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Rhode Island health plans

Looking for low-cost or no-cost health insurance? We offer Medicaid plans. We also offer dual health plans for people with both Medicaid and Medicare.

For general information about the plans in your state, visit Rhode Island's homepage.

EOHHS in collaboration with DHS, RIDOH and the Governor’s office, continue to monitor the COVID-19 outbreak in RI and will work with our government partners and MCOs to ensure all lines of communication remain open and available. The health, safety and welfare of our members is our highest priority. More information about COVID-19 is available in multiple languages at health.ri.gov/covid. People with questions about COVID-19 can call 401-222-8022. This is the COVID-19 Hotline that RIDOH has available to the public. Please call 211 after hours. 

View more information from the Centers for Disease Control and Prevention

You should get tested for COVID-19 if:

  • You have symptoms of COVID-19. Even if your symptoms are mild and you’re up to date with your COVID-19 vaccinations, you should isolate at home and get tested.
  • You’ve been identified as a close contact of someone who tested positive. Get tested 5 days after the last time you were with that person, even if you don’t have symptoms.
  • You work in a healthcare or congregate setting. Participate in on-site surveillance testing when it is available.

If you don't have symptoms, haven’t recently been exposed to someone who has COVID-19, and don’t work in a healthcare or congregate setting, you don’t need to get tested for COVID-19.

If you recently tested positive for COVID-19, Rhode Island Department of Health (RIDOH) does not recommend getting tested again for the following 90 days. Someone who has COVID-19 can continue to get a positive test result for up to 90 days.

1. Through the Federal government, each household can order a one-time shipment of 4 free OTC at-home COVID-19 tests shipped directly from covidtests.gov. Learn more about this program at covidtests.gov. Order your tests now so you have them when you need them.

2. As always, COVID-19 testing is free when you go to a COVID-19 testing location instead of testing at home. There are several ways to get tested for COVID-19 in Rhode Island. Click here to find the test site closest to you.

Schedule a free test for yourself or a dependent child at a State-run COVID-19 test site. All Rhode Islanders can schedule a test online at portal.ri.gov or by calling 401-222-8022. You do not need an appointment to get tested at a mobile test site in your community. 

3. Learn how to get free in home covid test kits at your local pharmacy.

Prior authorization (PA) requirements that were lifted as a result of the COVID-19 public health emergency will go back into effect as of October 1, 2021 for medically necessary services and as of January 1, 2022 for Behavioral Health Services that require a prior authorization. A PA is a request from your healthcare provider or a Behavioral Health provider for approval from UnitedHealthcare to provide certain medically necessary services. Both your healthcare and behavioral healthcare  providers are aware of the PA requirement and the effective dates.  

7  results  for Rhode Island

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UnitedHealthcare Dual Complete® (HMO-POS D-SNP)

H3113-010-000

CMS Rating 4 out of 5 stars.

Monthly premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility.

This dual health plan is for people who qualify for both Medicaid and Medicare Parts A & B (Original Medicare).

This is a Health Maintenance Organization (HMO) plan. With an HMO plan, you must use network providers to get your medical care and services.

This plan is available in all counties.

Benefits & Features

  • Food, OTC, Utilities

    $180 a month to buy healthy food and OTC products or pay utility bills

  • Prescription drug coverage

    $0 copay on covered generic and brand-name prescriptions including home delivery

  • Dental benefits

    Up to $3000 for covered types of preventive and comprehensive dental

Enroll in Plan (Opens modal window) View Plan Details Check Eligibility (Opens modal window)

Have questions?    8 a.m. – 8 p.m. local time,  7 days a week    1-844-812-5967    TTY 711

UnitedHealthcare Dual Complete® Select (HMO-POS D-SNP)

H2272-001-000

CMS Rating not applicable

Monthly premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility.

This dual health plan is for people who qualify for both Medicaid and Medicare Parts A & B (Original Medicare).

This is a Health Maintenance Organization (HMO) plan. With an HMO plan, you must use network providers to get your medical care and services.

