Overview: What is Medicaid?

Medicaid is a health insurance program. It helps people with low income pay for medical costs. The federal government sets basic rules about Medicaid that all states must follow, but each state runs its own program. For example, states have some flexibility to decide who gets Medicaid coverage and what services are covered.

Rhode Island Medicaid will pay for many different healthcare services when members have a medical need for the service.

RI Medicaid generally does not charge cost shares or co-pays for health care services. Long-term services and supports are the only kind of service where you might have cost-sharing, depending on your income.

Medicaid covers the cost of interpreter services needed for people to access any of the services listed below.

Here are examples of important services that RI Medicaid covers:

Inpatient hospitalization
Outpatient hospital services
Primary care and physician services
Lab and x-ray services
Home health services
Nursing facility services
Early and Periodic Screening, Diagnostic, and Treatment (Children’s services)
Non-emergency medical transportation
Prescription drugs
Case management
Home stabilization
Home care and personal care services (max 6 hours/week unless you qualify for LTSS)
Physical therapy
Occupational therapy
Dental services
Optometry
Behavioral health, psychology, and substance use disorder treatment

Services that are specifically available to people younger than 21:

Specialized dental services
Private duty nursing
Home-Based Therapeutic Services (HBTS)
Personal Assistance Services and Support (PASS)
Hippotherapy (also called horse or equine therapy)

Services that are available to people younger than 21 and adults who qualify for Long-Term Services and Supports (LTSS):

Personal care (amount of hours based on need)
Homemaker Services (amount of hours based on need)
Personal care and other home and community-based services provided in an Assisted Living facility
Respite Services
Other Home and Community-Based Services