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Rhode Island DHS

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Medical Assistance Program

 Program Description

The Rhode Island Medical Assistance Program, also known as " Medicaid", is a federal and state funded program that pays for medical and health related services for eligible Rhode Islanders. This includes inpatient and outpatient hospital care, preventive services, durable medical equipment, and many more services and benefits. (For a complete list, see below.) The RIte Care Program, RI’s Medicaid Managed Care Program, which covers children and parents, is a part of the Medical Assistance Program. Long Term Care services, including institutional care and home and community-based care, is also part of Medical Assistance.

Who’s Eligible for Medical Assistance

  • Adults over age 65
  • Individuals with disabilities (includes adults and children)

There are (2) two categories of eligibility: "categorically needy" and "medically needy". "Categorically needy" includes those individuals who are eligible for or receiving cash assistance from the Supplemental Security Income (SSI) Program or the Family Independence Program. This makes them eligible for Medical Assistance. Individuals may qualify for Medical Assistance as "medically needy" if they are under the income and resource limit or if they have large medical expenses that may qualify them for Medical Assistance. Please apply at a local office to see if this would apply to you or a family member.

To be eligible, you must:

  • be a RI resident
  • have income less than approximately $ 795 each month
  • have resources (savings) of less than:
  • $ 4,000 for an individual or $ 6,000. for a couple
    The house you live in and life insurance (below a certain face value) is not counted as a resource in determining eligibility.

The following list of covered benefits is for the "categorically needy" group. The "medically needy" group has the same covered benefits except as noted.

Covered Benefits

  • Inpatient hospital services
  • Inpatient psychiatric hospital services
  • Outpatient hospital services:
      Clinic and emergency room care +
      Laboratory and x-rays
      Pharmacy
  • Physician services
  • Pharmacy services
  • Dental services
  • Clinical Laboratory services
  • Durable medical equipment, surgical appliances, and prosthetic devices
  • Certified home health agency services
  • Podiatry services +
  • Ambulance services
  • Community mental health center services
  • Substance abuse services
  • Nursing facilities services
  • Optometric Services
  • Intermediate care facility and Day Treatment Services for the Mentally Retarded
  • Hospice Care Services
  • Organ Transplant Services

 +Podiatry services and outpatient hospital clinic and emergency room services are not covered benefits for "medically needy"eligibles.

How to Apply

See DHS’s Local Office Directory for the DHS office nearest to you. Call or visit your local DHS office to get an application or for more information on Medical Assistance.

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