This plan is available in all counties.

Benefits & Features

  • Food, OTC, Utilities

    $50 a month to buy healthy food and OTC products or pay utility bills

  • Prescription drug coverage

    $0 copay on covered generic and brand-name prescriptions including home delivery

  • Dental benefits

    Up to $1000 for covered types of preventive and comprehensive dental

Enroll in Plan (Opens modal window) View Plan Details Check Eligibility (Opens modal window)

Have questions?    8 a.m. – 8 p.m. local time,  7 days a week    1-844-812-5967    TTY 711

Need help finding a plan?

Answer a few quick questions to see what type of plan may be a good fit for you.

Plan eligibility tool

UnitedHealthcare Dual Complete® Choice (PPO D-SNP)

H0764-001-000

CMS Rating not applicable

Monthly premium: $0.00*

* Your costs may be as low as $0, depending on your level of Medicaid eligibility. 

This dual health plan is for people who qualify for both Medicaid and Medicare Parts A & B (Original Medicare).

This is a Preferred Provider Organization (PPO) plan. You have access to a local network of doctors and hospitals. Plus, you can see any provider outside the network nationwide that participates in Medicare and accepts the plan. You may pay a higher copay or coinsurance when you see an out-of-network provider.

This plan is available in all counties.

Benefits & Features

  • Food, OTC, Utilities

    $155 a month to buy healthy food and OTC products or pay utility bills

  • Prescription drug coverage

    $0 copay on covered generic and brand-name prescriptions including home delivery

  • Dental benefits

    Up to $2500 for covered types of preventive and comprehensive dental

Enroll in Plan (Opens modal window) View Plan Details Check Eligibility (Opens modal window)

Have questions?    8 a.m. – 8 p.m. local time, 7 days a week    1-844-812-5967    TTY 711

UnitedHealthcare Rhody Health Partners

CMS Rating not applicable

UnitedHealthcare® of New England's Medicaid health plan is accredited by the National Committee for Quality Assurance (NCQA).

Rhody Health Partners (RHP) is Rhode Island's Medicaid managed care plan for eligible adults with disabilities who are 21 years or older have an option to enroll in a participating Rhody Health Partners health plan. Rhody Health Partners members can use the large network of doctors specialists, hospitals and other healthcare providers who are part of the UnitedHealthcare of New England network.

This plan is available in all counties.

View Plan Details Check Eligibility (Opens modal window)

Call us to learn more: 1-800-587-5187 / TTY: 711 Monday – Friday 8:00am – 6pm

UnitedHealthcare Rhody Health Partners ACA Adult Expansion

CMS Rating not applicable

The Affordable Care Act (ACA) expanded health coverage to certain adults age 19 or older and under 65.  The UnitedHealthcare Rhody Health Partners ACA Adult Expansion plan is for  certain Adults aged 19-64 with no dependent children with an income at or below 133 percent Federal Poverty Level -in other words, You have to earn less than $15,654 per year or earn less than $1,305 per month and are a United States citizen or a legal permanent resident under 65 meeting income eligibility guidelines.

You are able to enjoy the many benefits and services that we have to offer, call us today to learn about all these benefits.  We will work with your doctors to give to you the quality of care you deserve.  

This plan is available in all counties.

View Plan Details Check Eligibility (Opens modal window)

Call us to learn more: 1-800-587-5187 / TTY: 711 Monday – Friday 8:00am – 6pm

Children with Special Health Care Needs

CMS Rating not applicable

Children with Special Health Care Needs (CSN) is Rhode Island's Medicaid managed care plan for Children with a disability or chronic condition and they are determined eligible for: Supplemental Security Income (SSI), Katie Beckett or Adoption Subsidy through the Department of Children, Youth, and Families (DCYF). When eligible for Medicaid, parents or guardians are then given a choice of enrollment in a participating health plan. Children who live in an institutional facility are excluded from health plan enrollment. In those situations, children will be enrolled in traditional Medicaid Fee-For-Service.

