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Guide to Rhode Island Medicare

Rhode Island may be the smallest US state, but there are still close to 220,000 beneficiaries enrolled in Medicare. Your health is vastly different from other enrollees, and it’s crucial you enroll in a plan that fits your unique needs and budget. Fortunately, Medicare Plan Finder makes understanding Rhode Island Medicare Advantage plans, Medicare Supplement plans, and prescription drug coverage that much easier.

Click below to learn more about Rhode Island Medicare:

Rhode Island Medicare Eligibility

Most people become eligible for Medicare when they turn 65, but that is not the only way you can qualify. If you have ESRD (end-stand renal disease) or ALS (Lou Gehrig’s Disease), you may qualify regardless of your age. Lastly, if you have been receiving SSDI (Social Security Disability Insurance), you will be automatically enrolled in Medicare during your 25th-month of SSDI benefits. If you have a question regarding your eligibility, fill out this form or give us a call at 833-438-3676.

Turning 65 Medicare

What Does Rhode Island Medicare Cover?

Your Medicare journey must first start with Original Medicare (Part A and Part B), which is regulated by the federal government and is the same regardless of which state you live in. Part A is hospital coverage, and Part B is medical coverage. Part A covers things like hospital stays, nursing homes, hospice, and home health services whereas Part B covers ambulance travel, medical equipment, mental health, partial hospitalization, lab tests, and x-rays.

Types of Rhode Island Medicare Plans

Once you are enrolled in Original Medicare, you can enroll in a Part D, Medicare Advantage, or Medicare Supplement plan. You should consider enrolling in a plan beyond Original Medicare that offers prescription drug coverage to avoid a late-enrollment fee down the road. You can enroll in one of the following combinations:

  • Medicare Advantage plan with prescription drug coverage
  • Original Medicare + Part D plan
  • Original Medicare + Medicare Supplement plan
  • Original Medicare + Medicare Supplement plan + Part D plan

Rhode Island Medicare Supplement Plans

Medicare Supplements work alongside Original Medicare and add financial benefits like help paying for your copayments, coinsurance, and deductibles. These benefits are generally the same no matter which carrier you enroll with. Medicare Supplements are broken down into ten standardized plans (A, B, C, D, F, G, K, L, M, and N), and each letter will offer different coverage at a different price depending on carrier, zip code, age, gender, and tobacco use. Plus, most plans are “guaranteed life,” which means that as long as you pay your premium on time, you should not be canceled from your plan if a new health condition develops.

If you would rather pay a small annual deductible for financial protection in the event of unforeseen health expenses, Medicare Supplements may be the best plan for you. Depending on which plan you choose, coverage can include financial assistance with Part A coinsurance and hospital costs, Part B coinsurance and copayments, blood work copays (up to three pints), hospice coinsurance and copayments, skilled nursing facility coinsurance, Part A deductible, Part B deductible, Part B excess charges, and foreign emergency travel. To learn about Medicare Supplement plans in your area, click here.

Rhode Island Medicare Advantage Plans

If you are looking for additional supplemental benefits beyond Original Medicare instead of financial benefits, a Medicare Advantage (MA) plan may be the way to go. MA plans offer additional benefits like prescription drug coverage, hearing, vision, and dental coverage, OTC pharmacy allowances, non-emergency transportation, group fitness classes like SilverSneakers, and so much more! These plans continue to grow in popularity each and every year. In fact, more than 37% of Medicare beneficiaries in Rhode Island are taking advantage of these amazing benefits. If you’re interested in learning about Medicare Advantage plans in your area, give us a call 833-438-3676 or fill out this form.

medicare advantage | Medicare Plan Finder

Rhode Island Medicare Cost

The cost for Original Medicare is the same across the country. You will not have to pay a premium for Part A if you were employed and paid Medicare taxes for at least 39 quarters. If you only paid Medicare taxes for 30-39 quarters, you’ll pay $240/month in 2019. If you did not pay Medicare taxes for at least 30 quarters, you’ll pay $437/month in 2019.

Most beneficiaries will pay $135.50/month in 2019 for your Part B premium, but this can change based on your income. Pricing for Medicare Advantage, Medicare Supplements, and Part D  plans will vary based on carrier, locations, and benefits since they are sold through private insurance companies.

Can I have Medicare and Medicaid in Rhode Island?

Medicare and Medicaid are two separate programs regulated by the government. It is possible to be eligible for both programs, but they were designed for two different audiences. Medicare is intended for older adults over the age of 65 and people with certain disabilities while Medicaid is intended for low-income families and individuals.

If you qualify for both programs, you will be eligible for a Dual Eligible Special Needs Plan (DSNP). A DSNP is a special type of Medicare Advantage plan that can get you extra benefits at lower costs. If you qualify for a DSNP, you will likely have a Special Enrollment Period too. A SEP allows you to enroll in the plan you need as soon as possible, without the need to wait until the Annual Enrollment Period. Plus, you may be eligible for other programs like Medicare's prescription drug program Extra Help, or other Medicare Savings Programs. To find out if you are eligible, contact one of our licensed agents by filling out this form or call us at 833-438-3676.

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Senior Resources on Rhode Island

The Rhode Island Division of Elderly Affairs offers programs that provide resources for seniors, family members, and caregivers. These programs can include:

Case Management: The Case Management Program helps provide assessment and care planning to older adults who wish to remain at home as long as possible.

Nutrition Services: The Nutrition Service Program provides nutritional lunches five days a week to more than 75 meal sites. Seniors can donate for the meal, but no one is denied a free meal. Transportation can be provided to the nearest meal site.

Heating Assistance: The Heating Assistance Program helps cover heating costs to seniors who meet certain household size and income guidelines.

Home and Community Care Services: The Home and Community Care Services Program provides innovative options that help seniors remain in the community and avoid premature institutionalization. These options help seniors and caregivers with medical, environmental, and social needs.

Legal Assistance: The Legal Assistance Program helps older adults with legal issues including age discrimination, utilities, abuse, guardianship defense, Social Security, Medicaid, and Medicare.

Ombudsman: The Ombudsman Program helps resolve issues from those who are living in long-term settings like nursing homes or assisted living facilities. This program helps educate residents on their rights and advocate for those who may not be able to.

How to Sign Up for Rhode Island Medicare

You can apply for Rhode Island Medicare through Social Security. There are three main ways to apply. You can go to www.SocialSecurity.gov, call 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday from 7 AM to 7 PM, or apply in person at your local Social Security office. If you are interested in enrolling a Medicare Advantage, Medicare Supplement, or Part D plan, we can help! Fill out this form or give us a call at 833-438-3676.

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