Full Guide to Assistance

Below is the Guide to Assistance in its entirety. Click the print icon above or below to print out the full Guide to Assistance.  

INCOME SUPPORTS

Child Support

The Office of Child Support Services will help a custodial parent pursue a legal action to establish paternity, obtain orders of child support and medical support, or enforce existing child support orders for a fee of $20.  The Office also assists non-custodial parents in establishing paternity, in filing motions to modify support orders and with job training and placement.

Parents who are receiving RI Works Cash Assistance, Child Care Assistance, or RIte Care Health Insurance are required to cooperate with the Office of Child Support in obtaining a child support and/or medical support order from a non-custodial parent.  A parent can request a waiver from cooperation based on domestic violence and will be referred to the Family Violence Option Advocacy Program (PDF, 604KB) (Spanish (PDF, 612KB)) for safety-planning and to prove eligibility for the waiver.

How to Apply

To apply for services, fill out the this application (PDF, 897KB) and return to the Office of Child Support Services. For more information, contact the Office of Child Support Services at (401) 458-4400. 

General Public Assistance (GPA)

The GPA program provides time-limited cash assistance to individuals who are disabled.  To be eligible for cash assistance, an individual must first be found eligible for GPA-Medical (see Health Care – GPA assistance) or Medical Assistance (see Health Care – Medical Assistance).

Who Qualifies?

  • Individuals found eligible for GPA-medical based on having a physical or mental disability that will last longer than 30 days and prevents the person from working.  These individuals may receive GPA “Hardship Fund” benefits of up to $200/month for a maximum of 3 months at a time. 
  • Individuals who have applied for SSI benefits and who are receiving Medical Assistance through the Department of Human Services are entitled to receive $200/month in “Bridge” payments.  Payments continue until a decision on eligibility for SSI is made.  If ineligible, repayment is not required.  If found eligible for SSI, the total amount of the payment is refunded to DHS out of the person’s retroactive SSI check.
  • Must be a citizen or legal immigrant.  Lawful permanent residents (green card), refugees, persons granted asylum, persons granted conditional entry or paroled into the U.S. are eligible.

Income and Resource Limits 

The resource limit is $400.  The home in which the person lives is not counted.  A car worth less than $4,650 and a car that is specially equipped/designed to transport a person with a disability are not counted.

The income limit is $327/month for an individual and $449/month for a couple.

How to Apply

Apply at the local DHS office. To find the nearest office contact DHS, (401) 462-5300. 

A decision on GPA is made within 30 days from the date of application.  If found eligible for GPA, the recipient can request “Hardship Funds.”  A decision on Medical Assistance is made within 90 days from the date of application.  If found eligible for MA, the individual can request “Bridge” payments.

If the request for Hardship Funds is denied, there is no appeal.  If the request for Bridge payments is denied, the applicant has 30 days to file a written request for an appeal. 

RI Legal Services (1-800-662-5034) may provide assistance to families that are denied benefits.

Rhode Island Works Program

(Replaced the Family Independence Program in July 2008)

The RI Works Program provides cash assistance to families with children up to age 18 and work readiness services for enrolled parents. The maximum benefit is the amount listed in the chart below and depends on family size and living arrangement. A family receives the difference between countable income (income after RI Works deductions to earned income are applied) and the benefit amount.  

Families eligible for RI Works also receive SNAP benefits, health insurance (through the RIte Care program), child care assistance necessary for the parent to participate in work-readiness activities or employment and transportation assistance.

Time limits are applied to the receipt of RI Works cash benefits.  Parents and caretaker relatives can receive RI Works cash benefits for 24 months (whether or not consecutive) in any 60 month period with a lifetime total of 48 months. Children are subject to the same time limits as their parents, except children who live with a parent who receives SSI benefits or who lives with a caretaker relative (who is not in the payment) can receive assistance until he/she turns 18. 

Families may be eligible for a “hardship extension” to either the 24 month or 48 month time limit. Hardship extensions are based on the parent’s inability to work due to disability of the parent, need to care for a disabled family member in the home, homelessness, domestic violence or high unemployment in the state. An initial hardship extension is granted for 6 months. Two additional extensions of 3 months each can be granted. The hardship extension is available to recipients to prevent loss of benefits, as well as to applicants who have exceeded the 24 or 48 month time limit.

