Medicare Plan Options

Rhode Island has several Medicare options available for its residents. Many people choose to enroll in Original Medicare, while others purchase Medicare Advantage Plans from private insurance companies. Original Medicare is a no-frills option that works well for people without many health problems. If you need ongoing medical care for a chronic condition, you may want to sign up for Medicare Advantage instead. Medicare Part D and Medicare Supplement Insurance are also available to some residents.

Original Medicare

Original Medicare includes Part A and Part B coverage. This basic form of Medicare is managed by the federal government. If you need to stay in a hospital or skilled nursing facility, the services you receive are covered under Part A, while Part B covers the outpatient care you get from your primary care physician, medical specialists, and other health care providers. It also pays for ambulance transportation and durable medical equipment. If you enroll in Original Medicare, you’ll pay a separate deductible for Part A and Part B. You’ll also have to pay 20% coinsurance for most Part B services.

Medicare Advantage Plans

Rhode Island’s Medicare Advantage program consists of several health plans offered by private insurers. One of the benefits of choosing Medicare Advantage over Original Medicare is that many Medicare Advantage plans cover additional services. If you have more health expenses than the average person, picking Medicare Advantage may help you reduce your out-of-pocket costs. Some companies even offer Medicare Advantage Plans that pay for wellness services, transportation to medical appointments, and participation in adult day care. If you choose Medicare Advantage, you’ll pay a monthly premium. Your plan may also have an annual deductible.

Medicare Prescription Drug Coverage Plans

With a few exceptions, Medicare Advantage Plans typically include prescription drug coverage. If you sign up for Original Medicare, you’ll have the option of purchasing Medicare Part D, an insurance supplement that covers the cost of prescription drugs. Like Medicare Advantage Plans, Medicare Part D plans are offered by private insurance companies. If you decide to enroll, you’ll pay a monthly premium and a copay for each medication you need. You may also have to pay an annual deductible. With Medicare Part D, your annual out-of-pocket costs will depend on your location and which plan you choose.

Medicare Supplement Insurance Plans

If you enroll in Original Medicare, you’ll also have the opportunity to buy a Medicare Supplement Insurance Plan, frequently referred to as a Medigap plan. Medigap covers things like deductibles, coinsurance, and copays. If you choose not to buy Medigap coverage, you’ll be responsible for these costs, as they’re not covered by Original Medicare. A major benefit of Medicare Supplement Insurance is that standardized plans are considered guaranteed renewable, meaning your insurance company can’t cancel your coverage if you have health problems. As long as you pay the premium, you’ll continue to be covered.

Medicare in Rhode Island by the Numbers

People enrolled in Original Medicare  Average plan cost Annual state spending per beneficiary Spending per beneficiary compared to the national average
116,453 Plan A: $0 to $471 per month*
Plan B: $148.50 per month**
$9,261 8.00%

*Most people pay no premium, but this can vary depending on how long they paid Medicare taxes.
**This is the average number, but it can vary based on income.

Medicare Resources in Rhode Island

Whether you’re signing up for the first time or trying to decide whether you should switch from Original Medicare to Medicare Advantage, comparing all the options can be overwhelming. In Rhode Island, several organizations are available to help you compare Medicare plans and determine which one is best suited to your health needs and your financial situation. These organizations include the Rhode Island Insurance Division, the Office of Healthy Aging, and Rhode Island POINT.

Rhode Island Department of Business Regulation – Insurance Division

The Rhode Island Department of Business Regulation operates the Insurance Division, which oversees every insurance company operating within the state’s borders. Specifically, the division’s Office of the Health Insurance Commissioner works to protect consumers against unfair business practices in the health insurance industry. Because Medicare Advantage Plans are offered by private insurers instead of the federal government, OHIC is a helpful resource if you’re enrolled in Medicare Advantage and have any concerns about how an insurance company is handling your claims.

Contact Information: Website | 855-747-3224

Rhode Island Office of Healthy Aging

The Rhode Island Office of Healthy Aging is the state agency charged with promoting the well-being of older adults and adults with disabilities. RIOHA aims to connect Rhode Island residents with tools and information to help them stay safe, maintain their good health for as long as possible, and stay engaged with everything Rhode Island has to offer. If you have questions about Medicare or need help accessing Medicare-related resources, visit one of the agency’s regional POINT offices or call 401-462-444 to connect with a POINT specialist.

Contact Information: Website | 401-462-3000

Rhode Island Senior Medicare Patrol

RIOHA also operates the state’s Senior Medicare Patrol program, which aims to prevent and detect health care fraud. SMP offers educational programs to help people learn how to prevent and detect identity theft and recognize the signs of Medicare fraud. You can even get one-on-one help from trained volunteers who will review your recent Medicare claims to make sure your charges are accurate. SMP volunteers are also trained to provide accurate Medicare information to family members and caregivers, ensuring that everyone has the information they need to make Medicare-related decisions.

Contact Information: Website | 401-462-0194

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