Rhode Island



 

About Health Insurance in Rhode Island

Rhode Island is a guarantee issue state and has a great deal of health insurance laws to digest. We are here to help explain what your benefits can be and how to get the best plan for your needs.

Statistics

  • Total Population: 1,037,500
  • Total Uninsured Population: 121,800 (16%)
  • Typical Cost of Inpatient Hospital Visit Per Day: $2,325
  • Average State Premium for Individual Health Insurance: $344

Information provided by Kaiser Family Foundation, 2010.

The Laws in Rhode Island

The current laws in Rhode Island are based around guarantee issue plans that have to give all residents coverage no matter what their medical condition may be.  At times limitations may apply, but it is mandatory to cover pre-existing conditions with no exclusion periods.

  • Guarantee issue plans require you have at least one year of continuous creditable coverage to be eligible. Individual guarantee issue plans go through one insurer (who will remain nameless) as they are required to provide services to all Rhode Island residents. There is a 30-day open enrollment period to apply each year.
  • Newborns and adopted children are put under their parents’ individual health insurance policy for 31 days after birth or the beginning of the adoption bonding period.
  • Mentally handicapped or physically disabled adult dependents can stay on their parents’ policies past the age it usually expires or are offered a separate conversion policy in the state of Rhode Island. Once the age limit is reached, the policy holder has to give proof of incapacity within 31 days to receive benefits.

Coverage

In Rhode Island, your coverage is dependent upon the plan you have. Not all plans cover specific services and conditions, but the state has made it so all health plans include a variety of benefits, for instance diabetes treatment and post-delivery hospital stays.

Pre-Existing Conditions

  • Rhode Islanders do not have a pre-existing condition exclusion period when covered under an individual, guarantee issue plan.
  • Without a guarantee issue plan, you can choose an alternate way to exclude your pre-existing condition.
  • Blue Cross Blue Shield of Rhode Island usually uses shorter pre-existing condition exclusions or has none at all.

Rhode Island Resources

  • Medicaid: 401-462-5300
  • Blue Cross Blue Shield of Rhode Island: 401-459-1000 www.bcbsri.com
  • Rhode Island Insurance Division: www.dbr.state.ri.us/divisions/insurance