Parents are required to enter into an employment plan or a rehabilitation plan (for parents with disabilities) as a condition of their family’s eligibility for RI Works cash benefits. Most parents are required to participate in job search as the first activity in the employment plan. Parents with limited literacy/English language skills are referred to an intensive 6-month program designed to help them gain the skills to find entry level employment, instead of job search. In addition, parents may be referred to short term skills training if appropriate to help the parent enter employment.  To get a list of approved programs where a caseworker may refer parents to satisfy their employment plan requirements, contact DHS at (401) 462-5300.

Parents must cooperate with the Office of Child Support Services in pursuing a support order against the non-custodial parent.  The parent can request a waiver from cooperation based on domestic violence and will be referred to the Family Violence Option Advocacy Program for safety planning and to prove eligibility for the waiver. See more information inEnglish (PDF, 604KB) or Spanish(PDF, 612KB).

Who Qualifies?

  • Families with children under the age of 18 (or 18 and in school if student will graduate before age 19).
  • Families include children living with parent(s) or with caretaker relatives (grandparents, aunts, uncles, adult siblings…).
  • Pregnant women in their 6th month of pregnancy.
  • Pregnant and parenting teenagers (under age 18) must live with parent/relative or in a supervised setting.
  • Must be a citizen or eligible legal immigrant: Eligible immigrants include : Refugees and persons granted asylum.  Lawful permanent residents (LPR) who entered the U.S. before 8/22/96 or if entered on/after 8/22/96 must be in status for five years or more.  Immigrants who are sponsored into the U.S. may have some of their sponsor’s income and resources counted.  For more information about immigrant eligible see “Immigrant Eligibility for Government Benefits.”

Income and Resource Limits

The income limits for families of different sizes are listed in the table below. Earned and unearned income are counted against the income limit.  Unearned income is counted dollar for dollar. Deductions are applied to earned income, so that families with limited earnings may qualify for a supplemental payment from RI Works.

The resource limit is $1,000. The home in which the family lives and one car per adult household member is not counted (to maximum of two).

How to Apply

Apply at the local DHS office, (401) 462-5300. 

The first step is a meeting with a DHS social worker to be screened for eligibility.  (The application for RI Works is also an application for SNAP and RIte Care for eligible family members.) Application forms and instructions are provided at this screening. The social worker schedules appointments for the applicant with an eligibility worker for an intake appointment and a social caseworker for development of the employment plan.

The intake appointment must be within 5 working days of the screening appointment.  In an emergency situation (the family has no income/resources and in the month of application has not/will not have income/resources in excess of the RI Works limits) the intake appointment is scheduled the next day.  A decision on the application must be made within 30 days of the screening appointment and the family is notified in writing of the decision.

Families are recertified for RI Works every 6 months.  The parent is notified of an appointment with the eligibility worker by mail.  Parents may also need to meet more frequently with the social caseworker to modify their employment plan.  

Applicants denied RI Works and recipients who are notified that benefits will be reduced or terminated can request a hearing within 30 days of the date on the notice.  If a hearing is requested within 10 days of the notice of benefit termination or reduction benefits can continue until a hearing decision is reached.  If the parent loses the hearing, benefits must be repaid.

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 RI Works.

Income Guidelines,  RI Works 2015

Family Size Income Limit/Maximum Monthly Payment Amount Income Limit if Living in Subsidized/Public Housing
1 $327 $277
2 $449 $399
3 $554 $504
4 $634 $584
5 $714 $664
6 $794 $744
7 $874 $824
8 $954 $907

Supplemental Security Income (SSI)

Provides cash assistance to persons age 65 and older and adults and children with serious physical or mental impairment(s). Maximum monthly payments in 2015 are $772.92 for an individual and $1,179.38 for a couple (if both spouses are eligible). SSI benefits are for individuals who have not worked and paid into the Social Security System or as a supplement to Social Security Disability or Retirement Benefits for workers who have limited benefits. Individuals receiving SSI also receive Medical Assistance and are eligible for SNAP benefits.

Who Qualifies?

