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Medicare in Rhode Island

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Medicare coverage in Rhode Island

If you’re a Medicare beneficiary in Rhode Island, you have a couple different options when it comes to your Medicare coverage. You can enroll in Original Medicare, Part A and Part B, which is the federal health-care program for people who are 65 or older, certain younger disabled individuals, and people with end-stage renal disease or Lou Gehrig’s disease.

If you want prescription drug coverage (Medicare Part D), you can also enroll in a Medicare Prescription Drug Plan for help with medication costs. Medicare Prescription Drug Plans are available through private insurance companies that are approved by Medicare. You might also have the option to buy a Medicare Supplement insurance plan, which can help pay for out-of-pocket costs under Original Medicare.

Alternatively, you can get your Medicare Part A and Part B benefits through a Medicare Advantage plan, which is also available through private insurance companies that are contracted with the Medicare program. Medicare Advantage plans must cover at least the same level of benefits as Original Medicare; however, many plans may also cover additional benefits, such as hearing, wellness programs, or prescription drugs.

As mentioned, Medicare Advantage plans and Medicare Prescription Drug Plans must have a contract with Medicare in order to offer Medicare insurance plans (such as a Medicare HMO or a Medicare Prescription Drug Plan). Depending on the terms of the contract between the plan and Medicare, not every plan is available statewide or in all service areas. In addition, the private insurance company must renew its contract with Medicare on an annual basis, meaning that plan availability in a specific service area is subject to change. Because of this, it’s important to review your coverage on an annual basis and compare Medicare plan options in your location.

By the numbers

Below is information on Medicare enrollment in Rhode Island from 2018:*

  • Rhode Island beneficiaries with Part A and/or Part B who don’t have Medicare Advantage plans: 119,791
  • Rhode Island beneficiaries with Medicare Part C (Medicare Advantage) and other health plans: 98,071
  • Total number of beneficiaries enrolled in Original Medicare or a Medicare Advantage plan: 217,862
  • Rhode Island beneficiaries enrolled in Medicare prescription drug coverage: 167,383

Medicare resources in Rhode Island

Rhode Island Medicare Savings Programs: If you’re a Rhode Island beneficiary with limited income, you may be eligible for help paying for Medicare premiums, copayments, and other out-of-pocket costs. To qualify for a Medicare Savings Program, you must meet certain income and asset requirements. Find out if you’re eligible by contacting the Rhode Island Department of Human Services.

Rhode Island State Health Insurance Counseling and Assistance Program (SHIP): Funded by the Centers for Medicare & Medicaid Services, Rhode Island SHIP has volunteers that give one-to-one counseling to beneficiaries and their families. SHIP helps Rhode Island residents better understand their Medicare benefits and deal with health insurance issues.

Source: Statistical data from the Centers for Medicare & Medicaid Services (CMS) “Medicare Enrollment Dashboard,” from the CMS Office of Enterprise Data & Analytics, February 2019.

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