If you’re looking for Medicare plans in Rhode Island, you’ll want to be aware of the different options available. There are a number of affordable Medicare plans available in Rhode Island, so you can choose one that meets your needs and budget. In Rhode Island, there are more than 227,000 Medicare beneficiaries, and the range of available plans is expanding. Finding the best plan for you requires comparing the various programs.

  • Options for Medicare plans include:
  • Primary Medicare (Part A and Part B)
  • Medicare Preferential
  • Part D of Medicare


To assist with additional out-of-pocket costs, you might choose to combine Original Medicare with a Medicare Supplement Plan (Medigap). Learn about your expenses, coverage, and selecting the right Medicare plan for your needs before making a decision.


What You Should Know About Medicare in Rhode Island 

Rhode Island’s typical Medicare costs Medicare Advantage monthly fees dropped by 3.86% in 2022, from $26.48 to $25.46. Rhode Island’s cheapest Part D plan is $7.40 per month.
The average cost per person For Medicare costs $9,355 on average per enrollee in Rhode Island.
A large number of students in Rhode Island In the state of Rhode Island, 131,085 people are covered by Medicare as of 2022. A total of 92,781 people are enrolled in a Medicare Advantage Plan.
Access to Medicare Advantage Since 2021, the number of Medicare Advantage Plans in Rhode Island has increased by 26.90%. In 2022, there will be 33 Rhode Island Medicare Advantage Plans available, up from 26 in 2021.

Who is Eligible for Medicare in Rhode Island?

You must fulfill certain eligibility conditions in order to be eligible for Medicare. You must first be a citizen or legal resident of the United States. Additionally, you must have a disability and have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months or be at least 65 years old. If you suffer from end-stage renal disease (ESRD), Lou Gehrig’s illness, or amyotrophic lateral sclerosis (ALS), you could be able to get Medicare at a younger age.

How does Rhode Island’s Medicare application process work?

You will automatically be enrolled in Medicare if you begin collecting Social Security or Railroad Retirement Board (RRB) payments at least four months before you turn 65. Otherwise, you must submit an online application or get in touch with your neighborhood Social Security office. Within the following timeframes, you can sign up for Medicare.


First-time enrolment Three months before and three months after your 65th birthday is the beginning and conclusion of your Initial Enrollment Period (IEP). During this time, you can enroll if you have never had Medicare. You could alter your plan even if you enrolled in Medicare when you were younger.
Enrollment in general In case you missed your IEP, select this enrollment period. The General Enrollment Period (GEP) for Medicare runs from January 1 to March 31. You have the option of selecting Part D, Medicare Advantage, Medigap, or Original Medicare.
Medicare Advantage enrollment is now available From January 1 to March 31, you have the ability to make adjustments to your Medicare Part C, generally known as Medicare Advantage.
Open Registration Every year, from October 15 to December 7, you can enroll, change plans, or discontinue your coverage. 
Periods for Special Enrollment (SEPs) If you lose coverage or your eligibility changes outside the typical enrollment periods, you might be eligible for a SEP.


Expert Tips for Enrolling in Medicare in Rhode Island 

Watch out for late fees If you don’t sign up for Medicare A, B, and Part D when you’re eligible, you’ll pay a penalty. You must have acceptable coverage through group health insurance or the U.S. Department of Veterans Affairs to avoid late enrollment fees (VA). Only if you are ineligible for premium-free coverage and fail to enroll in a plan when you first become eligible for it, will you be subject to a Medicare Part A penalty.
Make the proper plan Be careful to consider your coverage area, the providers you visit, and your overall healthcare requirements. Verify sure the health care providers you use and prefer are included in the network of the plan you select. Examine your insurance coverage before traveling to specialty clinics that are located outside of your state because of a medical condition. Only plans that are specific to your coverage area should be considered when searching. If you travel frequently, you might desire a plan with a wider network of coverage and acceptance outside of Rhode Island.
Don’t put things off Waiting till the last minute puts you at risk of missing anything crucial. Know the deadlines and enrollment dates. A smart time to start comparing plans, enrolling in classes, and getting ready is three months before your qualifying month.
Know your prescription drugs and pharmacy Make sure you have a list of the medications you use and know which pharmacy you will be utilizing before thinking about prescription drug coverage. You can use resources on Medicare.gov or through registered agents to find out which plan best covers your drug costs and whether your pharmacy will be in-network. Although you would think that all prescription drug plans (PDPs) are the same, each one has unique formularies and network suppliers.
Ask if you’re unsure Never hesitate to seek assistance. Pose inquiries. Speak with the Social Security Administration (SSA) or authorized insurance brokers in your area. Use the resources offered when you have queries.


