Are you turning 65 in 2020? Then it’s time to look into Medicare plans in Rhode Island, and there are many plans and coverage levels to consider.
Medicare Rhode Island is divided into several parts that cover a range of healthcare needs and budgets. Medicare plans in Rhode Island fall into one of the following parts:
Also called original Medicare, Part A is the most basic healthcare coverage provided by the federal government. Many people will qualify for premium-free Part A coverage, and if you’re eligible for Social Security benefits, you’ll automatically be enrolled in Part A when you turn 65.
Part A covers:
- inpatient hospital care
- very limited Skilled Nursing Facility (SNF) care
- limited, part-time home healthcare
- hospice care
The second part of original Medicare Rhode Island, Part B provides additional basic medical coverage for seniors with original Medicare.
Part B coverage includes:
- appointments with medical professionals
- outpatient hospital care
- medical equipment, such as wheelchairs or oxygen tanks
- preventive services such as screenings
- mental health services
- lab tests
Medicare Advantage plans in Rhode Island, or Part C plans, are offered by private health insurance carriers. While these plans are approved by Medicare, they’re not run by the federal government. Part C benefits include:
- original Medicare coverage, including all hospital and medical coverage
- prescription drug coverage
- additional healthcare services that may include vision, dental, hearing, or wellness services
Prescription drug plans, or Part D Medicare plans in Rhode Island, are also provided by private insurance carriers. These plans can be used to supplement your original Medicare Rhode Island coverage and reduce your out-of-pocket medication expenses.
Each drug plan has a list of prescription drugs they’ll cover. You will need to carefully read this list to see if your medications are covered by the plan.
Medicare Supplement (Medigap)plans in Rhode Island are available through private insurance carriers. They help cover some costs of your care like co-pays and coinsurance, since original Medicare does not have an out-of-pocket limit. These plans are only available with original Medicare. You may not purchase both a Medicare Advantage plan and a Medigap plan.
While original Medicare is provided by the federal government and offers the same coverage across the country, Medicare Advantage plans are unique to each state and even each county.
You can search for Medicare Advantage plans in Rhode Island to find plans that are offered in your county. These are the carriers of Medicare Advantage plans in Rhode Island:
- Blue Cross Blue Shield
- Neighborhood Health Plan of Rhode Island
- Sierra Health and Life
- First Health
- PACE Rhode Island
Medicare Advantage plans in Rhode Island are all-in-one plans that let you choose exactly which services you’d like covered, and which you’d like to pay for out of pocket.
The quality of Advantage plans can vary, so before enrolling in Part C coverage, research the plan to make sure it’s the right fit for both your budget and your healthcare needs.
In order to become eligible for Medicare plans in Rhode Island, you must meet the following eligibility requirements:
- You’re over the age of 65.
- You’re a permanent resident of Rhode Island, or you’re an American citizen.
Adults under the age of 65 may also qualify for Medicare Rhode Island coverage. Adults with a permanent disability or chronic illness are eligible for Medicare plans in Rhode Island.
Have you been receiving Social Security disability benefits for 24 months? You can enroll in Medicare for more comprehensive healthcare coverage.
You will have several opportunities to enroll in Medicare; however, your initial enrollment offers the best chance to avoid penalties and higher fees.
Enroll in Medicare as soon as you’re eligible. You’ll be able to enroll in Medicare Rhode Island during your initial enrollment period, which begins three months before your 65th birthday, and ends three months after your birthday. You may be automatically enrolled in original Medicare at this time, but you can also choose to add Part D coverage to your plan.
General enrollment (January 1 to March 31) and open enrollment (October 15 to December 7)
Once this initial enrollment period has passed, you will have two times per year to reevaluate your healthcare needs, add Part D coverage to your plan, enroll in an Advantage plan, or even switch between Medicare Advantage plans in Rhode Island. These are:
- The general enrollment period, from January 1 to March 31
- The open enrollment period, from October 15 to December 7
You may also quality for a special enrollment period, if some special circumstance disrupts your healthcare coverage.
Special circumstances include:
- moving outside the range of your healthcare plan
- moving into a nursing home
- leaving a job, and losing employer healthcare coverage
- becoming eligible for Medicare based on a disability or chronic illness
When deciding what Medicare Rhode Island coverage will meet your healthcare needs, you’ll need to consider budget, location, and coverage needs.
- If you are considering a Part C plan, check with your doctor first. Most Medicare Advantage plans in Rhode Island only provide coverage to certain in-network physicians.
- If you’re considering Part C or D Medicare plans in Rhode Island, make a complete list of the medications you regularly take. Read the list of covered drugs in each plan you’re considering, and rule out any plans that don’t pay for your medications.
- Check each plan’s coverage area using your zip code, and rule out any plans that don’t provide coverage in your county.
When looking for more specifics on Medicare plans in Rhode Island, you can contact Medicare or your state agencies directly to seek counseling or clarify coverage.
- Rhode Island Office of Healthy Aging: Get Medicare counseling with a SHIP counsellor, learn about the Medicare Savings Program, and see if you may be eligible for subsidized healthcare coverage. 888-884-8721.
- Point: You can access information, advice, and assistance applying in programs by calling Point. 401-462-4444.
- Executive Office of Health & Human Services, Elders: This office provides support to older adults, assists in long-term care placements, and administers the Medicare Premium Payment Program. 401-462-5274.
You should now have a short list of drug or Medicare Advantage plans in Rhode Island that you’re considering. These are your next steps to begin enrolling:
- Calculate when your initial enrollment period will begin, and plan to enroll in Medicare before your 65th birthday. Delaying enrollment will delay the plan start date, and you may have a gap in your coverage.
- Use the Medicare Star Ratings to pick a plan that’s been rated highly by other plan members.
- Contact one of the state agencies for help with the enrollment process for Medicare Rhode Island.
The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.