Medicare in Rhode Island
Key Takeaways
Adults 65 and older who live in Rhode Island are eligible for Medicare. Medicare is a government-funded insurance option that offers coverage for medical services, prescription drugs, and more.
Original Medicare (Parts A and B) will cover most of your inpatient and outpatient services. However, you can always choose to add additional coverage and assistance, such as Medicare Part D and Medigap.
Medicare Advantage Plans (Part C) in Rhode Island vary depending on the provider you choose. All Part C plans cover the same services as Original Medicare, but many also offer additional coverage like prescription drugs, dental, vision, and more.
From mansion tours in Newport to beach walks on Block Island, Rhode Island is full of beauty and charm. When you’re actively enjoying life on the East Coast, it’s important to have a health insurance plan that keeps you covered.
Whether you’ve already got a set insurance plan in mind or need help choosing one, GoHealth licensed insurance agents in Rhode Island can help you find a Medicare plan to meet your needs.
Find a local Medicare plan that fits your needs
How do I apply for Medicare in Rhode Island?
There are multiple ways to apply for Medicare Plans in Rhode Island, including online, over the phone, and in person. At GoHealth, we can help make the entire application process much easier.
- Call GoHealth to speak with a licensed insurance agent.
- Visit the Social Security website and use their online application.
- Apply over the phone using the Social Security administration’s toll-free number at 1-800-772-1213 (TTY 1-800-325-0778).
- Apply in person at your nearest Social Security office during business hours.
If you turn 65 and have been receiving Social Security disability benefits, you will be automatically enrolled into Original Medicare (Parts A and B). If not, you can apply to enroll in Medicare Part A & B during your 7-month Initial Enrollment Period. This period includes the three months before, the month of, and three months after your 65th birthday. Once you have enrolled in Parts A and B, Medicare Part C enrollment becomes available.
What are the different Medicare plans available?
The five parts of Medicare include Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, and Medigap. Enrolling in these Medicare plans can help cover most, if not all, of your medical needs.
- Medicare Part A covers hospital insurance.
- Medicare Part B covers medical insurance.
- Medicare Part C, also known as Medicare Advantage, replaces Part A and Part B and many Part C plans cover additional benefits like prescription drugs, vision, dental, etc.
- Medicare Part D helps cover prescription drugs.
- Medicare Supplement plans help cover out-of-pocket costs of Part A and B.
Original Medicare (Parts A and B) cover both inpatient and outpatient services and mental health services. You can add Medicare Part D to help cover the cost of your prescription drugs. Medigap is another add-on that can help lower some of your out-of-pocket costs, such as copayments, coinsurance, and more.
Are you eligible for cost-saving Medicare subsidies?
What is the requirement to qualify for Medicare?
All citizens or permanent residents aged 65 and older qualify for Medicare in Rhode Island. [i] Individuals aged 50 and older who are the child or widow of a government worker may also qualify for Medicare. Also, people below the age of 65 can receive Medicare if they have a qualifying disability and have received Social Security or Railroad Retirement Board disability benefits.
Generally, you must receive disability benefits for 24 months to qualify for Part A and Part B. However, suppose you have been diagnosed with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS). In that case, you will be automatically signed up for Medicare from the first month you receive disability benefits. GoHealth licensed insurance agents are trained to help walk you through how to first enroll in Medicare.
Do I qualify for Medicaid in RI?
Medicaid is a government-funded health insurance option that covers millions of low-income Americans. Many older adults receive both Medicaid & Medicare to help cover many of their healthcare needs. In Rhode Island, a Medicare-Medicaid Plan (MMP) coordinates Medicaid and Medicare coverage and benefits. You qualify for Medicaid in Rhode Island if you are low income and are 65 years or older, have a disability, or have a child under 18 years of age.
How do you qualify for Medicare if you are under 65?
