Benefits

With Neighborhood INTEGRITY, you get all the benefits you are receiving from Medicare, Medicare Part D and Rhode Island Medicaid through one plan. Certain Medicaid benefits will still be covered through Rhode Island Medicaid, such as your dental and transportation services. We can help you access those services.

For a full list of benefits, please see your Member Handbook on the Member Materials for a complete listing of covered services, exclusions, and prior authorization rules. 

2017 Benefits

2017 Benefits

  Medical Benefits*  Member Copay
  Hospitalization – medical and behavioral health   $0
  Skilled Nursing Facility  - 3 day hospitalization stay not required    $0
  Emergency Care in the US  $0
  Provider’s Visits  $0
  Annual Physical  $0
  Urgent Care  $0
  MRI, CT Scans, Labs  $0
  Durable Medical Equipment  $0
  Outpatient Behavioral Health Services  $0
  Part D, Part B and Over the Counter Rx Drugs  $0
  Preventive Services  $0
  Adult Day Health Programs  $0
  Respite Services  $0
  Homemaker  $0
  Physical Therapy Evaluation & Services  $0
  Minor Environmental Modification, e.g. shower chair  $0
  Personal Emergency Response System  $0

* Prior authorization rules may apply

Transportation will be provided through LogistiCare.

Behavioral Health and Substance Abuse Treatment Services

Neighborhood INTEGRITY benefits include behavioral health and substance abuse services. Covered benefits have a $0 copay, coinsurance or deductible. Prior authorization rules may apply.

These services are managed by our partner Beacon Health Strategies, LLC.  Our shared goal is to assist you in being as healthy as you can be, both mentally and physically. We cover both inpatient and outpatient mental health and substance abuse programs designed to help diagnose and treat your condition. 

Services include: 
  • Day treatment
  • Intensive outpatient services
  • Substance abuse residential treatment
  • Methadone maintenance
  • Integrated health homes (IHH) 
  • Mental health psychiatric rehabilitation residence (MHPRR)
  • Assertive community treatment (ACT); and
  • Psychiatric rehabilitation day programs.

Please contact Beacon Health Strategies directly at 1-800-215-0058 (TDD/TTY 1-866-727-9441) for more information on these services.  

Long-Term Services and Supports (LTSS)

If eligible for Long Term Services and Supports*, Neighborhood INTEGRITY provides coverage for:  

  • Skilled nursing services
  • Meals on Wheels
  • Ramps 
  • Assisted Living
  • RIte@Home shared living
  • Nursing Home custodial care. 

You may also be interested in the Personal Choice program. This program allows you to be your own boss in hiring personal care assistants and paying for the services that will help you to stay at home or in the community.

Please refer to Member Handbook for a complete listing of services. 

*Note: Members receiving Long Term Services and Supports (LTSS) may have a patient share responsibility. Please contact the Long Term Care Office (LTC) of the Rhode Island Executive Office of Health and Human Services (EOHSS) for more information on whether patient share applies to you.

Limitations and restrictions may apply. For more information, call  Neighborhood INTEGRITY Member Services or read the Member Handbook.

Have Questions?

Have questions?

Please call us at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free. 

Neighborhood Health Plan of Rhode Island is a health plan that contracts with both Medicare and Rhode Island Medicaid to provide the benefits of both programs to enrollees.

This information is available for free in other languages. Please call our Member Services at 1-844-812-6896 (TTY 711), 8 am to 8 pm, Monday – Friday; 8 am to 12 pm on Saturday. On Saturday afternoons, Sundays and federal holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free.

Esta información está disponible de forma gratuita en otros idiomas. Por favor llame a nuestro Departamento de Servicios para Miembros al 1-844-812-6896 (TTY 711) de 8 am a 8 pm, lunes-viernes; sábados de 8 am a 12 pm. Los sábados por la tarde, domingos y días festivos federales, se le pedirá que deje un mensaje. Su llamada será devuelta dentro del siguiente día laborable. La llamada es gratuita.

Estas informações estão disponíveis gratuitamente noutros idiomas. Por favor telefone para os Serviços dos Membros em 1-844-812-6896 (TTY 711), das 8 às 20 horas, de Segunda a Sexta-feira; e das 8 às 12 (meio-dia) aos Sábados. Nos Sábados à tarde, Domingos e feriados federais, poderá ser-lhe pedido que deixe uma mensagem. A sua chamada será respondida no próximo dia útil. Esta chamada é grátis.

Our plan can also give you materials in Spanish and Portuguese and in formats such as large print, braille, or audio. Call Neighborhood INTEGRITY Member Services to make a standing request to receive your materials now and in the future, in your requested language or alternate format.

Last Updated January 9, 2017, 3:54 pm

H9576_WebBenefits CMS Approved 9/13/16