Our Members

Neighborhood is a safety net health plan.

We insure about 60 percent of the vulnerable populations—with low income, disabilities or other special needs—in Rhode Island. We are committed to a culture of caring and ensuring our members have access to the medical treatment and community services necessary within a culturally and linguistically appropriate setting to achieve health and wellbeing.

Through our ACCESS Medicaid Plan, we insure*:

    • Children up to 19 years old with low to moderate income, lawfully present in Rhode Island less than 5 years
    • Parents with low to moderate income and lawfully present in Rhode Island at least 5 years
    • Pregnant women with low to moderate income
    • Children up to 21 years of age with special health care needs
    • All children up to age 18 years old in the Rhode Island foster care system

Through our TRUST Medicaid Plan, we insure*:

    • Adults 21 years or older, receiving supplemental security income or low income, and not enrolled in Medicare or receiving long-term services and supports (LTSS)
    • Adults 19 to 64 years old, with no dependents or pregnant at time of enrollment, low income and not eligible for Medicaid or Medicare Part A and Part B; must be have lawfully resided in Rhode Island for at least 5 years

Through our INTEGRITY Medicare-Medicaid Plan (MMP)*, we insure dually eligible (Medicare/Medicaid) beneficiaries:

    • Adults 21 years or older, permanent Rhode Island resident, entitled to Medicare Part A, enrolled in Medicare Part B, and eligible to enroll in Medicare Part D; and are receiving full Medicaid benefits

If you have questions about our ACCESS and TRUST plans, please call 1-800-459-6019 ( TTY 711).

For more information on INTEGRITY (Medicare-Medicaid Plan), please call 1-844-812-6896 (TTY 711).

*Neighborhood Health Plan of Rhode Island does not establish eligibility requirements. The State of Rhode Island defines eligibility for Medicaid plans and Centers for Medicare and Medicaid Services (CMS) determines eligibility requirements for the Medicare-Medicaid Plan (MMP).

Individuals and small businesses choose our low cost plans on HealthSourceRI.

We also provide health coverage for about 25,000 individuals* through Rhode Island’s health insurance exchange, HealthSourceRI. Neighborhood’s eleven plans are the lowest cost plans available through Rhode Island’s health insurance exchange.

During Open Enrollment each November and December or when a qualifying event occurs—you lose your job, your income changes–Individuals are able to select one of the commercial plans below.

For individuals and families selecting their own insurance, Neighborhood offers:

    • INNOVATION Bronze plan, offering lower monthly cost, higher cost sharing
    • ECONOMY Bronze plan with Health Savings Account (HSA), offering the lowest monthly cost, highest cost sharing
    • COMMUNITY Silver plan with Health Savings Account (HSA) base only, offering a low monthly cost and high cost sharing
    • VALUE Silver plan with highest monthly cost and low cost sharing
    • PLUS Gold plan with high monthly cost and lower cost sharing
    • ESSENTIAL Gold plan with higher monthly cost, lower cost sharing

Employers, with 2 to 50 employees, may select a plan from our Small Business Health Options Program (SHOP).

    • STANDARD Bronze plan with Health Savings Account (HSA), offering the lowest monthly cost, highest cost sharing
    • EDGE Gold plan
    • CHOICE Silver plan with high monthly cost and low cost sharing
    • PREMIER Gold plan with higher monthly cost and lower cost sharing
    • PRIME Platinum plan with highest monthly cost and lowest cost sharing

If you have questions about any of our plans offered through HealthSourceRI, please call 1-855-321-9244.

 

  1. *Number of members as of January 2019 with 23,776 through the individual plans and 1,190 through the SHOP plans.