Enrolled in RI Medicaid? Learn about Your Benefits

Medicaid covers a wide range of services for anyone enrolled in the program. For services to be covered, they must be medically necessary. There are no co-pays or deductibles for Medicaid services. 

Here are some examples of important covered services: 

• Inpatient and Outpatient Hospital Services
• Ambulatory surgery center services 
• Primary care and specialist physician services
• Federally Qualified Health Center services
• Dental services (not including orthodontics for adults)
• Preventive healthcare services such as family home visiting, doula, and community health worker services
• Behavioral healthcare services such as counseling/psychotherapy, residential treatment for medical health and substance use disorders, and Certified Community Behavioral Health Clinics
• Prescription drugs, including prescribed over-the-counter medicines
• Physical therapy, occupational therapy, and speech therapy
• Home health care, including skilled nursing, home health aide, durable medical equipment, and minor environmental modifications for the home.
• Adult day services
• Non-emergency medical transportation
• Personal care and homemaker
• Home Stabilization services 

More services are also available to certain groups, like children and people who need long-term services and supports (LTSS). For more information about these services, please visit the below pages. 

• Adults with Special Needs & Disabilities
• Families with children
• Older adults (Age 65 and older) 

Most Medicaid members get their services from a managed care plan. For more information about how managed care works, please visit the below pages.  

• Picking your Managed Care Organization
• Connect with your Managed Care Organization or Find a Provider

Some Medicaid members are not enrolled in managed care. In that case, Medicaid pays health care providers directly for your covered services. This is called “Fee-for-service Medicaid.” 

For example:  

• If you are on Medicare, you can choose whether to enroll in managed care or stay in Fee-for-service.
• If you have health insurance from an employer, your wraparound Medicaid will be under fee-for-service, not managed care.
• If you are enrolled through a program for working adults with disabilities, your wraparound Medicaid will be under fee-for-service, not managed care.