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An Overview on Medical Insurance in Rhode Island

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Medical Insurance in Rhode Island

Medical Insurance in Rhode Island

Introduction: In accordance to a survey conducted by The Center of Disease Control, almost 10% of the total Rhode Island residents did not get Rhode Island medical insurance coverage for each year, between 2001 and 2003.

In the below mentioned article, we have discussed about Rhode Island medical insurance regulations and Rhode Island state medical insurance alternative programs.

Some Important Regulations for Rhode Island Medical Insurance

To administer the Rhode Island health insurance market and to monitor the activities of different medical insurance companies, the Rhode Island department of insurance has introduced certain regulations that are mentioned below:

  • A Rhode Island individual qualified for medical insurance though an employer can not be refused or restricted having access to coverage under that employer Rhode Island medical insurance policy.
  • However, as per state health insurance law, a Rhode Island individual looking for coverage under individual Rhode Island medical insurance can be refused based on age, health and other deciding factors.
  • Rhode Island individuals, who have had a credible coverage of 12 months before beginning of the policy, should be offered an option of minimum two state medical insurance plans.
  • All Rhode Island medical insurance policies should have a guaranteed provision for renewal. A guaranteed renewability provision lets an individual renew his or her existing Rhode Island medical insurance policy. However, he or she should have disbursed all the premiums, in time and provided no fake information during the tenure of the policy.
Regulations for HIPAA Eligible Rhode Island Individuals
  • All HIPAA qualified individuals can compulsory access coverage under Rhode Island medical insurance.
  • HIPAA eligible Rhode Island individuals don't have to go through a pre-existing waiting periods. This rule is also applicable to individuals, who have had a prior coverage of at least 1 year.
  • Other than HIPAA eligible individuals and individuals who have had prior coverage of one year, all Rhode Island individuals are subject to go through a pre-existing waiting period.
  • A pre-existing condition may be defined as an illness for which an individual has been treated, received medical advice or otherwise diagnosed within 3 years, before commencement of a new Rhode Island medical insurance policy.
  • Rhode Island medical insurance companies can implement a waiting period for pre-existing condition for no more than one year.
  • During the term of a waiting period, an individual is not able to get any coverage for the particular health condition.
  • Medical insurance policies offered by Blue Cross and Blue Shield (BCBS) do not hold a pre-existing waiting period. BCBS implements pre-existing condition of shorter length, if implements any.
  • As per Rhode Island health insurance law, most of the insurers consider pregnancy to be a pre-existing medical condition.
  • There is no limitation for what the Rhode Island medical insurance organizations can charge. They can charge any amount as premium, based on age, health and other deciding factors. Rates of premium can be hiked at the starting of renewal or at the starting of a new plan.
  • All newborns and adopted children should get coverage under their parent's medical insurance plans that offer dependant coverage for the initial 31 days from the day of birth or adoption.
  • Handicapped and disabled children are entitled to get coverage under their parent's individual Rhode Island health insurance policy, even if they have crossed the decided upper age limit.
  • Rhode Island individuals, who are between medical insurance policies or jobs, are able to access temporary Rhode Island medical insurance plan.

Rhode Island Medical Insurance Alternative Options

Rhode Island individuals, who are considered as uninsurable or unable to afford the cost of medical insurance of the state, can, opt for any of the below-mentioned alternative medical insurance programs offered by the Rhode Island Division of Insurance.

  • RI Share: This program is created to assist Rhode Island families pay their employer Rhode Island medical insurance premiums, every month.
  • RI Care: This is Rhode Island's Children's Health Insurance Program (CHIP) that offers coverage to the children below and up to the age of 19 along with parents expecting women. However, individuals belong to the families that are unable to afford the cost of Rhode Island health insurance are only eligible for the program.

Rhode Island Department of Insurance

For more information on Rhode Island heath insurance, you can contact at the following address.

Department of Business Regulations

233, Richmond Street
Providence, Rhode Island 02903


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