Medicare Plans in Rhode Island

For American citizens or green card holders who are at least 65 years old, Rhode Island offers a number of Medicare programs. If you are under 65, have ESRD, ALS, or have been disabled for at least twenty – four months while receiving SSDI, you are eligible.


Medigap Standardized Medigap policies are offered by private insurance firms. Plans are made to fill in the gaps in coverage left by Original Medicare regarding cost.
Original Medicare Two components comprise the coverage: Part A hospital and Part B medical insurance. Hospital, home health, hospice, and skilled nursing care facilities are covered by Medicare Part A. Doctor’s appointments,  diagnostic testing, urgent care, outpatient services, lab work, preventative care, and medical supplies are all covered in Part B. It may also pay for some prescriptions that must be provided in a clinic or other settings and cannot be taken at home.
Medicare Part D When you add Part D to Original Medicare or Medicare Advantage, you get prescription medication coverage. Private insurance providers provide the plans, but Medicare controls them.
Advantageous Medicare (Part C or MA) Original Medicare can be replaced by Medicare Advantage plans sold by private insurance providers. Many programs include medicines and give you more coverage than Original Medicare. They might also cover the cost of transportation to doctor’s appointments, vision, dental work, and hearing care.


medicare advantage plans in rhode island

Medicare Advantage Plans

Part A (hospital insurance) and Part B (basic coverage for Medicare recipients) make up Original Medicare (medical insurance). Here are some specifics regarding Original Medicare:

  • Part A
  • Part B


Part A

Home Health, Hospital, hospice, and skilled nursing care facilities are covered by Medicare Part A. You are responsible for paying the remaining copays, deductibles, coinsurance, and out-of-pocket expenses after Part A pays 80% of your medical expenses. If you or your spouse have paid the required Medicare tax, Part A is typically premium-free. You might spend up to $499 a month for Part A if you did not satisfy the requirement.

Part B

Part B includes coverage for outpatient treatment, emergency services, lab work, emergency services, diagnostic tests, and medical supplies. It may also pay for some prescriptions that must be provided in a clinic or other settings and cannot be taken at home. The cost of the Part B premium, which is dependent on the Income Related Monthly Adjustment Amount (IRMAA), is typical $170.10 each month. After satisfying a $233 deductible per year, you will be accountable for 20% of your medical expenses in 2022.

Whom Original Medicare is suitable for

If you want more freedom, Original Medicare is a fantastic choice. It covers a large portion of the country. If you have a number of medical issues, you might wish to combine Medicare and Medigap. Enrolling in a stand-alone medication plan is crucial because Original Medicare does not cover prescriptions. The out-of-pocket expense is a disadvantage of the plan if it isn’t combined with a Medigap.

Rhode Island’s Original Medicare

Part A premium is free on the other hand for Standard Part B premium you have to pay $170.10 per month.

  • 80% of the majority of medical bills are covered
  • You are responsible for the remaining 20% of expenditures, with no yearly cap on your out-of-pocket spending.
  • To assist cover your portion of expenses, you can purchase Medicare Supplement Insurance Medigap coverage.
  • You can enroll in a separate Drug plan if you need prescription drug coverage (Part D).
  • Can use any Medicare-accepting medical facility or doctor nationwide.


