Rhode Island Health Insurance Guide

From scenic beaches to rich cultural experiences, Rhode Island remains a desirable place to live — and understanding your health insurance options here is key to protecting your health and finances. As of 2025, the uninsured rate in Rhode Island is notably low, thanks to expanded access to coverage through Medicaid and ACA marketplace plans. If you’re currently without coverage, here’s what you need to know about getting insured in Rhode Island.

Health Insurance Options in Rhode Island

Rhode Island offers a variety of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many Rhode Island residents receive health insurance through their employer. If your workplace offers coverage, this is typically the most cost-effective and convenient option.

ACA Marketplace Plans

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through the Health Insurance Marketplace. These plans offer essential health benefits, free preventive care, and protection for preexisting conditions. If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA marketplace plans are available in four tiers: Bronze, Silver, Gold, and Platinum, each with distinct costs and coverage levels. Plans also vary by provider networks and out-of-pocket expenses, so compare carefully to find what fits your needs.

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum (if available): Highest premiums, lowest out-of-pocket costs.

Medicaid

Rhode Island’s Medicaid program provides free or low-cost coverage for eligible low-income residents. Medicaid benefits typically include preventive care, hospital visits, mental health services, prescriptions, and more. Medicaid plan benefits are comprehensive and vary depending on individual needs.

Short-Term Plans

Rhode Island does not offer short-term medical (STM) plans. While STM plans may be available in other states, Rhode Island has restrictions to ensure that all coverage meets ACA standards, making short-term plans less accessible for residents.

Children’s Health Insurance Program (CHIP)

Rhode Island’s CHIP program helps children and pregnant women in families that earn too much for Medicaid but need affordable insurance. The program provides low-cost coverage to children from birth through age 18 and pregnant women.

Student Health Insurance

College students in Rhode Island have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans—making student health insurance in Rhode Island accessible and flexible for a wide range of needs.

Medicare

Medicare plans are available for residents aged 65+ and younger individuals with qualifying disabilities. Options include:

• Medicare Advantage Plans (Part C): These plans are offered by private insurers and provide additional benefits beyond Original Medicare, often including prescription drug coverage. Learn more about Medicare Advantage.
• Prescription Drug Plans (Part D): Medicare Part D provides coverage for prescription drugs and vaccines, offered by private insurers.
• Medicare Supplement (Medigap): Medicare Supplement plans help cover the out-of-pocket costs that Original Medicare does not pay, such as deductibles, copayments, and coinsurance.

COBRA Coverage

If you’ve recently lost job-based insurance, COBRA allows you to continue your employer coverage temporarily—typically at full cost.

Enrollment Periods in Rhode Island

Open Enrollment for 2026 Coverage:

• November 1, 2025 – January 31, 2026

During this window, all eligible residents can apply for, renew, or change their marketplace health plans.

Special Enrollment Period:

Available year-round for those experiencing qualifying life events, such as:

• Loss of coverage
• Marriage or divorce
• Birth or adoption of a child
• Relocation
• Major change in income

You typically have 60 days from the event to enroll.

Health Insurance Providers in Rhode Island

As of 2025, these insurers typically offer individual and family plans through the HealthSource RI Marketplace:

• Blue Cross Blue Shield of Rhode Island
• Neighborhood Health Plan of Rhode Island

Plan availability may vary by county or zip code. Some carriers may also offer standardized plans if Rhode Island provides a public option or similar initiative.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common cost terms:

• Premium: Monthly payment to maintain your plan.
• Deductible: What you pay before insurance covers services.
• Copayment (Copay): Fixed amount per visit/service.
• Coinsurance: Shared costs with your insurer after the deductible.
• Out-of-Pocket Maximum: Your yearly cost cap for covered services.
• In-Network vs. Out-of-Network: Staying in-network helps you avoid higher charges.

Understanding health insurance doesn’t have to be overwhelming. This glossary offers clear definitions of key terms—from agents to costs like copayments, coinsurance, and deductibles—to help you make confident coverage decisions.

Bottom Line

Health insurance in Rhode Island offers a range of options, whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure affordable, reliable coverage that supports your well-being and budget.

Need help choosing a plan? Use our ACA Subsidy Calculator to see if you are eligible for ACA plan financial aid or speak with a licensed insurance agent about all your options.