  • Individuals unable to work due to serious physical and/or mental impairment(s) that have lasted or will last for at least one year or result in death and prevents any substantial gainful activity. 
  • Individuals age 65 or older.
  • Citizens can qualify on basis of age or disability. Lawful permanents resident who entered the U.S. before 8/22/96 can qualify based on disability (but not based solely on age unless s/he has worked for 40 quarters). Lawful permanent residents who entered the US on/after 8/22/96 must be in status for five years and be credited with 40 quarters of work before being eligible for SSI based on either age or disability. Refugees, persons granted asylum and other limited categories are eligible for SSI based on either disability or age for the first 7 years in status (regardless of date of entry). (Some immigrants may be eligible for 9 years).

Income and Resource Limits

Countable income must be less than SSI payment. (A $20 deduction is applied to unearned income and certain deductions are applied to earned income.) The resource limit is $2,000 ($3,000 for a couple).  The home in which the person lives and a car used to obtain medical care do not count. 

SSI and Medical Assistance

Individuals found eligible for SSI are eligible for Medical Assistance coverage. An applicant for SSI can apply separately for Medical Assistance at the DHS office while the SSI application is pending. The disability standard for SSI and Medical Assistance are the same, but it can take many months for a decision on the SSI application to be made, while DHS must make a decision on Medical Assistance eligibility within 60 days for individuals requesting coverage based on disability. Apply at local DHS Office for medical assistance benefits. 

How to Apply

Apply to your local Social Security Office, 1-800-772-1213. 

The application process includes a determination of financial eligibility (income and resources below the limits) and a determination of whether the applicant meets the age or disability standard.

Applicants will be notified of a decision in writing. If the application is denied, the applicant can pursue a several-step appeal process by requesting appeals in writing. The requests must be filed within 60 days of the written decision(s). Recipients are notified in advance if SSI benefits will be terminated due to change in disability status or other reason. RI Legal Services may be able to represent individuals denied SSI benefits or who are notified of termination.

For more information, contact the Social Security Administration or the RI Office of Rehabilitative Services.

Unemployment Insurance Program

The unemployment insurance program provides eligible individuals with up to 60% of his or her weekly wage for a specified period of time.

Who Qualifies?

Workers who are unemployed and who:

  • Were employed for at least 8 weeks,
  • Are unemployed through no fault of their own,
  • Are able to work, available to work and searching for work,
    • Effective September 1, 2014, NEW Unemployment Insurance (UI) customers must post a résumé to EmployRI by the 6th consecutive week of collecting UI benefits. Failure to post a résumé within 6 weeks will cause a delay or loss of benefits.For information see the DLT Unemployment Website.
  • Meet certain earnings requirements: 
    • Either earned $9,600 in last year or  
    • Earned at least $3,200 in last year, $1,600 of which was in one 3-month period 

How to Apply

  • To apply call the UI call center at (401) 243-9100 or file the claim online.
  • Applicants need to provide their social security number and the full name, address and phone number of all employers they have worked for in the last 2 years. Applicants who are not citizens must provide their alien registration number.
  • Applicant need to be prepared to show that unemployment is not their fault. Keep handy any written notification of layoff, termination, or severance that may have been received.
  • The Department of Labor and Training has a guide to help applicants prepare the questions they may be asked when filing a new claim.  Access the guide.

How much are the weekly payments?

The amount depends on how much was earned when working. Effective July 6, 2014, the minimum weekly payment is $41.00 and maximum is $566. The beneficiary may also receive an added dependency allowance if they have children.

If child support payments are owed, a deduction may be made from the benefit check.

How long can I receive payments?

The length of time depends on how much was earned when working. For regular unemployment insurance, the longest you can collect is 26 full weeks during the year.

Note: The State Extended Benefits program and the Federal Emergency Unemployment Compensation program are no longer available.

An applicant who is denied benefit may appeal by submitting a request in writing to the Central Adjudication Unit, PO Box 20067, Cranston, RI 02920-0941.  RI Legal Services 1-800-662-5034, may be able to provide assistance with an appeal.

For more information, go to the Department of Labor and Training website.

FOOD ASSISTANCE

Free / Reduced School Meals

Provides breakfast and lunch to school aged children at no or reduced cost.

Who Qualifies?

  • School-aged children through grade 12 whose families meet income guidelines
  • No requirement to document citizenship or immigrant status

Income and Resource Limits

There is no resource test.  Depending on income, the child receives a free or reduced price meal.  Children whose families receive SNAPbenefits orRI Works are eligible for free meals.

How to Apply

Families receive an application at the beginning of the school year that is returned to the school.  A family can apply at any time during the school year if income changes.  If the application is denied, the applicant can request a hearing by contacting the person listed on the program application.