Children with Special Healthcare Needs may qualify for RIte Care under UnitedHealthcare Community Plan. The Department of Human Services will enroll Children with Special Healthcare Needs who are eligible for Medicaid.

This plan is available in all counties.

View Plan Details Check Eligibility (Opens modal window)

Call us to learn more: 1-800-587-5187 / TTY: 711 Monday – Friday 8:00am – 6pm

UnitedHealthcare RIte Care

CMS Rating not applicable

UnitedHealthcare® of New England's Medicaid health plan is accredited by the National Committee for Quality Assurance (NCQA).

RIte Care is Rhode Island's Medicaid managed care program for families on the RI Works Program and eligible uninsured pregnant women, children, and parents. Members enroll in a participating health plan. UnitedHealthcare RIte Care members can use the large network of doctors specialists, hospitals and other healthcare providers who are part of the UnitedHealthcare of New England network.

This plan is available in all counties.

View Plan Details Check Eligibility (Opens modal window)

Call us to learn more: 1-800-587-5187 / TTY: 711 Monday – Friday 8:00am – 6pm

Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. This information is not a complete description of benefits. Call 1-800-905-8671 TTY 711, or use your preferred relay service for more information. Limitations, co-payments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Nurseline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your doctor's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid Plan) information, please contact our Member Services at 1-877-542-9236 (TTY 711,) from 7 a.m. to 8 p.m. Monday through Friday (voice mail available 24 hours a day/7 days a week) for help at no cost to you.

Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-877-542-9236 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana).

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

UnitedHealthcare Connected® (Medicare-Medicaid Plan)

UnitedHealthcare Connected® (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al 1-800-256-6533, TTY 711, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes (correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro. Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)

es un plan de salud que tiene un contrato tanto con Medicare como con el programa MassHealth (Medicaid) para proporcionar los beneficios de ambos programas a sus miembros.

 

UnitedHealthcare Connected benefit disclaimer 

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits and/or copayments may change on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call 1-866-633-4454, TTY 711, 8 am - 8 pm., local time, Monday - Friday (voicemail available 24 hours a day/7 days a week). The call is free. You can call Member Engagement Center and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers. 

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al 1-866-633-4454, TTY 711, de 8am. a 8pm, hora local, de lunes a viernes (correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro. Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.

You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services, 8 a.m. - 8 p.m., local time, Monday - Friday (voicemail available 24 hours a day/7 days a week). The call is free.

You can call Member Services and ask us to make a note in our system that you would like materials in Spanish, large print, braille, or audio now and in the future.

Language Line is available for all in-network providers.

Puede obtener este documento de forma gratuita en otros formatos, como letra de imprenta grande, braille o audio. Llame al Servicios para los miembros, de 08:00 a. m. a 08:00 p. m., hora local, de lunes a viernes correo de voz disponible las 24 horas del día,/los 7 días de la semana). La llamada es gratuita.

Puede llamar a Servicios para Miembros y pedirnos que registremos en nuestro sistema que le gustaría recibir documentos en español, en letra de imprenta grande, braille o audio, ahora y en el futuro.

Los servicios Language Line están disponibles para todos los proveedores dentro de la red.

UnitedHealthcare Senior Care Options (HMO SNP) Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Availability of non-english disclaimer

ATTENTION: If you speak an alternative language, language assistance services, free of charge, are available to you. Call 1-800-905-8671 TTY 711, or use your preferred relay service.

ATENCIÓN: Si habla Español, hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Llame al 1-800-905-8671 TTY 711, o utilice su servicio de retransmisión preferido

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system.

Formularies

The formulary, pharmacy network and provider network may change at any time. You will receive notice when necessary.

NCQA

UnitedHealthcare Connected® has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connected’s Model of Care.

Important provider information

The Choice is Yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

American Disabilities Act notice

In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 888-638-6613 TTY 711, or use your preferred relay service.

Declaration of Disaster or Emergency

If you’re affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non- contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.

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Last Updated: 08.02.2022 at 12:46 PM CDT

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