Medicare Advantage Insurance Companies of Rhode Island

Medicare Advantage Plans, commonly known as Part C, are an alternative to Original Medicare. They provide the same coverage as Part A and Part B but frequently include extra benefits. Programs for Medicare Advantage in Rhode Island have networks and might only be accessible in specific regions of the state. Plan choices are determined by ZIP code. You are often responsible for copayments, deductibles, and out-of-pocket maximums under these plans. Plans, however, might begin with a $0 premium and increase from there. Rhode Island’s typical premium is $25.46 per month in 2022. There are four different types of plans in the Rhode Island Medicare Advantage Program:

  • Health maintenance organization (HMO)
  • Preferred provider organization (PPO)
  • Private fee-for-service (PFFS)
  • Special needs plans (SNPs)


Health maintenance organization (HMO)

Except in cases of medical emergencies, HMO plans typically only cover services from providers who are in their network. Typically, you need a primary care physician (PCP) who can recommend you to specialists. The majority of HMO plans cover prescription drugs.

Preferred provider organization (PPO)

PPOs feature a network of medical facilities and providers where you can receive treatment at a lower rate. Although your care will cost more if you use out-of-network providers, you can. In most cases, you can acquire recommendations to see specialists or seek treatment without a primary care physician. Prescription drug coverage is typically included with PPO policies.

Private fee-for-service (PFFS)

You can use any Medicare-approved provider with PFFS insurance. Some PFFS plans feature provider networks where you can access less expensive medical care. In PFFS plans, you can consult experts without a referral, but not all prescription medications are always covered.

Special needs plans (SNPs)

Beneficiaries with specific diseases or features are eligible for SNPs. These plans adapt benefits and providers according to the particular needs of the population they serve. Usually, you are limited to the network of doctors and hospitals covered by the plan, need a primary care physician, and must ask for referrals to specialists. All SNP plans offer prescription medicine coverage.

And aligns with your priorities in terms of costs, provider options, and accessibility to the one that you can enroll in. In 2022, 33 plans will be offered in Rhode Island. In Rhode Island, Medicare Advantage has become more and more well-liked.


Who is Ideal for Medicare Advantage Plan?

If you have a limited income or are in a healthy life and don’t want to overpay for the care you don’t use much, this type of plan is appropriate for you. The convenience of using just one card and the added benefits included in the package can be tempting. 

You must be registered in both Medicare Parts A and B in order to be eligible. You have to ask yourself  what to Consider Before Comparing Medicare Plans? The main drawbacks of Medicare Advantage Plans are a constrained selection of providers and service locations. Before undergoing some procedures, prior approvals and referrals could also be required.

Rhode Island Medicare Advantage Insurance Companies

Company Name Medicare rating Better Business Bureau (BBB) rating A.M. Best rating National Committee for Quality Assurance (NCQA) rating J.D. Power ranking
UNITEDHEALTHCARE 4.2 stars Not rated A 3.5 to 4 stars 7 out of 10
CIGNA 4 stars Not rated A 3.5 to 4 stars 3rd out of 10
BLUE CROSS BLUE SHIELD 3.9 stars B A 3 to 3.5 stars 8th out of 10
Well Care 3.7 stars Not rated A- 2.5 to 3.5 stars Ninth out of 10
AETNA 3.9 stars A+ A 2.5 to 4.5 stars 6th out of 10


Compare Rhode Island Part C Plan Options

Plan  The cost per month Cost of annual premiums and prescription drugs Deductibles
BlueCHiP for Medicare Advanced (HMO) $0 $0 Health: $0


Drug: $200

BlueCHiP for Medicare Core (HMO) $0 $0 Health: $0


Drug: N/A

BlueCHiP for Medicare Value (HMO-POS) $0 $0 Health: $0


Drug: $0


Medicare Prescription Drug Coverage Programs

Private insurers provide Medicare Part D, but Medicare controls its availability. Both standalone PDPs and Medicare Advantage Plans provide Part D for purchase (MA-PD). Part D monthly fees in Rhode Island begin at $7.40. In Rhode Island right now, there are 21 independent PDPs. The Senior Savings Model, which decreases the cost of insulin out-of-pocket, is supported by 14 Medicare Advantage Plans and seven standalone plans that cover prescription drugs. 


