Rhode Island Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Rhode Island.
7.6 million Medicaid long-term care recipients nationwide
Rhode Island Executive Office of Health and Human Services (EOHHS)
Processing Time
30-45 days for standard Medicaid; Elderly Waiver applications take 45-60 days. Rhode Island generally has adequate capacity relative to its small population.
Rhode Island Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Rhode Island, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Rhode Island follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month
Married Couple (One Applying)
$5,964/month
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$4,000
Community Spouse (At-Home Spouse)
$6,000
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Rhode Island Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $12,778/month average (semi-private), $14,022/month (private) (the average monthly nursing home cost in Rhode Island).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Rhode Island
Nursing Home Care
Medicaid pays 100% of nursing home costs in Rhode Island once eligibility is established. The average monthly cost is $12,778/month average (semi-private), $14,022/month (private). Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Assisted Living Coverage
Elderly Waiver - Assisted Living Services: Rhode Island's Elderly Waiver includes services for seniors residing in licensed assisted living residences. Medicaid covers personal care, medication management, and care coordination. Room and board costs are not covered by Medicaid—residents must pay housing costs from their monthly income or private resources.
Note: This program covers personal care services but does not cover room and board costs. Residents need approximately $1,500-$2,500/month from Social Security or other income to cover housing expenses.
Home and Community-Based Services (HCBS) Waivers
Rhode Island offers 2 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Home and Community-Based Services for the Elderly (Elderly Waiver)
Serves individuals age 65+ who meet nursing facility level of care. Provides adult day services, assistive technology, case management, environmental modifications, home-delivered meals, homemaker services, non-medical transportation, personal care, personal emergency response systems, respite care. Approximately 1,600 participants—relatively small due to Rhode Island's size.
Program Details →Community Care Medicaid Waiver
Serves adults age 18+ with physical disabilities who meet nursing facility level of care. Similar services to Elderly Waiver including personal care, homemaker, adult day, case management, and respite.
Program Details →How to Apply for Medicaid in Rhode Island
Rhode Island Medicaid applications typically take 30-45 days for standard Medicaid; Elderly Waiver applications take 45-60 days. Rhode Island generally has adequate capacity relative to its small population.. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Rhode Island through:
- Online at HealthSourceRI.com (state health exchange also processes Medicaid)
- Phone: 1-855-697-4347 (RIte Smiles and Medicaid Customer Service)
- Download application at dhs.ri.gov and mail to: RI Dept of Human Services, 57 Howard Avenue, Cranston, RI 02920
- In-person at Department of Human Services office
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Rhode Island from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Rhode Island-Specific Programs and Resources
Medicare Savings Programs (QMB/SLMB/QI)
QMB pays Medicare premiums, deductibles, and coinsurance. SLMB pays Part B premiums. QI pays Part B premiums (limited funding).
Learn MorePACE Rhode Island
Program of All-Inclusive Care for the Elderly available through two providers in Rhode Island (serving Providence and surrounding areas). Comprehensive medical and social services for frail elderly age 55+.
Learn MoreRIte Care (RI Medicaid Managed Care)
Rhode Island's Medicaid managed care program covering most Medicaid beneficiaries through contracted health plans.
Learn MoreNeed Help with Rhode Island Medicaid?
Contact Rhode Island Executive Office of Health and Human Services (EOHHS) for specific questions about eligibility, application status, or covered services.