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Medical Assistance Program
Program Description
The Rhode Island Medical Assistance Program, also known as " Medicaid", is a
federal and state funded program that pays for medical and health related services for
eligible Rhode Islanders. RIte Care, RI’s Medicaid Managed Care Program, covers
families receiving cash assistance through the Family Independence Program and income
eligible children, parents, and pregnant women without health insurance. For more
information, see RIte Care.
In addition to RIte Care, the Medical Assistance Program also covers children with
special needs. If a child is found eligible for Supplemental Security Income (SSI) due to
a disability, then they are also eligible for Medical Assistance. SSI is a Federal program
which provides monthly cash payments to families who have children with physical,
developmental, and/or mental impairments. Eligibility is based on family income and
medical need. For more information on SSI, call 800-772-1213.
Who’s Eligible for Medical Assistance
- Children, Parents, and Pregnant women (through RIte Care)
- Children with special needs (through Medical Assistance)
Covered Benefits
- Inpatient hospital services
- Inpatient psychiatric hospital services
- Outpatient hospital services:
Clinic and emergency room care
Laboratory and x-rays
Pharmacy
- Physician services
- Pharmacy services
- Dental services
- Clinical Laboratory services
- Durable medical equipment, surgical appliances, and prosthetic devices
- Certified home health agency services
- Podiatry services
- Ambulance services
- Community mental health center services
- Substance abuse services
- Nursing facilities services
- Optometry Services
- Intermediate Care Facility and Day Treatment Services for the Mentally Retarded
- Hospice Care Services
- Organ Transplant Services
- Therapy services, such as physical therapy, occupational therapy, and speech therapy
- Vision care
- Skilled nursing care
- Transportation
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
Early and Periodic Screening, Diagnosis
and Treatment (EPSDT)
Through the Early and Periodic Screening, Diagnosis and Treatment benefit, children
under age 21 who are covered by Medical Assistance may receive routine as well as needed
specialized medical services. For more information about EPSDT services, ask your
child’s doctor or health care professional. There is not a separate application for
these services; however, a plan of treatment must be presented to DHS for review. Examples
of specialized services may include:
- Pediatric private duty nursing
- Special assistive devices, such as, showers, tubs, and/or feeding chairs
- Assistive technology services, such as, specialized communication devices
- Case management services
- Home-based services
Katie Beckett
Medical Assistance coverage is also available for certain children under age 18 who
have disabling conditions and live at home. This program enables children with special
health care needs or disabilities to be cared for at home instead of in an institution.
Only the child’s income and resources are used in determining financial eligibility.
The cost of care at home compared to the cost in an institutional setting is also used in
determining eligibility.
How to Apply
See DHS’s Local Office Directory for the office
nearest to you. To apply parents or guardians need to complete an application. Call your
local DHS office for more information or an appointment.
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