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Rhode Island Health Insurance Information

From , former About.com Guide

Updated July 31, 2008

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If you live in Rhode Island, the following health insurance contact information may be helpful to you:

Rhode Island Office of the Health Insurance Commissioner

The Rhode Island Office of the Health Insurance Commissioner is responsible for regulating health insurance policies sold in the state of Rhode Island.

If you are looking for health insurance coverage, the Office of the Health Insurance Commissioner has a list of insurance companies licensed to sell individual policies in Rhode Island. Contact their office for more information.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Office of the Health Insurance Commissioner. Find out more about the consumer complaint process, and then contact the Office of the Health Insurance Commissioner when you are ready.

Rhode Island Office of the Health Insurance Commissioner
1511 Pontiac Ave, Building #69 first floor
Cranston, RI 02920
Phone: 401-462-9517
Fax: 401-462-9645
Email: HealthInsInquiry@ohic.ri.gov

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). They make and enforce the rules that your employer must follow when offering health insurance coverage to employees -- for example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage -- for example, if you think you should have been offered COBRA continuation coverage, but were not, or if you feel that you were wrongly terminated from your health plan -- contact your regional EBSA office.

U.S. Department of Labor Employee Benefits Security Administration
Boston Regional Office
J.F.K. Building, Room 575
Boston, MA 02203
James Benages - Director
Phone: 617-565-9600
Fax: 617-565-9666

Buying Individual Policies in Rhode Island

As a general rule, insurers in Rhode Island are allowed to reject your application for coverage based on your health status. However, you may be eligible for a "guaranteed issue" policy if you have at least 12 months of continuous creditable coverage with no gap. In this case, all insurers must offer you a choice of two individual policies, regardless of your health status.

You may also qualify for coverage as a "HIPAA-eligible" individual if you:

  • had at least 18 months of continuous creditable coverage, the last day of which was under a group plan AND
  • you have exhausted all COBRA continuation coverage which was available to you.

People who are HIPAA-eligible are guaranteed the right to buy an individual policy from a private insurer. If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Rhode Island Office of the Health Insurance Commissioner can help you find out.

Rhode Island Senior Health Insurance Program (SHIP)

SHIP provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit, or Medigap coverage.

SHIP
Phone: 401-462-4000

Rhode Island Medicaid

Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals.

Rhode Island Medical Assistance
Phone: 401-462-5300

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