprehensive
health insurance coverage. Families receive most of their health care
through three participating health plans: Neighborhood Health Plan of
Rhode Island, United Healthcare of New England, and Blue Chip. (To find
out more about these health plans please refer to the Rhode Island Cancer
Council’s Certified Health Plans binder.)
RIteShare is a premium assistance program that helps families get health
insurance coverage through their employer or spouse’s employer. If a
family qualifies, RIte Share will pay for all or part of the employee’s share
of the health plan insurance premium.
The qualifying agents necessary for participation in the RIteCare and
RIteShare programs are:
1.Families with children and/or;
2.Children up to age 19 and/or;
The costs of RIte Care and RIte Share are:
1.Families with incomes up to 150% of the federal poverty level receive
either program at no cost.
2.Families with incomes between 150% and 250% of the federal poverty
level pay a monthly premium of $61, $77 or $92, depending on the family's
For information or an application, contact the RIteCare/RIteShare
Medicaid Covered Benefits
The following is a list of covered benefits for both categorically and
medically needy individuals. However the benefits that are followed by an
asterisk sign (*) are not covered benefits for the medically needy group.
2.Outpatient hospital services including clinical and emergency room care
(*), laboratory and x-rays, and pharmacy services.
6.Clinical laboratory services
7.Durable medical equipment, surgical appliances, and prosthetic devices
8.Certified home health agency services
9.Podiatry services (*)
10. Ambulance services
11. Nursing facility services
12. Hospice care services
13. Community Mental Health Center services
14. Substance abuse services
15. Nursing facility services
16. Optometric services
17. Intermediate care facility and day treatment services
18. Treatment services for the mentally retarded
19. Organ transplant services
To find out if you or other members of your family qualify for
Medicaid, you can contact the:
Rhode Island Department of Human Services
Call (401) 462-5300, to obtain the locations and telephone numbers of
the office nearest to you.
More information is available at:
THE RHODE ISLAND CANCER COUNCIL, INC.
249 Roosevelt Avenue, Suite 201
Pawtucket, RI 02860
Toll Free: 866-879-4100