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 five 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 for Duals (HMO D-SNP), we insure Rhode Islanders who are eligible for both Medicare and Medicaid:
- Adults 21 years or older, individual incomes at or below 120 percent FPL monthly income limit $1,565; entitled to or enrolled in Medicare Part A and Part B, and may be eligible for certain Medicaid benefits.
Through our Dual CONNECT (HMO D-SNP), we insure Rhode Islanders who are eligible for both Medicare and Medicaid, and are Qualified Medicare Beneficiaries (QMBs):
- Adults 65 years or older, or 18+ with disabilities; individual monthly income limit at or below 100% FPL monthly income limit $1,304; entitled to or enrolled in Medicare Part A and Part B; and may be eligible for partial Medicaid benefits. (Medicaid benefits administered by RI Medicaid Fee-for-Service program.)
If you have questions about our ACCESS and TRUST plans, please call 1-800-459-6019 ( TTY 711).
For more information on INTEGRITY for Duals or Dual CONNECT, 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 the Centers for Medicare and Medicaid Services (CMS) determines eligibility requirements for the dual-eligible plan.
Individuals and small businesses choose our low cost plans on HealthSource RI.
We also provide health coverage for about 25,000 individuals* through Rhode Island’s health insurance exchange, HealthSource RI. Neighborhood’s 11 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:
- Two SELECT Bronze plans with Health Savings Account (HSA), offering lower monthly cost, highest cost sharing
- Two PRIMARY Silver plans (one with an HSA), offering a low monthly cost, higher cost sharing
- Five PLUS Gold plans with higher monthly costs and lower cost sharing
- Two DELUXE Platinum plans with higher monthly costs, lower cost sharing
Employers, with 2 to 50 employees, may select a plan from our Small Business Health Options Program (SHOP).
- STANDARD Bronze HSA plan
- CHOICE Silver plan
- EDGE Gold plan
- PEAK Gold plan
- PREMIER Gold plan
- PRIME Platinum plan
- PEAK Elite Gold HSA plan
- PREMIER Elite Gold plan
- PRIME Elite Platinum plan
If you have questions about any of our plans offered through HealthSourceRI, please call 1-855-321-9244.