Who is the Ideal for Plan D?

Even if you don’t take any medicines, PDPs are always the finest? If you don’t enroll as soon as you’re eligible, you’ll pay a fee for each month you don’t.


Compare West Virginia Part D Insurance Companies

Company Name Medicare rating Better Business Bureau (BBB) rating A.M. Best rating National Committee for Quality Assurance (NCQA) rating J.D. Power ranking
UNITEDHEALTHCARE 4.2 stars Not rated A 3.5 to 4 stars 7 out of 10
CIGNA 4 stars Not rated A 3.5 to 4 stars 3rd out of 10
BLUE CROSS BLUE SHIELD 3.9 stars B A 3 to 3.5 stars 8th out of 10
WELL CARE 3.7 stars Not rated A- 2.5 to 3.5 stars Ninth out of 10
AETNA 3.9 stars A+ A 2.5 to 4.5 stars 6th out of 10


Compare Rhode Island Part D Plan Options

Plan  The cost per month Cost of annual premiums and prescription drugs Deductibles
Wellcare Value Script $13 $65 $480
SilverScript SmartRx (PDP) $7.40 $37.00 $480
Humana Walmart Value RX $22.70 $113.50 $480


Health Insurance Plans for Medicare Supplements

Standardized Medicare supplemental health insurance plans are offered by private insurance firms. These plans are intended to fill in the coverage gaps left by Original Medicare in terms of pricing. In Rhode Island, ten standardized lesson plans are identified by various alphabet letters (A, B, C, D, F, G, K, L, M, and N). Only people who were eligible for Medicare before January 1, 2020, are eligible for Plans C and F. In Providence, the cost of a Plan G for a 65-year-old nonsmoking female range from $163 to $215 each month. The $233 Part B deductible is also your responsibility.


Who is the Ideal Medigap Plan?

If you regularly use your benefits, don’t want to be limited to a small coverage region, and prefer to pick your own provider, Medigap may be a suitable option for you. If you cannot afford the monthly premium and want the additional benefits offered by Medicare Advantage, such as having the PDP, vision, dental, and hearing services covered, you shouldn’t choose a supplement. Check to see whether the company offers additional savings for having people who reside in your household or for nonsmokers if you are thinking about buying a supplement.

Compare Rhode Island Medigap Plan Options

Plan premiums for each month Coinsurance/Copays Deductibles Plan advantages
Plan G $123 to $347 $0 Hospital costs nothing (Part A)

$333 for medical (Part B)

  • Professional nursing facility
  • Deductible in Part A and extra fees in Part B
  • Travel emergency elsewhere
Plan F $132 to $362 $0 Hospital with no cost (Part A)

Zero dollars for medical (Part B)

  • Professional nursing facility
  • Deductibles for parts A and B
  • Excess charges for Part B
  • Travel emergency abroad
Plan N $85 to $267 With certain $20 and $50 copays, generally your cost for qualified Part B services is zero. $0 hospital (Part A)

$233 for health (Part B)

  • Skilled nursing facility
  • Foreign travel emergency
  • Part A deductible

Medicare Cost in Rhode Island

Medicare Advantage Plans In 2022, a Medicare Advantage Plan in Rhode Island will cost an average of $25.46 per month. Some plans have $0 premiums at the outset.
Part D plans The cheapest premium per month starts at $7.40.
Original Medicare Monthly Part A premiums might be anywhere from $0 to $499. 

