Medicare Special Needs Plan

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Providers of Medicare Advantage health care plans approved by Medicare that accept applications for enrollment in specialized plans that focus on individuals with special needs, i.e., people who are institutionalized or who reside in the community but require an equivalent level of care as those residing in a long term care facility; people with both Medicare and Medicaid (dual eligibles); and/or people who have severe or disabling chronic conditions (e.g., cardiovascular disease, diabetes, congestive heart failure, mental disorders, end stage renal disease, and HIV/AIDS). (AIRS NS-8000.500-480.60)

Center for Child and Family Health Hazard Building #74
74 West Road
Cranston, RI 02920
Service Categories:
Organization Name: State of Rhode Island
(Show others in Organization)
Address:
Center for Child and Family Health Hazard Building #74
74 West Road
Cranston, RI 02920
Eligibility:

As of 11/23/2021, there is a waiting period for Early Intervention
services. Referred children will be placed on a statewide waitlist, and
families will be contacted about their referral. They will be given the
option to be matched with the first provider in their community who
has an opening, or they can choose to wait for a specific provider who
serves their community.

Early Intervention Referral Status


There are several ways to refer a child to the Early Intervention
statewide waitlist.

• Email the referral to Jennifer.Kaufman@ohhs.ri.gov
• Fax the referral to (401) 462-2939, Attn: Early Intervention
• Call (401) 462-3425 and leave a voicemail with the referral
information.
• Refer to the agency that you typically would, via phone, fax or
email.

Services Provided:

EOHHS extensive programs serve all ages in Rhode Island. Please go to website for additional information. 

Early Intervention

Healthcare Programs

Children with Special Needs

Katie Beckett Program
Families with Children 

Adults with Special Needs
Adults, ages 19-64
Elders



Provider Profiles:

Mission:

Ensure access to high quality and cost effective services that foster the health, safety, and independence of all Rhode Islanders. 

People w/ Special Needs: People with Disabilities and Special Needs have access to the right services, at the right time and in the least restrictive setting. The EOHHS agencies touch the lives of consumers and the communities where they live in a wide variety of ways.

The Executive Office of Health and Human Services (EOHHS) serves as “the principal agency of the executive branch of state government” (R.I.G.L. §42-7.2-2) responsible for managing the departments of: Health (DOH); Human Services (DHS); Children, Youth and Families (DCYF); and Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH). Last year, these agencies provided direct services to nearly 306,000 Rhode Islanders as well as an array of regulatory, protective and health promotion services to our communities.  Health and human services benefits represent $3.1 billion spending per year, or over 40 percent of the entire state budget.

Source: Rhode Island Quality Institute
Last Updated: 11/22/2021
910 Douglas Pike
Smithfield, RI 02917
Phone: 800-459-6019
Service Categories:
Organization Name: Neighborhood Health Plan of RI
(Show others in Organization)
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
Washington, DC
Service Categories:
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
7500 Security Boulevard
Baltimore, MD 21244
Service Categories:
Organization Name: U.S. Centers for Medicare and Medicaid Service
(Show others in Organization)
Address:
7500 Security Boulevard
Baltimore, MD 21244
Eligibility:

Must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.

Services Provided:

Medicare beneficiaries can qualify for a low income subsidy (also known as Extra Help) paying for their monthly premiums, annual deductibles, and co-payments related to Medicare Part D (prescription drug coverage). The Extra Help is worth about $5,000 per year. 

Source: MHP-Nationwide
Last Updated: 8/2/2021
7500 Security Boulevard
Baltimore, MD 21244
Phone: 800-633-4227
Service Categories:
Address:
7500 Security Boulevard
Baltimore, MD 21244
Phone: 800-633-4227
TDD: 877-486-2048
Toll Free Phone: 800-633-4227
Languages Spoken: Spanish
Eligibility:

Persons age 65 and older, anyone with certain disabilities or end-stage renal disease.

Services Provided:

Provides health insurance for Americans age 65 and older, people under age 65 with certain disabilities, and people of all ages with end stage renal disease (permanent kidney failure requiring dialysis or a kidney transplant).

  • Medicare
Source: Nationwide Suggest Providers Queue
Last Updated: 6/2/2021