Medicaid

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A combined federal and state program administered by the state that provides medical benefits for individuals and families with limited incomes who fit into an eligibility group that is recognized by federal and state law. (AIRS NL-5000.5000)

910 Douglas Pike
Smithfield, RI 02917
Phone: 800-459-6019
Organization Name: Neighborhood Health Plan of RI
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Address:
910 Douglas Pike
Smithfield, RI 02917
Phone: 800-459-6019
Toll Free Phone: 800-459-6019
Eligibility: A RIte Care plan for families, children, pregnant women and children with special health care needs.
Services Provided:

NHPRI follows the Network model and serves the following Medicaid populations in Rhode Island:

  • Families with low to moderate income
  • Children with special health care needs
  • All children in the RI foster care system
  • Medicaid-only adults with disabilities
  • Medicaid expansion population, and
  • Dually eligible (Medicare/Medicaid) beneficiaries https://www.nhpri.org/medicare-medicaid/
  • We also serve individuals and small businesses through HealthSource RI (Rhode Island’s health benefits exchange).

ACCESS is Neighborhood’s plan through the RIte Care program for children, families and pregnant women. 

Care Coordination programs are available through Neighborhood including:

  • Neonatal Case Management Program can help you coordinate and manage the many needs of your baby after being discharged from the Neonatal Intensive Care Unit (NICU).
  • The Children with Special Health Care Needs (CSN) Care Management Program can help to improve a child's health and wellness if they are at risk due to complex medical and/or social issues.
  • The Substitute Care Program can help improve the health and wellness of children in foster care.
Provider Profiles:

Neighborhood Health Plan of Rhode Island (Neighborhood) is a non-profit HMO that was founded in 1994 to make sure everyone in the state has access to high-quality, low-cost health care. Neighborhood has been ranked as one of the top Medicaid health plans in America for the past twelve years and currently serves more than 190,000 members. Neighborhood also recently extended its great service, benefits and value to individuals and businesses through HealthSource RI – the state’s health insurance exchange.

Source: Rhode Island Dept of Health, Office of Special Needs
Last Updated: 9/8/2020
United Healthcare Community Plan
475 Kilvert Street
Warwick, RI 02886
Organization Name: United Healthcare of New England
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Address:
United Healthcare Community Plan
475 Kilvert Street
Warwick, RI 02886
Toll Free Phone: 800-587-5187
Eligibility: UnitedHealthcare offers coverage to beneficiaries of Rhode Island's RIte Care program, including Children With Special Healthcare Needs. Children with Special Healthcare Needs includes: children who are eligible for Rhode Island Medical Assistance through Supplemental Security Income (SSI), Katie Beckett or Adoption Subsidy.) Eligibility for enrollment in RIte Care is determined by the Department of Human Services (DHS). Eligibility basis Children under the age of 21 are eligible for Medical Assistance due to their eligibility for Katie Becket, SSI, or Adoption subsidy Must live in Rhode Island Are not covered by other health insurance And do not live in an institutional long-term facility
Provider Profiles: Children with Special Healthcare Needs (CSN) is Rhode Island's Medicaid managed care plan for Children with a disability or chronic condition and they are determined eligible for: Supplemental Security Income (SSI), Katie Beckett or Adoption Subsidy through the Department of Children, Youth, and Families (DCYF). When eligible for Medicaid, parents or guardians are then given a choice of enrollment in a participating health plan. Children who live in an institutional facility are excluded from health plan enrollment. In those situations, children will be enrolled in traditional Medicaid Fee-For-Service.

Children with Special Healthcare Needs may qualify for RIte Care under UnitedHealthcare Community Plan. The Department of Human Services will enroll Children with Special Healthcare Needs who are eligible for Medicaid.
Source: Rhode Island Dept of Health, Office of Special Needs
Last Updated: 7/10/2019
Address:
Washington, DC
Services Provided:

Govbenefits.com is a free confidential prescreening tool for state and federal government programs. Search for benefits you may be able to receive.

Provider Profiles:

Internet resource, State and Federal resources
Partners with USA.gov

Source: MHP-Nationwide
Last Updated: 6/22/2020
Address:
823 Main Street
Hope Valley, RI 02832
Phone: 401-539-2461
Eligibility: Community Health Centers provide services to those who are eligible for RIte Care , RIte Smiles and/or medical assistance. There is also a sliding fee option.
Services Provided:
  • Primary Care
  • Family Practice
  • Pediatrics
  • Women's Health
  • Internal Medicine
  • Behavioral Health
  • Dental
  • Integrated care management supports to manage complex conditions and social service needs.


Referrals to Medicaid or RIteCare

Behavioral Health and Crisis Intervention
Woman's Health
Dental
Care Coordination

Assistance before and after hospital care

Provider Profiles:

Wood River Health Services provides a full range of medical, dental and social services to the community. These services include primary and urgent care, including routine physical exams, short- and long-term illnesses, immunizations and chronic disease management. Disciplines represented are Internal Medicine, Family Practice and Pediatrics.

Staff is also available to help navigate the complicated areas of health insurance and other benefits support.

Information on WIC services is available at a separate listing.

Source: Rhode Island Dept of Health, Office of Special Needs
Last Updated: 11/10/2020
Organization Name: WellOne Primary Medical and Dental Care
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Address:
142A Danielson Pike
Foster, RI 02825
Phone: 401-647-3702
Fax: 401-647-5380
Eligibility: WellOne accepts most major insurances including Rhode Island Medical Assistance as well as major credit cards and has special programs for patients with limited or no health insurance.
Services Provided: Locations in North Kingstown, Foster and Burrillville
Primary Care
Woman's Health
Dental
Behavioral health
Provider Profiles: WellOne Primary Medical and Dental Care is a 106 year-old, nonprofit community health center dedicated to providing high quality healthcare to individuals and families in the communities we serve. We are committed to achieving the highest attainable level of physical, psychological, and social well-being for all through not only treatment but also prevention and wellness.
WellOne is a nationally recognized patient-centered medical home. WellOne earned this recognition by adhering to strict standards set forth by The National Committee for Quality Assurance. Our team of professional providers has the experience and knowledge to help manage a range of healthcare needs at any age. All of our healthcare professionals are licensed by the Rhode Island Department of Health and are Board Certified in their particular specialties.
Source: Rhode Island Dept of Health, Office of Special Needs
Last Updated: 6/27/2016
Organization Name: WellOne Primary Medical and Dental Care
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Address:
36 Bridge Way
Pascoag, RI 02859
Phone: 401-567-0800
Fax: 401-568-7949
Eligibility: WellOne accepts most major insurances including Rhode Island Medical Assistance as well as major credit cards and has special programs for patients with limited or no health insurance.
Provider Profiles: WellOne Primary Medical and Dental Care is a 106 year-old, nonprofit community health center dedicated to providing high quality healthcare to individuals and families in the communities we serve. We are committed to achieving the highest attainable level of physical, psychological, and social well-being for all through not only treatment but also prevention and wellness.
WellOne is a nationally recognized patient-centered medical home. WellOne earned this recognition by adhering to strict standards set forth by The National Committee for Quality Assurance. Our team of professional providers has the experience and knowledge to help manage a range of healthcare needs at any age. All of our healthcare professionals are licensed by the Rhode Island Department of Health and are Board Certified in their particular specialties.
Source: Rhode Island Dept of Health, Office of Special Needs
Last Updated: 6/27/2016