Income Guidelines for School Meals

(School Year 2013-2014)

Family Size Maximum Annual Income
 1 $21,257
 2 $28,694
 3 $36,131
 4 $43,568
 5 $51,005
 6 $58,442
 7 $65,879
 8 $73,316

*For households with more than 8 people, add $7,437 for each additional person.

(formerly Food Stamps)

The Supplemental Nutrition Assistance Program, or SNAP, provides a monthly benefit for the purchase of food items through an Electronic Benefits Transfer card (EBT). The card is used at participating supermarkets and convenience stores. The monthly amount depends on countable income and family size. The maximum amount of benefits is shown below.

Who Qualifies?

  • Parents and children.
  • Elders (age 60+) and people with disabilities.
  • Must be a citizen or eligible legal immigrant. Eligible immigrants include : Persons granted refugee or asylum status or withholding of deportation/removal, Cuban/Haitian entrant or Amerasian immigrant. Lawful Permanent Residents (LPRs) who are under age 18 or are receiving disability-related assistance are eligible. Otherwise LPR must have entered U.S. before 8/22/96 or if entered on/after after 8/22/96, must be in status for five years or more or have credit for 40 quarters of work.

Income and Resource Limits

For most households there is no resource test for SNAP benefits.  For seniors or households with a member age 60+ there is a resource test of $3,000 if the senior has income above 200% FPL.  One car per adult household member is not counted (to maximum of two).  The home in which the senior/household lives in not counted.

For most households, there is a gross income test and net income test (countable income after food stamp deductions are applied). For households with an elder or disabled member, there is no gross income test. These households may qualify for SNAP benefits even if gross income is $500 or so higher than the amount listed on the guidelines chart below.

How to Apply

Apply online or fill out a paper application and mail or bring it to the local DHS office.

Proof of income and other documentation is required. Applicants must also have an interview with a DHS worker which can be at the DHS office or by phone, at the applicant’s choice.

The SNAP paper application is the “DHS-2” which is an application for many other DHS benefits. Applicants using the DHS-2 who only want SNAP benefits can answer only those questions where the SNAP icon appears. A printable DHS-2 can be accessed online: click here for English, click here for Spanish, click here for Portuguese. (As of November, 2015 the SNAP-only application and the SNAP application for elderly are no longer available).

DHS must make a decision on a SNAP application within 30 days of the date of filing the application (the date the application is submitted on-line or signed at the DHS office). Some households are entitled to have a decision on their application and SNAP benefits provided within 7 days of their application. Households entitled to this “expedited service” are those who have gross income less than $150/month and less than $100 in resources; households with combined monthly income and resources less than monthly rent and utilities and destitute migrant or seasonal farm workers. 

Households need to renew eligibility for SNAP once a year.

Applicants denied SNAP benefits and recipients who are notified that benefits will be reduced or terminated can request a hearing within 30 days of the date on the notice.  If a hearing is requested within 10 days of the notice of benefit reduction or termination, benefits can continue until a hearing decision is reached.  If the household loses the hearing, benefits must be repaid. RI Legal Services (1-800-662-5034) may provide assistance to households who denied or terminated from SNAP.

For more information on applying for SNAP benefits contact the RI Food Stamp Outreach Project at 1-866-306-0270. 

Income Guidelines, SNAP

(as of October 2015 – September 2016)

Family Size Gross Income Limit (Monthly) Maximum SNAP Benefits (per month)*
1 $1,815 $194
2 $2,456 $357
3 $3,097 $511
4 $3,739 $649

*The amount of SNAP benefit is based on household income.  The higher the income, the lower the benefit.  The minimum benefit for a household is $16.

Summer Food Service Program

Provides free lunch and sometimes breakfast to children in low-income communities.  Meals are generally provided at a city site, such as a park. To find sites near you, refer to this 2015 listing or call 2-1-1. 

Who Qualifies?

  • Children under 18.
  • No requirement to document citizenship or immigrant status.

Income and Resource Limits 

There is no resource test or income limit.

How to Apply

Contact the United Way’s 2-1-1 to find meal sites in your community, or call the National Hunger Hotline at 1-866-3-HUNGRY or 1-877-8-HAMBRE.

