HealthSource RI (HSRI) is the state’s health insurance marketplace where Rhode Islanders can compare affordable health plans and purchase coverage that meets their health care needs and budget. HSRI also hosts the on-line application process for both Medicaid and subsidized commercial coverage.
Individuals who are not eligible for Medicaid, Medicare, and other public health insurance coverage, and who do not have affordable coverage at work, may qualify for help purchasing a health plan and may also qualify for help paying for out-of-pocket costs.
Families and individuals with income below 400% of the federal poverty level (“FPL”) may be eligible for a tax credit from the federal government to help pay for the cost of coverage (see chart below). The tax credit can be claimed at the end of the tax year when the person files their income tax return. It can also be received in advance each month to help pay the monthly premium to enroll in coverage. This is commonly called the Advanced Premium Tax Credit or “APTC” and is typically how people use the credit.
Lawfully present immigrants are eligible to enroll in health insurance through HealthSource RI and to qualify for tax credits. This includes lawful permanent residents (people who have a “green card”) who are ineligible for Medicaid during the 5 year waiting period as well as people with Temporary Protected Status and Deferred Enforced Departure. DACA recipients are not eligible to buy coverage through HSRI.
Annual Income Guidelines for Cost-sharing Subsidies and Tax Credits (January 2020)
| Family Size
||Tax Credit Income Limit (400% FPL)
How to Apply
Families and individuals can apply for health insurance on-line at https://healthyrhode.ri.gov or by submitting a paper application which you can download at https://tinyurl.com/RI-DHS-2-2018. You can also request a paper application from a DHS office or by calling: 1-855-697-4347. Eligibility will generally be determined by using data about income, citizenship, immigration status, and other required documentation from other government agencies. Applicants will be asked to provide paper documentation if a computer data match is not possible. The first month’s premium must be paid to HealthSource RI before coverage starts. Payments can be made by check or electronic transfer from a bank account.
There is an open enrollment period for each year. The next open enrollment period will start November 2020 for enrollment for coverage for calendar year 2021. Generally, people cannot enroll outside of the open enrollment period. However, if they have a “qualifying event” such as a birth of a child or marriage, loss of a health insurance due to loss of employment, they can enroll in coverage through HealthSource RI through a special enrollment period.
People needing help with the application can call the Contact Center at 1-855-840-4774. People who want to work with a person in their community can find a “Navigator” in their neighborhood. You can find a Navigator at https://healthyrhode.ri.gov/HIXWebI3/DisplayNavigatorSearch or call 2-1-1. You can also contact RIPIN for assistance (401-270-0101).
Special Note for Parents with Children Enrolled In RIte Care:
For parents with children enrolled in RIte Care, whose income is between 138% FPL and 175% FPL, there is additional state assistance (The State Premium Assistance Program) to help parents pay their premium.
Parents must enroll in a “silver level” plan through HealthSource RI to quality for this extra assistance.
Annual Income Limit and Amount of Monthly State Premium Assistance Available (January 2020)
|Family Size||For Income Less Than 150% FPL||Monthly Reimbursement||For Income Between 150-175% FPL||Monthly Reimbursement|