RIte Care Income Limits in Rhode Island (2026)

RIte Care covers approximately 303,000 Rhode Islanders, roughly one in four state residents, making it the single largest health coverage program in the state. Rhode Island launched the RIte Care brand in 1994 as a managed care program for children and families, and expanded the program significantly under the Affordable Care Act in 2014. The 2026 RIte Care income guidelines are set by the Executive Office of Health and Human Services and are updated annually each March to reflect the new federal poverty guidelines published by HHS ASPE. Rhode Island administers RIte Care through three managed care health plans: Neighborhood Health Plan of Rhode Island, Tufts Health Plan, and UnitedHealthcare Community Plan. Most RIte Care enrollees choose one of these plans and receive all covered services through their plan's provider network. Understanding which RIte Care category applies to your household is the first step in determining your income limit, because different populations (adults, parents with children, pregnant women, children) face different FPL percentage thresholds.

Rhode Island is a Medicaid expansion state. The state adopted the ACA expansion effective January 1, 2014, creating an expansion group for adults ages 19 to 64 without dependent children funded 90% by the federal government and 10% by Rhode Island. Under the expansion, RIte Care covers adults up to 138% of the Federal Poverty Level, which in 2026 is $22,025 per year for a single person or $45,540 per year for a family of four. Rhode Island does not impose an asset test for the MAGI-based RIte Care categories (the expansion group, parents, children, and pregnant women). The asset test applies only to the traditional aged, blind, and disabled Medicaid category, where the 2026 countable asset limit is $4,000 for an individual and $6,000 for a couple. Adults who qualify for the RIte Care expansion group receive comprehensive benefits including medical, dental (through RIte Smiles), vision, prescription drugs, behavioral health, and transportation to medical appointments.

The household-size table below shows 2026 RIte Care income limits for three covered populations: adults under expansion (138% FPL), children under age 19 (261% FPL), and pregnant women (253% FPL). Rhode Island's children's threshold of 261% FPL is among the more generous in New England, reflecting the state's historical commitment to children's coverage stretching back to the original 1994 RIte Care launch. The pregnancy threshold of 253% FPL includes 12 months of postpartum Medicaid coverage following delivery, which is required under federal law since April 2022. Rhode Island also operates RIte Share, a premium assistance program that helps families with employer-sponsored insurance by covering the employee share of premiums when enrolling in RIte Care would otherwise be available. If your household income exceeds the RIte Care threshold but falls below 400% FPL, you may qualify for subsidized coverage through HealthSource RI, Rhode Island's state-based ACA marketplace. As of January 1, 2026, enhanced premium tax credits from the American Rescue Plan Act have expired, returning the subsidy cliff to 400% FPL.

RIte Care (Rhode Island Medicaid) income limits by household size (2026)

2026 RIte Care (Rhode Island Medicaid) income limits by household size. Adult column = Medicaid expansion threshold (138% FPL, adults 19-64). Children column = RIte Care children's threshold (261% FPL, ages 0-18). Pregnancy column = RIte Care pregnant women threshold (253% FPL). All figures based on 2026 HHS poverty guidelines for the 48 contiguous states.

RIte Care (Rhode Island Medicaid) eligibility requirements (non-income)

Rhode Island RIte Care eligibility depends on both income and non-income criteria. Meeting the income threshold is necessary but not sufficient. The following non-income requirements also apply to all RIte Care categories.

• Rhode Island residency: Applicants must reside in Rhode Island at the time of application. There is no minimum length-of-residency requirement; Rhode Island cannot require a waiting period for residency under federal Medicaid rules. A utility bill, lease agreement, mortgage statement, or statement from a shelter or social service agency can establish residency.
• Citizenship and immigration status: U.S. citizens, U.S. nationals, and certain lawfully present immigrants qualify. Lawfully present non-citizens with five or more years of U.S. residency (or who meet a qualifying exception such as refugees, asylees, Cuban/Haitian entrants, certain trafficking victims, and veterans/active-duty military) are eligible. Newly arrived lawful permanent residents are subject to a five-year bar for most Medicaid categories under federal law. Undocumented immigrants are not eligible for RIte Care except for emergency Medicaid services.
• Social Security Number: Every household member applying for RIte Care must provide a valid Social Security Number (SSN) or apply for one. Household members who are not applying for coverage for themselves (for example, a parent applying only for their child) do not need to provide their SSN but must still report their income. Newborns are deemed eligible through their mother's RIte Care enrollment for the first year of life and do not need a separate SSN at birth.
• Age and category: The adult expansion group covers ages 19 to 64 who are not pregnant, not receiving Medicare Parts A or B, and not otherwise eligible for a different Medicaid category. Parents with children under 18 qualify up to 133% FPL under the traditional RIte Care family category. Children under age 19 qualify under RIte Care up to 261% FPL. Pregnant women qualify up to 253% FPL. Adults 65 and older (or under 65 with a qualifying disability) qualify for the aged, blind, and disabled Medicaid category, which uses a separate income test and does impose an asset test.
• Asset test: Rhode Island does not apply a countable asset test to MAGI-based RIte Care categories (adults, parents with children, children, and pregnant women). Asset tests apply only to the traditional aged, blind, and disabled (ABD) Medicaid category, where the 2026 countable asset limit is $4,000 for an individual and $6,000 for a couple. For long-term care (nursing home) Medicaid, the asset limit is also $4,000 for an individual, with a 60-month lookback period for asset transfers.
• Other coverage: Applicants who are enrolled in Medicare Parts A and B are generally not eligible for the RIte Care expansion adult group but may qualify for Medicare Savings Programs (QMB, SLMB, QI) administered through the Rhode Island Department of Human Services. Applicants who have access to cost-effective employer-sponsored health insurance may be routed to RIte Share (Rhode Island's premium assistance program) instead of direct RIte Care enrollment.