Supplemental Food Program for Woman, Infants and Children (WIC)

Provides vouchers to purchase nutritionally appropriate foods and nutrition education to pregnant and post-partum women and children under age five.

Who Qualifies?

  • Pregnant women
  • Mothers with babies under 6 months old
  • Mothers who are breastfeeding
  • Babies 
  • Children under age 5 who are at nutritional risk
  • Fathers, grandparents and foster parents can also apply for WIC for children in their care
  • Citizen and immigrant information is not required

Income and Resource Limits

There is no resource test in WIC.  Income must be within the limits in the chart,  In addition, a woman or child who is receiving RIte Care is considered to have income within the limits.

How to Apply

WIC sites are located at community health centers, St. Joseph Health Center and Woman and Infants Hospital.  For more information or the nearest office contact the Department of Health, 1-800-942-7434. 

Income Guidelines, WIC

(July 1, 2015 – June 30, 2016)

Family Size* Maximum Income (Annual)
1 $21,775
2 $29,471
3 $37,167
4 $44,863
5 $52,559
6 $60,255
7 $67,951
 8 $75,647
Each Add’l Member  +  $7,696

*Pregnant woman counts as 2

Other Food Assistance

There are a number of meal sites and food pantries around the state. For more information contact the Rhode Island Community Food Bank or call 2-1-1.

HEALTH CARE

Dental Care

People receiving RIte Care/RIte Share or other Medical Assistance coverage:

  • Dental care is covered by Medical Assistance and recipients can see any provider who accepts this insurance.  Dentists in private practice may accept Medical Assistance but are not required to do so. The community health center dental clinics, St. Josephs (children only) and Samuels Dental Clinic (adults and children with disabilities) accept Medical Assistance. 
  • Children born after May 1, 2000 who receive RIte Care are enrolled in RIte Smiles, a managed care dental benefit program that assures access to dental providers.
  • View a list of providers accepting Medical Assistance. To search for a private practice in your area that may accept Medical Assistance, click on OHHS website.

People without Medical Assistance or other insurance:

Seven community health centers have eleven dental clinics serving adults and children. Patients who are uninsured pay on a sliding scale basis. For the nearest health care center providing dental care, contact the Rhode Island Health Care Association , (401) 274-1771.

In Providence, St. Joseph’s Hospital (401-456-4461) provides care to uninsured children and Samuels Sinclair Dental Center at Rhode Island Hospital (401-444-5284) provides dental care to uninsured people with disabilities (adults and children) on a sliding scale basis.

In Lincoln, the Dental Hygiene Clinic at CCRI (401-333-7470) offers cleanings, exams, x-rays and sealants for $10.00/appointment from September through May of each school year.  

 For a list of all Dental Safety Net Providers in Rhode Island, click here.

Emergency Medical Assistance

Individuals that meet the eligibility criteria for one of the Medical Assistance Programs (seniors, people with disabilities, children and parents) but who are ineligible for benefits because of immigrant status (including undocumented individuals, Lawful Permanent Residents ineligible due to the 5 year bar and other legally present immigrants who are not eligible under federal rules) may be eligible for restricted Medical Assistance coverage. Only emergency in-patient hospital services and hospital emergency room services are covered under this program. Generally the hospital will assist the person with the application which is filed with DHS.

For more information contact DHS at (401) 462-5300.

General Public Assistance (GPA) Medical

Provides limited medical coverage to individuals who are disabled longer than 30 days and unable to work.  Coverage includes doctors visits and limited types of prescriptions.  GPA recipients are entitled to free hospital care.

Who Qualifies?

  • Adults who cannot work due to a physical or mental problem that will last longer than 30 days.
  • Must be a citizen or eligible immigrant.  Eligible immigrants include : lawful permanent residents, refugees, persons granted asylum, persons granted conditional entry or paroled into the U.S. 

Income and Resource Limits

The resource limit is $400.  The home in which the person lives is not counted.  A car worth less than $4,650 and a car that is specially equipped to transport a person  with a disability is not counted.  The income limit is $327/month for an individual and $449/month for a couple.

How to Apply

Apply at the local DHS office, (401) 462-5300.  

Information from the treating physician must be provided.  A decision on GPA medical must be made within 30 days from the date of application.  If found eligible for GPA, the recipient can request “Hardship Fund” cash assistance.

