The Poverty Institute works to develop and promote policies to improve the economic security of low- and modest- income Rhode Islanders and ensure that tax and budget policies are equitable and adequate to fund vital public services.
RIte Care/RIte Share (Medical Assistance) Provides comprehensive medical coverage to pregnant women, children and their parents or caretaker relatives.
RIte Care: Recipients enroll in one of 2 managed care plans, Neighborhood Health Plan of RI or UnitedHealthcare of New England. Dental coverage is provided through the RIte Smiles program to children born after May 1, 2000. Older children access dental coverage using their Medicaid card.
RIte Share: Families in which a parent works for an employer that offers a qualified health plan are provided medical coverage through their employer's plan and Medical Assistance. DHS pays all or part of the employee's share of the premiums and Medical Assistance covers services not provided in the commercial plan (e.g. dental coverage, transportation and interpreter services).
Who Qualifies? • Pregnant women (upon verification of pregnancy) with income less than 250% FPL. (Pregnant women with income between 250% and 350% FPL can purchase RIte Care coverage.)
• Children under age 19 (whether or not living with a caretaker relative) with income less than 250% FPL.
• Parents (or caretaker relatives) living with a child(ren) under age 18 (or 18 and will complete High School before turning 19) with income less than 175% FPL.
• A child must be a citizen or eligible immigrant. Eligible immigrants include refugees and persons granted asylum. Lawful permanent residents (LPR) or otherwise lawfully present in the U.S. (e.g. applicant for asylum).
• Parents/caretaker relatives must be citizens or eligible immigrants. Eligible immigrants include: refugee or person granted asylum. LPR who entered the U.S. before 8/22/96 or if entered on/after 8/22/96 must be in status for at least 5 years. In addition, immigrants who were in lawful status in the U.S. before 8/22/96 and lived in RI at some time before 7/1/97 may be eligible for coverage.
• All pregnant women are eligible for RIte Care/RIte Share coverage regardless of status (including undocumented).
• Families with income above 150% FPL must pay a monthly premium two months after they apply. Premiums range from $61 to $92 per month depending on income. (See chart below) Failure to pay the premium for two months results in a sanction of ineligibility for 4 months. The family can reapply for RIte Care when the sanction ends and does not need to pay the back premiums as a condition of eligibility.
• Parents must cooperate with the Office of Child Support Services in obtaining a medical support order against the non-custodial parent.
Income/Resource Limits There is no resource test for RIte Care/RIte Share. Countable income (income after RIte Care/RIte Share deductions) must be within the applicable limit for a child, parent, or pregnant woman.
How to Apply Request an application from the DHS office or hotline (401) 462-5300 or click hereto download one from the DHS website.
The completed application can be mailed to the office No interview at DHS is required. Documentation must be provided with the application. Generally, copies of documents can be provided. However, citizens need to provide original birth certificates for applicant family members and a license or other proof of identity for applicants age 16 and older. These documents should not be mailed to DHS, but will need to be presented at the DHS office or be reviewed by a Family Resource Counselor(FRC) at a community health center (English speaking directory, Bilingual directory). Family Resource Counselors at the community health centers and hospitals can also help complete the application and forward necessary documentation to DHS.
DHS must make a decision on a RIte Care/RIte Share application within 30 days of receiving the application at the DHS office or the date the application is signed with a Family Resource Counselor. Benefits are retroactive to the first of the month in which the application is made.
Families need to recertify for RIte Care/RIte Share on a yearly basis and are mailed a renewal form to complete prior to the recertification date.
Families denied RIte Care/RIte Share and recipients who are notified that benefits will be terminated can request a hearing within 30 days of the date of the notice. If a hearing is requested within 10 days of the a notice of benefit termination or reduction, benefits can continue until a hearing decision is reached.
RI Legal Services (1-800-662-5034) may provide assistance to families who are denied benefits, receive notice of termination or have other problems with RIte Care/RIte Share.
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