What income counts for RIte Care (Rhode Island Medicaid)

RIte Care uses the Modified Adjusted Gross Income (MAGI) methodology for its MAGI-based categories (adults, children, parents, pregnant women). MAGI counts most taxable income but excludes several common income types. The income calculation uses projected annual income for the current year, not last year's tax return, which means self-reported income at the time of application determines initial eligibility. Rhode Island does not apply the optional 5% MAGI disregard for the children's or pregnancy categories; the adult expansion group uses the standard 138% FPL threshold established by federal law.

Income sources included

• Wages, salaries, and tips (W-2 income): All gross wages before any deductions, including overtime and tip income.
• Self-employment net earnings: Net profit from a business or freelance work after allowable business deductions, reported on Schedule C or Schedule F of the federal tax return.
• Social Security Disability Insurance (SSDI): SSDI benefits count toward MAGI income. Supplemental Security Income (SSI) does NOT count.
• Social Security retirement and survivor benefits: The taxable portion of Social Security retirement and survivor benefits counts toward MAGI. If Social Security benefits are the household's only income, most or all may be non-taxable and therefore excluded.
• Pension and retirement distributions: Taxable distributions from pension plans, 401(k) accounts, traditional IRAs, and other retirement accounts count toward MAGI.
• Unemployment compensation: All unemployment benefits received count toward MAGI income for Rhode Island RIte Care eligibility.
• Interest, dividends, and capital gains: Taxable interest, ordinary and qualified dividends, and net capital gains all count toward MAGI income.
• Rental and royalty income: Net rental income (after allowable expenses like mortgage interest, property taxes, and depreciation) and royalty income count toward MAGI.

Income sources excluded

• Supplemental Security Income (SSI): SSI payments are excluded from MAGI income entirely. Receiving SSI may make a person categorically eligible for Medicaid through a separate pathway outside the MAGI rules.
• Child support received: Child support payments received by a household member are excluded from MAGI income under federal Medicaid rules.
• Veterans' benefits: VA disability compensation, GI Bill education payments, VA pension, and other Department of Veterans Affairs benefits are excluded from MAGI income.
• Workers' compensation and certain disability payments: Workers' compensation payments and most non-taxable disability payments are excluded from MAGI income.
• Cash assistance (TANF): Temporary Assistance for Needy Families (RI Works in Rhode Island) payments are excluded from MAGI income.
• Gifts, inheritances, and loan proceeds: Gifts received, inheritances, and loan proceeds are not taxable income and are excluded from MAGI for RIte Care purposes.

How to apply for RIte Care (Rhode Island Medicaid) in Rhode Island

Rhode Island RIte Care applications are submitted through HealthyRhode, the statewide benefits portal operated by the Rhode Island Department of Human Services (DHS) and the Executive Office of Health and Human Services. HealthyRhode is powered by the RIBridges eligibility system and captures applications for RIte Care, RIte Share, SNAP, RI Works (TANF), and other DHS programs in a single application. You can apply online, by phone, by mail, or in person at any DHS office. The application phone line for RIte Care is 1-855-697-4347.