GPA Medical is granted for a 6 month period and can be renewed for an additional 6 months.  After 12 months, the recipient must submit a new application.

Applicants denied GPA Medical benefits and recipients who are notified that coverage will be terminated receive written notice and have 10 days from the date on the notice to file a written request for appeal. Recipients can ask that benefits be continued until the hearing decision is reached. For more information on GPA go to the DHS website.

RI Legal Services (1-800-662-5034) may provide assistance to families who are denied benefits.

Hospital Free Care

Each hospital in Rhode Island has a “charity care program.”  The hospital may cover all or part of the bill if the applicant is unable to pay.  The income limit is 200% FPL for full coverage and up to 300% FPL for partial coverage.  Hospitals can choose to apply an asset test in determining eligibility for charity care.  The hospital should post its charity care eligibility rules. To apply for charity care, request an application from the business office of the hospital.

For more information contact the Health Information Line at 1-800-942-7434.

Income Guidelines 2014

Family Size

Annual Income –
200% FPL
(Full Coverage)

Annual Income –
300% FPL
(Partial Coverage)
1 $23,340  $35,010
2 $31,460  $47,190
3 $39,580  $59,370
4 $47,700  $71,550

 

Katie Beckett Program

Provides medical coverage through the Medical Assistance Program to children with serious disabilities so they can live with their parents instead of in an institution.

Who Qualifies?

  • Children under the age of 19 living at home but who need the level of care provided in a hospital, nursing facility or institutional facility where the estimate cost to provide care in the home is less than the cost of the institution.
  • Must be citizen or eligible immigrant. Eligible immigrants are: 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) See Immigrant Eligibility for Government Benefits (PDF) for more information. 

Income and Resource Limits

Only the child’s income and resources are counted.  Resources must be less than $4,000 and income must be less than the cost of the care in the institution.

How to Apply

For an application call the DHS Katie Beckett Social Caseworker at (401) 462-0760 or download the application and instructions here.

A decision on the application is made within 90 days. 

Children denied Katie-Beckett coverage 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 notice of benefit termination or reduction, benefits can continue until a hearing decision is reached.  

RI Legal Services (1-800-662-5034) or the Disability Law Center (401) 831-3150 may provide assistance to families who are denied benefits, receive notice of termination or have other problems with Katie Beckett Medical Assistance coverage. 

For more information about Katie Beckett coverage go to the EOHHS website. 

Medicaid – Adults 65 and older & people with disabilities

Program provides comprehensive medical coverage to seniors (age 65+) and people with permanent disabilities.  People receiving SSI benefits automatically qualify for Medical Assistance. Seniors and people with disabilities who are receiving Social Security Retirement or Disability benefits and have income/resources that exceed the SSI limits may still be eligible for Medical Assistance which has higher income and resource limits.  In addition, people with disabilities who are waiting for a decision on eligibility for SSI or Social Security Disability Insurance benefits may be eligible for Medical Assistance.

Who Qualifies?

  • 65 and older.
  • People who have a severe physical and/or mental disability that has lasted or will last longer than one year or will result in death and prevents any substantial gainful employment.
  • Must be citizen or eligible immigrant. Eligible immigrants include :  refugee or person granted asylum.  Lawful Permanent Residents 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.

Income and Resource Limits

There are two programs within the Medical Assistance Program that provide coverage for seniors and people with disabilities.  The first is called “The Low Income Aged/Disabled program.” For this program, the resource limits are $7,280 for an individual and $10,930 for a couple. The home in which the individual lives and a car used to get medical treatment are not counted.  The monthly countable income limit in 2016 is $990 for an individual and $1,335 for a couple.

The second program is called “Medically Needy.”  The resource limits and exemptions (home, car) are the same as for the Low Income Aged/Disabled program. The monthly income limit in 2016 is $867 for an individual and $908 for a couple. If the applicant has income above the Low Income Aged/Disabled limit, s/he can become eligible for Medical Assistance coverage for a six month period through the “flex test” by showing medical bills that equal the difference between income and the Medically Needy limit.

How to Apply

Apply at the local DHS office, (401) 462-5300.

For seniors, a decision is made within 30 days of the date of the application. People with disabilities (who are not receiving Social Security Disabilities Benefits) need to submit medical information from their doctor. A decision on the application is made within 90 days of the date of application.

Re-certification: Renewal of eligibility for Medical Assistance is required every 12 months.