Each benefit period’s Medicare Part A hospital deductible is $1,556. Most people pay the usual $170.10 monthly premium for Part B. The Part B deductible is $233.

Medigap plans Cost of a Plan G for a nonsmoking female 65 years old in Providence ranges from $123 to $347.

Tips from experts on contrasting Medicare plans

  • Premiums
  • Copay/coinsurance
  • Deductible
  • Coverage area
  • Benefits
  • Out-of-pocket cost
  • Star rating
  • Provider choice



Regardless of the care you receive, this is the monthly cost of your plan. Although some plans have $0 premiums or assist with your Part B payment, you could need to pay your plan’s premium in addition to the Medicare Part B premium.


You pay a copay as your portion of the price for a service, like a doctor’s visit or prescription medication. In most cases, the cost is fixed. 

Following the payment of deductibles, you will be responsible for a portion of the cost of a service, such as 20%.


The sum you must pay out-of-pocket before your insurance plan begins to contribute to the cost is known as your deductible. Medicare Advantage Plans determine their deductibles, which are only subject to change on January 1 of each year.

Coverage area

The precise geographic area that is covered by your plan. Original Medicare covers a vast geographic area. It is usable everywhere in the United States and its territories. A Medicare Advantage Plan can have stricter limitations. In some cases, the coverage area is limited to a particular state or ZIP code.


Benefits of what your plan includes. Benefits are the parts of your program that cover your medical expenses. For instance: Dental insurance is an added benefit provided by a Medicare Advantage Plan.

Out-of-pocket cost

The highest you might have to pay for your Medicare-covered benefits in a year is the out-of-pocket maximum dollar amount included with Medicare Advantage Plans. Your maximum out-of-pocket value does not include costs for non-covered or partially covered medical services and supplies, such as dental, vision, and hearing coverage. There is no cap on how much you will have to spend if you have Original Medicare and do not have a Medigap policy to cover out-of-pocket expenses.

Star rating

Evaluates the effectiveness of PDP and Medicare Advantage plans. This technique is used by Medicare to rate factors such as medical treatment quality and customer satisfaction. The range is from 1 to 5, where one is the lowest and five is the highest.

Provider choice

When you select the service provider you want to use. It may occasionally be advantageous to select a provider network and visit particular providers. Discounted prices may be available for certain provider-choice plans. The provider has chosen to take advantage of in-network specials.


Rhode Island’s Medicare Resources

Making Medicare decisions might occasionally feel daunting. Utilizing the resources and equipment Rhode Island has to offer is a wonderful idea. The organizations employ individuals who are familiar with state-specific initiatives. Most of the services provided are gratuitous. For instance, the Senior Medicare Patrol program run by the Rhode Island Office of Healthy Aging can assist you in understanding Medicare and prevent theft and identity fraud by providing trained volunteers. Never be reluctant to inquire. Use these resources to get started with Rhode Island Medicare:

Organization Way of getting help Phone Number Website Link
Disability Rights Rhode Island Provides legal assistance to help Rhode Islanders of all abilities pursue full societal inclusion and exercise their civil and human rights. (401) 831-3150 Website
Rhode Island Division of Insurance  Defends your interests and assists in making selections regarding private insurance and Medicare plans. It can also provide you with information on the policies and procedures of insurance providers. (401) 462-9520 Website
Rhode Island Office of Healthy Aging Gives older people and their careers support advocacy and various services. (401) 462-3000 Website
State of Rhode Island Department of Health  The division safeguards, promotes, and protects Rhode Islanders’ health and safety and prevents disease. Additionally, it guarantees all residents of Rhode Island, including the states for most vulnerable groups, access to high-quality healthcare services. (401) 222-5960 Website
Senior Medicare Patrol  The program aids in the prevention, detection, and reporting of instances of medical fraud. You are informed about fraud and theft by a network of qualified volunteers. (888) 884-8721 Website