Who is Eligible for Medicaid?

Learn about Medicaid eligibility requirements for individuals and families, including people with disabilities.

Basic requirements for coverage

You must live in Rhode Island to get health insurance through the Rhode Island Medicaid Program. Your eligibility for Medicaid may depend on:

your income,
the number of people in your household, or
your disability status.

Eligibility for different types of coverage

To find out if you're eligible, you must fill out an application.

Rhode Island Medicaid offers health coverage to many different populations:

Parents and caretakers living with children younger than 19 years of age
Children younger than 19 years of age
People under age 26 who aged out of foster care
Adults 19 through 64 years of age without children
People who are pregnant
Adults living with a disability
Adults who need long-term care
People already receiving Social Security Income (SSI)
Adults older than 64 years of age

There are different income and/or asset limits for each of these populations. The best way to find out if you are eligible is to fill out an application.

Coverage for Certain Special Needs

Some people make too much money to qualify for Medicaid but have certain special needs. For example:

If your 12-month postpartum coverage has ended, and you are not otherwise eligible for Medicaid, you can get coverage for a set of family planning services.
If you're living with HIV, you may get coverage to help pay for HIV medicines. Click here to learn about the Ryan White Program.
If you have Medicare, Medicaid may be able to help you pay for your Medicare premiums and other cost-sharing (like co-insurance). Click here to learn more about the Medicare Premium Payment Program.
If you are a parent or caretaker of a dependent child under age 19, Medicaid may be able to help you pay for part of your premium for a Qualified Health Plan through HealthSource RI. This is called the Parent/Caretaker Premium Assistance Program

In some cases, Medicaid can cover services related to your or a loved one’s special needs. The best way to know whether you or a loved one are eligible for Medicaid is to submit an application.

Help for People with High Medical Costs

If your income is too high for regular Medicaid, but you have high medical bills, you may be able to get Medicaid coverage through the Medically Needy pathway. The state can subtract your medical bills from your income, and if the amount left is low enough, you can get Medicaid for a 6-month period.

Help for Adults Who Need Long-Term Care

Long-term services and supports (LTSS) are for people with healthcare conditions and/or disabilities who can’t do everything needed to take care of themselves. 

For older adults and adults with medical or age-related disabilities, LTSS is focused on services to help with normal daily tasks like eating, dressing, and using the bathroom.
For adults with an intellectual or developmental disability, LTSS can include both support with activities of daily living as well as supports to help people fully participate in their communities such as employment supports and day/residential habilitation.

Click here to learn more about LTSS options.

Help for Children with Special Healthcare Needs

Medicaid's Katie Beckett Program helps kids with disabilities and complex medical needs under the age of 19 whose families have income too high for regular Medicaid eligibility. The purpose of Katie Beckett is to make sure children can get care in their homes instead of in a facility.

If your family’s income is low enough to get coverage under regular eligibility rules, Medicaid will cover the home-based services your child needs, including disability and/or complex medical needs. You only need the Katie Beckett option if your family income is too high for regular Medicaid.

Many children enrolled through Katie Beckett have health insurance from their parents’ jobs. These health insurance plans must pay first for all services that they cover. For services that the family’s commercial insurance doesn’t cover, Medicaid will provide coverage.