Rhode Island Health Insurance: 2021 Guide

Fran
Fran Majidi
November 3, 2020

Rhode Island Affordable Healthcare Insurance

The residents of Rhode Island looking to buy health insurance have a few plan options and they should compare different rates carefully. If you’re an individual buying coverage for yourself or your family, you can get the best value by comparing your options with SmartFinancial. Do note that you may only enroll in a health plan during open enrollment, unless you are eligible for the Special Enrollment Period due to a qualifying event.

When Is Open Enrollment in Rhode Island?

November 1, 2020 - December 15, 2020. Coverage begins January 1, 2021.

How to Get Health Insurance in Rhode Island

To figure out which plan fits your needs and which will end up saving you money, we suggest that you look at the number of times you visited a health care provider in the last year, the amount of prescription medications you buy and whether you anticipate the need for increased care in 2021. If you see your health care providers frequently in a given year, a higher premium plan may end up saving you money.

The smartest way to get the best value for health care coverage is to compare health insurance companies and health insurance quotes. After you submit the form you’ll get a list of health insurance rates to choose from. We’ll also connect you with an health insurance advisor in your area so you can ask questions about the plans you’re considering.

What Types of Health Insurance Are Available in Rhode Island?

In Rhode Island, you can choose from HMOs, EPOs, PPOs and POS plans. These plans are available at different tiers, which provide different levels of coverage. Plans in Rhode Island are available in bronze, silver, gold and platinum. Keep in mind that the more you pay in monthly premiums, the less you pay in copays and coinsurance. Also, the higher the tier, the lower your deductible.

Does Health Insurance Cover Pre-existing Conditions?

The Affordable Care Act made it illegal for marketplace health plans to deny anyone health insurance coverage based on pre-existing conditions.

Compare Health Insurance Plans in Rhode Island

Do I Qualify for a Special Enrollment Period?

Common reasons people qualify for a special enrollment period:

  • Lost or quit a job. You may have lost a job, changed jobs or even started your own business. If you lost a job and with it your health insurance, you qualify for the special enrollment period. If you changed jobs and are not offered health insurance, you qualify to buy health insurance after the enrollment period.
  • Turned 26. If you were on your parents’ health insurance plan but turned 26 after the enrollment period, you can enroll in an individual health plan.
  • Moved to another state or out of an HMO coverage area. You may have had a health plan that was only valid in one state but you moved to another state after the enrollment period. You can sign up for a new health plan.
  • Cobra coverage ended. If you extended your healthcare with Cobra and reached the deadline, you can enroll in a new health plan.
  • Divorce. If you were married and shared a health plan with your spouse but divorced, you still have time to enroll in a new health plan.
  • Marriage. If you recently married, you may be able to get added onto your spouse’s policy or start an entirely new one together.
  • Birth or adoption of a child. If your baby was born or brought home after the open enrollment date, you can still buy health insurance for that child.
  • Death of spouse or partner. If you were covered under your spouse or partner’s health plan but that person passed away, you can take advantage of the special qualifying events exception to enroll in an individual plan.
  • Spouse of partner loses coverage. If you previously had health insurance through a partner or spouse who lost his/her coverage for any qualifying reason, you are eligible to buy an individual plan or buy coverage with that spouse/partner again.

Is Health Insurance Required in Rhode Island?

Yes, health insurance is required in California, Massachusetts, New Jersey, Vermont, Rhode Island, and DC. Otherwise, there is a tax penalty. Even though it’s not required in every state, buying health insurance is necessary to avoid medical bankruptcy.

How Much Is Health Insurance in Rhode Island?

The average cost of health insurance in Rhode Island for a 40-year-old is around $403 a month. Health insurance is less expensive, the younger you are. Tobacco use increases health insurance rates.

How to Save on Health Insurance in Rhode Island

The best way to save on health insurance in Rhode Island is to compare rates based on the tier system. First, estimate your medical costs by looking at the previous year.

Medicare in Rhode Island

Medicare is government-subsidized health insurance coverage for Americans ages 65 years and older. The government also allows younger people with disabilities to enroll in the program. Individuals with End-Stage Renal Disease (a permanent kidney failure treated with dialysis or a transplant) can also sign up as can some individuals with severe mental health issues. Others who qualify for Medicare disability coverage are individuals with Amyotrophic Lateral Sclerosis (also called Lou Gehrig’s Disease). Most beneficiaries will receive Original Medicare (Parts A and B). Some people buy Medicare Advantage, which includes Part A and B as well as offering vision, dental, and prescription drug coverage.

How Many People Are on Medicare in Rhode Island?

21% of the population of Rhode Island is on Medicare.

How Much Is Medicare in Rhode Island?

If you do not qualify for Medicare, you can buy it for $458 a month for Part A in 2020 and a standard monthly premium for Medicare Part B was $144.60 for 2020, or even higher depending on income.

Original Medicare vs Medicare Advantage: What’s the Difference?

Medicare is a government-subsidized health plan that is available to qualified Americans age 65 and older. Medicare Advantage is sold through private health insurance companies, but these policies are also regulated by the government. Medicare Advantage plans offer the same benefits as Medicare Parts A and B. Medicare Advantage plans also offer more coverage for dental, vision, hearing, and prescription drugs. Medicare Advantage plans have a maximum out-of-pocket limit. For 2020, it was $6,700 but many plans set their maximums at a much lower cost. That is why it’s important to compare companies. People who opt for original Medicare can buy Medicare Supplements to help with out-of-pocket costs. You cannot buy both Medicare Advantage and Medicare Supplements. If you enroll in a Medicare Advantage Plan during open enrollment, you will automatically be disenrolled from original Medicare.

How to Get Medicare Coverage in Rhode Island

If you receive social security payments, you may automatically enroll in Medicare, but you may have to sign up if you do not receive payments. The easiest way to enroll in Medicare is by working with a trusted insurance agent to get the coverages you want. Just enter your zip code and answer a few simple questions.

Types of Medicare Plans Available

Original Medicare, Medicare Advantage, Medicare Cost Plans (only offered in certain areas), Demonstration/Pilot Programs (also called Research Studies; only offered in certain areas) and Programs of All-Inclusive Care for the Elderly (PACE).

How Do I Qualify for Medicare?

You must be a citizen of the U.S. or have been a legal resident for at least five years. If you are age 65 or older and you/your spouse have worked for at least 10 years (40 quarters) or you have a disability, Amyotrophic Lateral Sclerosis (ALS) or end-stage renal disease (ESRD), you most likely qualify for Medicare.

How Can I Save on Medicare in Rhode Island?

You can save on Medicare by signing up for Part B as soon as you’re eligible. People who enroll late must pay a penalty every year. If you’re interested in buying Medicare Advantage, you can shop and compare Medicare plans for the best value.

Rhode Island State Health System Ranking

  • Rhode Island: Overall State Ranking: 7 of 51
  • Rhode Island: Overall Performance: Average
  • Rhode Island: Access & Affordability: 3
  • Rhode Island: Prevention & Treatment: 5
  • Rhode Island: Avoidable Hospital Use & Cost: 26
  • Rhode Island: Healthy Lives: 11
  • Rhode Island: Health Care Disparities: 13

Rhode Island Health Insurance Coverage

The people of Rhode Island have different kinds of health insurance while some Rhode Island residents are not insured at all. See the breakdown below:

  • Private coverage: 50%
  • Medicaid: 24%
  • Medicare: 21%
  • Uninsured: 5%

Rhode Island Health Insurance Companies

The following carriers offer health insurance and/or Medicare in Rhode Island.

Get a Free Health Insurance Quote Online Now.

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