You can qualify for Medicare before 65 if you receive benefits for a disability. People who have received Social Security or Railroad Retirement Board disability benefits for 24 months are eligible to apply for Medicare. Individuals with Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD) are automatically eligible for Medicare after the first month of their disability benefits. If you are 50 years or older, and you meet the requirement of the Social Security Disability program, you may also qualify for Medicare if you are the child or widow of someone who worked in a Medicare-covered government position.
What extra benefits and savings do you qualify for?
What Medicare plans are required at 65?
If you do not enroll in Original Medicare when you are first eligible, you risk facing late enrollment penalties for Part A or Part B. The exception to this rule is when you are transitioning from a group health plan to Medicare. Once you enroll in Medicare, if you do not enroll in either Part D or another creditable drug coverage, you also risk a Part D permanent late enrollment penalty. As soon as you are eligible for Medicare, reach out to a GoHealth licensed insurance agent so that we can help you enroll on time.
Is Medicare free at 65?
Although Medicare may offer some low and zero-cost options for beneficiaries in Rhode Island, Medicare plans are never “free” – however, if you meet the criteria, some parts of Medicare may cost you nothing out-of-pocket. You can qualify for premium-free Part A if you’re already receiving Social Security or Railroad Retirement Board disability benefits or if you’re eligible for disability benefits. You can also qualify for a premium-free plan if you previously had Medicare coverage through your place of employment. Since Medicare costs can vary based on income, low-income beneficiaries may also be eligible for lower out-of-pocket Medicare costs.
Who has the best Medicare Advantage program?
Many private insurance companies offer Medicare Advantage in Rhode Island, making it difficult to choose the right Medicare plan. However, it’s essential to understand that there is no single “best” Medicare Advantage plan. Instead, the best Medicare plan for you will be one that meets your healthcare and financial needs. The Center for Medicare & Medicaid Services’ (CMS) five-star rating system can help you compare plans and providers in Rhode Island. [i] If you need help comparing your options, GoHealth licensed insurance agents can also help you find a plan that meets all of your needs.
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Medicare in Rhode Island by the Numbers
Thousands of older adults enroll in Medicare every day across the United States. The latest CMS data shows that 204,250 people are enrolled in Medicare Part A and B in Rhode Island. The total number of beneficiaries enrolled in Medicare Advantage Increased from 105,022 to 111,572 year over year. Medicare Advantage participation in Rhode Island went from 52.61% to 54.63% year over year. If you’d like to dive deeper into how Medicare in Rhode Island breaks down across the state, we provide a glance at who is using Medicare and how.
Medicare
Rhode Island
204,250 Beneficiaries with Part A & Part B
111,572 Medicare Advantage Beneficiaries
54.63% Meducare Advantage Participation Rate
55.05% Female
44.95% Male
86.34% Non-Hispanic White
3.01% African American
5.22% Hispanic
5.42% Other/Unknown
15.56% Eligible for Medicaid
0.97 Average HCC Score
$9,928.77 Actual Per Capita Costs
18.32% Hospital Readmission Rate
25.61% of Beneficiaries with an Emergency Department Visit
105,022 Medicare Advantage Beneficiaries, Previous Year
Increased Medicare Advantage, Year over year
52.61% Meducare Advantage Participation Rate, Previous Year
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Table reflects the latest Beneficiary Demographics Data: Medicare Geographic Variation – by National, State & County
Average HCC Score: The Hierarchical Condition Category score gauges a population’s overall health. The score is based on a value of 1.0. Populations with an HCC score of less than 1.0 are considered relatively healthy. The score can be used to estimate health costs.
Rhode Island Medicare Resources & Contacts
Beneficiaries spend an average of $10,369.28 each year on Medicare in Rhode Island. To be certain you are not leaving anything on the table, let us help. A GoHealth licensed insurance agent can assess your coverage or explain which Rhode Island-based resources, like these, may be able to help:
Nationwide Resources
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
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Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
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Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
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Medicare Beneficiary Guide
For those currently enrolled in Medicare
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Low Income and Medicare Guide
For individuals with a qualifying income status
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A Caregiver’s Guide
For individuals with a qualifying income status
