How to get Medicaid or low-cost care in Rhode Island

One application covers Medicaid and private plans

Medicaid is a program that helps people with low incomes pay for health care. In Rhode Island, you apply for it in the same place where you shop for private health plans. That place is HealthSource RI, the state's health insurance marketplace. A marketplace is a website where people compare plans and learn what help they can get with the cost.

The single application sorts you into the right program. A low income may lead to free or low-cost Medicaid. A higher income may lead to a private plan with help paying the monthly bill. HealthSource RI says its Medicaid page covers low-income adults, children, older adults, people with disabilities, pregnant people and others.

The Kaiser Family Foundation lists Rhode Island as a state that adopted Medicaid expansion on January 1, 2014. Expansion means adults can qualify based on income. Our guide on who qualifies for Medicaid explains the groups and the income rules in plain words.

Ways to apply

HealthSource RI says you can enroll in Medicaid at any time. You can apply online at the HealthSource RI website, by phone at 1-855-840-4774, or in person at your local Department of Human Services office. The Department of Human Services, called DHS, sends the notice that tells you if you were approved, denied or asked for more information.

The state's Executive Office of Health and Human Services also points people to a second portal called HealthyRhode for health and human services programs. HealthSource RI has certified enrollers who give free local help, and you can find them through its Find Help page. Another choice is 2-1-1, which is the state's 24 hour help line for local services.

Our guide on how to apply for Medicaid lists the papers to bring, such as proof of income and ID.

The 2027 work rule

The state tells members that, starting in 2027, some adults on Medicaid will need to meet work requirements. They will also need to renew their coverage every six months. Updates are posted on a website called Stay Covered RI.

The federal rule behind this comes from a 2025 law. The Centers for Medicare and Medicaid Services, called CMS, says states must generally start it by January 1, 2027. It applies to adults ages 19 to 64 in the expansion group. Affected adults must show 80 hours a month of work, community service, a work program or school. Earning at least $580 a month also counts, according to CMS.

Parents and caregivers of a child 13 or younger do not have to meet the rule. Pregnant people and people with serious health problems are also exempt. Our guide on the Medicaid work rule lists the other groups.

The state also posted a separate change for noncitizens. It says that since October 1, 2026, some adults who are not U.S. citizens have lost Medicaid eligibility under federal law. If this may affect you, call HealthSource RI at 1-855-840-4774 to ask about other options.

The state penalty for going without coverage

Rhode Island has its own health coverage mandate, which means a rule that residents must have coverage. It began on January 1, 2020, after the federal penalty dropped to $0. If you go without qualifying coverage and have no exemption, the state can charge a penalty when you file your Rhode Island income tax return.

HealthSource RI explains how the fee is figured. The fee is either 2.5 percent of your yearly household income above the tax filing line or a flat amount per person. You pay whichever is higher. The flat amount is $695 per person, plus $347.50 for each child under 18. If you were uninsured for only one or two months in a row, you do not owe the fee.

A lot of people are exempt from the fee. Some exemptions are claimed on your state tax return, such as being a member of a federally recognized tribe or a health care sharing ministry. Others are requested from HealthSource RI, such as a hardship or coverage that was not affordable for your income. Our guide on whether it is illegal to go without insurance compares Rhode Island with the few other places that have a penalty.

When your income is above the Medicaid limit

HealthSource RI can show you which private plans fit your budget. Private plans have a yearly Open Enrollment period, so check the HealthSource RI website for the dates for 2027 coverage. Outside those dates you usually need a qualifying life event, such as losing other coverage. If you lost your job, our guide on losing a job and losing insurance walks through your first steps.

Health centers and doctor license checks

Community health centers get federal money and serve everyone. Their prices follow your income and family size. Enter your zip code in the Find a Health Center tool from the Health Resources and Services Administration to see the ones near you. Our guide to sliding-scale clinics can help you compare what you would pay.

The Rhode Island Department of Health licenses doctors through the Board of Medical Licensure and Discipline. Its page offers a tool called Verify a Physicians License. The department also posts a list of disciplinary actions. The licensing unit takes calls on weekdays at 401-222-5960. Its hours are 8:30 in the morning to 3:30 in the afternoon.

The same page warns about scam callers who say a doctor's license is suspended. The board says its staff never ask for personal information by phone.

Monthly-fee doctors and ER rights in Rhode Island

Some doctors in Rhode Island charge a flat monthly fee for primary care instead of billing insurance, which is called direct primary care. You can search our directory of cash-pay doctors and ask each office to write down its fee.

If you have an emergency, call 911 or go to the nearest emergency room. Hospitals with emergency rooms must see you first and sort out payment later, because federal law says so. If a bill arrives later, our guide on hospital financial assistance explains how to ask for help.