1. 1. Gather your documents before starting: photo ID, Social Security Numbers for all household members applying for coverage, proof of Rhode Island residency, proof of citizenship or immigration status, and recent income documentation for everyone in the household.
2. 2. Create an account at healthyrhode.ri.gov or call 1-855-697-4347 to start an application by phone. The online system is available 24/7. In-person help is available at any Rhode Island Department of Human Services office; the main Providence office is at 57 Howard Avenue.
3. 3. Complete the application by listing every household member, reporting all income from all sources for every household member (including non-applicants), and reporting household expenses. The application takes approximately 20 to 40 minutes to complete online.
4. 4. Submit the application and upload or mail any required supporting documents. DHS will send a confirmation with your case number. Save this number for follow-up inquiries.
5. 5. Respond promptly to any DHS requests for additional information. DHS may send a Request for Information notice asking for clarifying documents. Failing to respond within the specified window (typically 10 days) is the most common reason applications are denied or delayed.
6. 6. Wait for the eligibility determination notice. Standard RIte Care applications are decided in 45 days. Pregnancy applications are decided in 15 days under federal expedited-processing rules. If approved, you will receive a RIte Care card and information about choosing a managed care health plan from the three participating plans.

Official portal: healthyrhode.ri.gov

Documents needed

• Photo ID for the head of household (Rhode Island driver's license, state ID card, or U.S. passport)
• Social Security Numbers for every household member applying for RIte Care coverage (newborns may be exempt for the first year)
• Proof of Rhode Island residency (utility bill, lease or mortgage statement, or written statement from a shelter or social service organization dated within 60 days)
• Proof of U.S. citizenship or lawful immigration status (U.S. birth certificate, U.S. passport, Certificate of Naturalization, Permanent Resident Card, or other USCIS-issued documentation)
• Most recent 30 days of pay stubs for all employed household members (or 12 months of records for self-employed applicants with variable income)
• Documentation of any other household income: Social Security award letter, unemployment benefit verification, pension or retirement income statements, or rental income documentation
• For pregnant women: verification of pregnancy from a licensed health care provider (a letter or prenatal visit record confirming pregnancy and estimated due date)

Processing timeline: Standard Rhode Island RIte Care applications are decided in 45 days from the date DHS receives a complete application. Pregnancy applications are decided in 15 days under federal expedited rules. Disability-based Medicaid applications can take up to 90 days because they require a medical determination by the Rhode Island Disability Determination Services unit. If DHS sends a Request for Information notice, the 45-day clock pauses until the applicant responds. Medicaid coverage can be backdated up to three months before the application date if the applicant was eligible during that period.

Common reasons applications get denied

• Income above the category-specific threshold: The household's MAGI income exceeds the applicable RIte Care income limit for the category the applicant applied under (138% FPL for adults, 261% FPL for children, 253% FPL for pregnant women).
• Failure to respond to a Request for Information notice within the specified deadline: DHS sends written notices requesting clarifying documents; missing the response deadline results in denial. Applicants who miss the deadline can reapply.
• Rhode Island residency cannot be established: The applicant could not provide an acceptable document confirming their current Rhode Island address.
• Immigration status not qualifying: The applicant's immigration status does not meet the federally qualifying categories, or the applicant is in the first five years of lawful permanent residency and does not meet an exception to the five-year bar.
• Enrolled in Medicare Parts A and B: Adults who are enrolled in Medicare Parts A and B are not eligible for the RIte Care expansion adult group. They may be eligible for Medicare Savings Programs (QMB or QI) administered by DHS.

If your child's family income is above the RIte Care children's limit

RIte Care covers children under age 19 in families earning up to 261% of the Federal Poverty Level, which is $86,130 per year for a family of four in 2026. Children in families with income above 261% FPL may qualify for RIte Share, Rhode Island's premium assistance program. RIte Share helps families whose employer offers health insurance by covering all or part of the employee premium contribution, making employer-sponsored coverage more affordable. Families using RIte Share receive the same comprehensive benefit package as RIte Care direct enrollees, including dental coverage through RIte Smiles. If your family's income exceeds the RIte Share limits or your employer does not offer insurance, HealthSource RI, the state's official ACA marketplace, offers subsidized plans for children and families with income between 261% and 400% FPL (and potentially higher in future plan years).

Compare Medicaid and CHIP income limits across all 50 states

If you are 65 or older or have Medicare with limited income

Rhode Island operates Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries, administered through the Department of Human Services. The Qualified Medicare Beneficiary (QMB) program covers Medicare Part A and Part B premiums plus all Medicare deductibles and coinsurance for individuals with income at or below 100% FPL; federal law bars providers from billing QMB enrollees for that cost-sharing. As of February 1, 2026, Rhode Island consolidated the Specified Low-Income Medicare Beneficiary (SLMB) category into QMB, so individuals with income between 100% and 120% FPL are now enrolled in QMB automatically. The Qualifying Individual (QI) program covers Part B premiums for individuals with income between 120% and 135% FPL. MSP applications go through the same DHS process as RIte Care; call 1-855-697-4347 or apply at healthyrhode.ri.gov. Approximately 12 million Americans are dual-eligible (both Medicaid and Medicare); Rhode Island's MSP programs serve this population at the state level.

Read the Medicare eligibility guide

Frequently Asked Questions