Rhode Island Health Insurance

According to the Center for Disease Control, an average of 9.3% of Rhode Island residents went uninsured for Rhode Island health insurance between 2001 and 2003.

Rhode Island Health Insurance Regulations

Any individual covered under an employer’s or group health insurance plan in Rhode Island cannot be denied or limited access to that policy’s coverage. All individuals are also guaranteed the right to renew an existing Rhode Island health insurance policy provided they have not provided false information and have paid all premiums on time. This is called guaranteed renewability.

Individual Rhode Island health insurance companies can, however, deny an individual applicant based on health or other factors. However, any individual who has had 12 months of credible coverage prior to the plan must be offered a choice of at least two Rhode Island health insurance plans. HIPAA eligible individuals are also guaranteed access to health insurance in Rhode Island.

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HIPAA Eligible

Individuals who are either HIPAA eligible or have had 12 months prior coverage do not face pre-existing exclusion periods. Other individuals can face pre-existing condition exclusion periods in which a Rhode Island health insurance company will withhold coverage for any condition treated, diagnosed or advised within the 36 months prior to the beginning of the plan. Pre-existing exclusion periods can last up to 12 months. Blue Cross and Blue Shield typically does not carry pre-existing exclusion periods or shorter ones than most.

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Rates

Rhode Island health insurance rates can vary depending on an individual’s health, age and other risk factors. Premium rates can rise at the beginning of renewal and at the beginning of new plans.

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Pregnancy

Pregnancy is considered a pre-existing condition to most Rhode Island health insurance companies. Newborns are automatically covered under the parents’ individual health insurance policy for at least the first 31 days after birth. Policies need to be adjusted after that time. Disabled children can remain under their parents’ individual health insurance policy past the dependent age limit provided they meet eligibility requirements.

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Temporary Insurance

Some Rhode Island medical insurance companies sell temporary health insurance plans to individuals who need medical coverage between policies or jobs.

Alternative Rhode Island Health Insurance Options

For individuals who have difficulty accessing Rhode Island health insurance, there are some state programs that may help:

• RI Care is the state’s children’s health insurance program that is designed to provide health insurance for children up to age 19 as well as pregnant women and parents who belong to families who might otherwise not be able to afford Rhode Island medical insurance.
• RI Share is the Health insurance premium assistance program that is designed to help families pay monthly medical insurance premiums for coverage under an employer.

Rhode Island Division of Insurance

DEPARTMENT OF BUSINESS REGULATION
233 RICHMOND STREET
PROVIDENCE, RI 02903
Phone Number (401) 222-2246
FAX Number (401) 222-6098

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For other Rhode Island Insurance Resources, See:

• Rhode Island Auto Insurance
• Rhode Island Home Insurance
• Rhode Island Health Insurance

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