Medicare plays a key role in providing health and financial security to beneficiaries residing in Rhode Island. With more than 223,300 Rhode Island beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Rhode Island. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Rhode Island?

Medicare covers most Rhode Island residents who are 65 or older, and it also covers disabled Rhode Island residents. In general, Medicare enrollment in Rhode Island works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Rhode Island Medicare Enrollments

116,695

Original Medicare Plans
(Part A and B)

106,691

Medicare Advantage & Other Health Plans

73,267

Stand-alone Medicare
Part D (Drug plans)

223,386

Total Medicare Beneficiaries
in Rhode Island

Rhode Island Medicare Advantage Plans (Part C)

More than 46% of Rhode Island Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Rhode Island who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 21 Medicare Advantage plans are available in Rhode Island. The average monthly Medicare Advantage premium changed from $35.83 in 2019 to $24.76 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Rhode Island. Out of Rhode Island’s five counties, four of them have 19 Medicare Advantage plans available. The fifth county, Kent County has 18 plans available.

According to the Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 106,691 beneficiaries enrolled in Medicare Advantage and other plans in Rhode Island. More than 46% of Rhode Island Medicare beneficiaries were enrolled in a private Medicare Advantage plan in 2019. 100% of people with Medicare have access to a Medicare Advantage plan.

Rhode Island Medicare Supplement (Medigap) Insurance Plans

Rhode Island ensures access to Medigap plans for people under age 65 who are eligible for Medicare due to a disability.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

There are two initial times to enroll in a Medigap plan before and after you turn 65:

  • 6 months prior to turning 65
  • Once you turn 65, your 6 month period begins the month you enroll in Part B

During this period, an insurance company can’t use medical underwriting. 

Based on Rhode Island’s 2020 Medigap rate filing details, there are 10 insurers that offer Medigap plans in the state. However, only one insurer offers coverage (Medigap Plan A) to enrollees under age 65.

Rhode Island Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of May 2020, There are 73,267 Medicare beneficiaries in Rhode Island enrolled in stand-alone Part D prescription drug plans and 102,147 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 25 stand-alone Part D plans available in Rhode Island, with premiums ranging from about $14 to $128 per month. About 30% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call.

Local Medicare Health Plan Resources in Rhode Island

  • Rhode Island’s Executive Office of Health and Human Services (EOHHS) serves the state’s seniors through various agencies to help seniors maintain dignity and independence with Medicare counseling, food assistance, adult day services, and protective supports. EOHHS also provides assistance with long-term care issues. The EOHHS oversees the Senior Health Insurance Program (SHIP).
    Contact: Call 401-462-5274

  • Rhode Island’s Senior Health Insurance Program (SHIP) is part of a national partnership to help consumers make informed healthcare choices. Tri-County SHIP counselors provide one-to-one, unbiased counseling to seniors, adults with disabilities, families, and caregivers. The program is designed to help seniors and adults with disabilities understand healthcare costs and coverage options. Tri-County SHIP counselors discuss Medicare Part A and B, Medicare Part D, supplemental insurance, Medicare Advantage plans, and other health insurance options with their clients.
    Contact: Call 401-462-0510

  • The Office of Healthy Aging, formerly known as the Division of Elderly Affairs, collaborates with organizations all over the state to connect seniors with resources and information, including healthcare information, and advocate for the rights and comforts of the elderly.
    Contact: Call 401-462-3000, TTY at 401-462-0740, or via email

  • Warwick Senior Services in Warwick provides SHIP counseling for the community’s older residents by appointment only. The staff screens interested seniors to determine eligibility for Medicare Advantage and other programs using monthly income. The center also offers a legal clinic, tax help, and assistance with subsidized housing and heating expenses.
    Contact: Call 401-468-4070 or 401-468-4090

  • Senior Services, Inc. has provided services to seniors and adults with disabilities residing in Northern Rhode Island since 1975. In accordance with the Congregate Meal Program financed through a grant with R.I. Office of Healthy Aging, Senior Services, Inc. provides nutritionally balanced lunches five days a week at our meal sites throughout northern R.I. Senior Services, Inc. offers activities, entertainment, computer classes, and Wellness programs, including our weekly blood pressure clinic and exercise classes. As a partner in the state’s Point network, this organization has a Community Information Specialist who shares free information on eligibility for programs, including Medicare Advantage, throughout the state.
    Contact: Call 401-766-3734

  • The West Warwick Senior and Community Center offers the town’s older residents SHIP options, counseling, and pharmaceutical assistance in addition to meals, financial education, and social activities.
    Contact: Call 401-822-4450 to set an appointment with a SHIP counselor

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Rhode Island. Our process makes it easier for you to access your Medicare eligibility in Rhode Island so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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