Applicants denied Medical Assistance coverage 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) or the Disability Law Center may provide assistance to families who are denied benefits, receive notice of termination or have other problems with Medical Assistance coverage.

For more information on Medical Assistance see the EOHHS website.

MEDICAID – ADULTS AGE 19 – 64

(Effective January 1, 2014)

The Medicaid Program provides comprehensive medical coverage to
low-income adults age 19 – 64 who do not have children in their care.   

Income must be less than 138% of the federal poverty level
which is $15,856 for a single adult.  There is no resource test for
eligibility. 

Note for people with disabilities:  People with disabilities can
be eligible for Medicaid through this new category of coverage, if
income is within the limit.  If income is above the income limit, a
person with disabilities may be eligible for Medicaid under the current
disability category and can submit an application through the Department
of Human Services (DHS).  A person with disabilities who needs long
term services and supports also needs to apply for coverage through DHS
since these services are not covered benefits through this new
income-based category.  

The individual must be a citizen or eligible immigrant.  Eligible immigrants include : refugees, persons granted asylum, lawful permanent residents.  Refugees
and persons grants asylum are eligible immediately.  Lawful permanent
residents (LPR) who entered the U.S. after 8/22/96 must be in status for
five years before they are eligible

Individuals who are determined eligible for Medicaid will have a
choice of enrolling in one of two managed care plans, Neighborhood
Health Plan of RI or UnitedHealthcare, or can enroll in a primary care
case management program.

Individuals can apply for coverage using a web-based application
available at Healthsourceri.com, the state’s new health insurance
marketplace.  Eligibility will generally be determined by
using data about income, citizenship, immigration status and other
required information from other government agencies.  Applicants may be asked to provide paper documentation if a computer data match is not possible.

People needing help with the application can call the Contact Center at 1-855-840-4774.  The
Center is open Monday-Saturday, 8 am – 9 pm and Sunday 12 pm – 6 pm. 
Staff can answer questions while the person is completing the on-line
application or can take an application over the phone.  People who want
to meet with a person to complete the application can ask the Contact
Center for the location of a “Navigator” in their neighborhood.  Navigators
are located at community health centers and community organizations
around the state.  The Contact Center can also provide in-person
assistance.  The office is located at 70 Royal Little Drive in Providence.

NOTE:  The application can be submitted starting October
1, 2013, but coverage will not start until January 1, 2014.  The
individual will receive information from their selected health plan
sometime before mid-December, 2013.

Medical Assistance for Women with Breast Cancer

Program provides comprehensive medical coverage to women who need treatment for breast or cervical cancer or for a precancerous condition of the breast or cervix. To qualify for this medical assistance, the woman must be screened through theDepartment of Health’s Women’s Cancer Screening Program (WCSP). Women over age 40 with income less than 250% FPL who are uninsured or whose insurance does not cover screening services are eligible for the free WCSP. WCSP does not check for citizen or immigrant status. All community health centers and hospitals participate in WCSP as do many community providers. For more information or to find a local provider contact the Women’s Cancer Screening Programat (401) 222-4324. 

Women screened through WCSP who are in need of treatment can qualify for medical assistance.

Who Qualifies?

  • Under age 65.
  • Screened through the WCSP and need treatment for breast or cervical cancer or for a precancerous condition of the breast or cervix.
  • Not otherwise eligible for Medical Assistance and has no creditable health insurance.
  • Must be citizen or eligible immigrant. Eligible immigrants include :  refugee or person granted asylum. Lawful Permanent Residents (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.

Income and Resource Limits

There is no resource test. There is no separate income test: as long as the woman was income eligible for the WCSP, she is income eligible for the Medical Assistance.

How to Apply

Complete a one page application for Medical Assistance at the WCSP provider site. The provider needs to complete a Verification of Medical Need for Treatment which is attached to the application. The application is mailed to the Department of Health which transmits it to the Center for Adult Health at the Department of Human Services. A decision of eligibility must be made within 30 days from the date the application was filed. If the application is denied, the woman has 30 days to file a written appeal. For more information contact the Women’s Cancer Screening Program. 

