Out-of-Network Coverage

Most of the time, the health care services that you get must be from a provider who is in Neighborhood INTEGRITY’s network. Sometimes, you may need to get care from a provider who is not in our network. There are some exceptions as to when you can receive care from an out-of-network provider and your services will be covered. Those exceptions are:

  • Emergency or urgently needed care.
  • Kidney dialysis services received at a Medicare-certified dialysis facility when you are temporarily outside of Rhode Island.
  • Family planning services.
  • The Continuity of Care (COC) period. The COC period is for members who were receiving a treatment or seeing a provider before having coverage with Neighborhood. Even if the provider or service is not in our network, your services are covered during the COC period.
  • During a declared disaster.


Please call us at 1-844-812-6896 (TTY 711), 8 a.m. to 8 p.m., Monday – Friday. 8 a.m. to 8 p.m., 8 a.m. to 12 p.m. on Saturday. On Saturday afternoons, Sundays, and 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.

Last updated: October 25, 2023 @ 5:09 pm

H9576_ WebOON24 Approved, 10/24/2023