Income Guidelines Women’s Cancer Screening Program (2015)

Family Size Monthly Income  Annual Income
1  $2,452 $29,425
2  $3,318 $39,825
3  $4,185 $50,225
4  $5,052 $60,625
5  $5,918 $71,025
6  $6,785 $81,425

Medicare Premium Payment Program

These programs pay for some of the cost of Medicare for seniors and people with disabilities who are not otherwise eligible for Medical Assistance. People receiving Medicare pay a monthly premium that is usually deducted from their Social Security check. For 2016 the monthly premium is $121.80 but most people will continue to pay the 2015 amount of $104.90. They also pay co-payments for doctor visits and a deductible for hospitalization. The types of costs covered by the Medicare Premium Assistance Program is determined by the applicant’s income level as shown in the chart below.

Who Qualifies?

  • People that have Medicare Part A (elders receiving Social Security Retirement benefits; people who have received Social Security Disability benefits for two years).
  • Must be citizen or qualified immigrant.  Eligible immigrants include :  refugee or person granted asylum.  Lawful Permanent Residents (LPRs) 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.

Income and Resource Limits

The resource limit is $7,280 for an individual and $10,930 for a couple. The home in which the person lives and a car used to get to medical treatment does not count.

*The income and resource limits for the Qualified Medicare Beneficiary Program (QMB) and the Low-Income Aged/Disabled program described here. Medical Assistance provides more comprehensive coverage, including prescriptions  MA can also pay for the Medicare premiums, co-pays and deductibles. Therefore, people will generally want to apply for Medical Assistance, and not just QMB.

How to Apply  

Apply at the local DHS office or for more information on the Medicare Premium Payment Program go to the EOHHS website.

A decision must be made within 30 days of application.  If denied, the person can file a written appeal within 30 days of the date on the notice. 

RI Legal Services (1-800-662-5034) may provide assistance to families who are denied benefits.

Monthly Income Guidelines

Medicare Premium Payment Programs (2015)

Program Individual Income Limit Couple Income Limit Coverage
Qualified Medicare Beneficiary (100% FPL) $990   $1,335 Medicare premiums, co-pays and deductibles
Specified Low Inc Beneficiary (120% FPL) $1,188 $1,602 Medicare Part B Premium
Qualifying Individual (135% FPL) $1,336.50 $1,802.25 Medicare Part B Premium (limited # of eligibles)
Qualified Disabled Working Individuals (200% FPL) $1,980 $2,670 Payment of Medicare Part A premium

Health Insurance for Families and Pregnant Women (RIte Care/RIte Share and Affordable Coverage Through Health Source RI)

Beginning January 1, 2014, families and pregnant women can enroll in health insurance coverage using an on-line application through HealthSource RI.  For families with low income, all family members may be eligible for RIte Care/Rite Share (Medicaid).  For families with moderate income, children will be eligible for Rite Care and the parent(s) may be able to enroll in coverage through HealthSource RI and receive federal and state assistance to help buy a commercial health insurance plan.  Similarly, pregnant women may be eligible for Rite Care/RIte Share if income is within the limits or for help purchasing commercial coverage.

Pregnant women, children and young adults (under age 19) and parents/caretaker relatives are eligible for comprehensive medical and dental coverage through the Medicaid program.  For medical coverage, families/individuals are enrolled in either RIte Care or RIte Share depending on whether there is access to employer sponsored health insurance coverage.  For dental coverage, children born after May 1, 2000 are enrolled in RIte Smiles, a managed care program.  Older children and adults use their Medicaid card to access dental care.

RIte Care: Recipients enroll in one of 2 managed care plans: Neighborhood Health Plan of Rhode Island or United Health Care of New England.  There is no cost for enrollment.  (Effective January 1, 2014.)

RIte Share:  Pregnant women and families in which an individual can enroll in health insurance at their job are required to enroll in that coverage if the state determines that the insurance meets certain standards.  The state pays the employee’s share of the cost (minus a required co-payment if income is above 150% FPL).  Recipients also receive a Medicaid card to cover costs and services not provided through the employer’s plan (e.g., transportation, interpreter services).

Who Qualifies?

  • Children/young adults under age 19 with income less than 266% FPL.  Child/young adult must be a citizen or eligible immigrant.  Eligible immigrants include refugees, granted asylum, lawful permanent residents (LPR) and other lawfully present statuses (e.g., applicant for asylum).

  • 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 138% FPL.  Parent/caretaker relative must be a citizen or eligible immigrant.  Eligible immigrant includes refugee, granted asylum and lawful perma