To begin, keep in mind these key points about health insurance in Rhode Island:
1. Rhode Island law requires you to have health insurance.
The federal tax penalty for going without health insurance ended in 2019, but a handful of states, including Rhode Island, have enacted laws to replace it. Beginning in January 2020, Rhode Island residents must have health insurance that meets the requirements of the Affordable Care Act or face a state tax penalty, unless they qualify for an exemption.
To sign up for a health plan under the Affordable Care Act (Obamacare) you can go directly to the online health insurance marketplace for Rhode Island -- or you can get help in person or over the phone.
You can find the health insurance exchange for Rhode Island at Health Source RI. This is where you can learn about the various health insurance options available to you under Obamacare. If you see a plan you like, you'll be guided through the enrollment process online.
Getting In-Person Help with Enrollment
In Rhode Island, if you need help understanding your options for coverage under Obamacare or signing up for a plan, you can get free assistance from a certified navigator or from a licensed health care agent or broker.
Navigators can explain your options, answer your questions, and help you apply for the plan you choose -- but they can’t legally recommend a specific plan for you.
Private insurance agents or brokers can also help you understand your health care coverage options under Obamacare. Unlike government-trained navigators, they are allowed to suggest the best plan for you.
Beginning January 1, 2020, Rhode Island law requires you to have health insurance.
Since the federal penalty for going without health insurance went away in 2019, a handful of states -- including Rhode Island -- have passed their own health insurance requirements.
To avoid the Rhode Island tax penalty, you must have what the state considers "minimal essential coverage" or prove your eligibility for an exemption.
What qualifies as minimal essential coverage in Rhode Island?
In Rhode Island, minimal essential coverage is the same under state law as it is under the federal Affordable Care Act. That means if you have any of the following types of health coverage, you have minimal essential coverage and you won’t have to pay a penalty:
Get a colonoscopy, mammogram, vaccinations, and other essential services for free
The Affordable Care Act requires health insurance plans to offer certain preventive care services free of charge -- or more accurately, for nothing more than the cost of your monthly insurance premiums. This rule applies to most plans sold directly by insurance companies and all plans sold through Health Source RI, the health care marketplace for Rhode Island. Covered preventive services are available for free (meaning no co-pay or other out-of-pocket charges) whether or not you’ve met your plan’s annual deductible.
Tips for Using Your Preventive Care Benefits – And Avoiding Unexpected Charges
Below, you’ll find a list of free preventive benefits -- screening tests, counseling services, and vaccinations -- for adults, women, and kids. But first, here are some pointers to help you avoid an unexpected bill for services you thought were preventive.
Use a network provider. To get a preventive service for free, you must use a health care provider in your insurance plan’s network.
Many self-employed people will be quick to tell you that getting and paying for health insurance is one of the biggest hassles they face. But this may change for the better under Obamacare, which provides new coverage options for the self-employed.
Are You Self-Employed or an Employer?
Before you start evaluating your options for health coverage, you need understand whether you are in fact considered self-employed under Obamacare.
The law says you are self-employed if you are an independent contractor or a sole proprietor without employees. (If you hire other independent contractors to do some work for you, you probably still qualify as self-employed.) Self-employed people can use the new health care marketplace to purchase individual health insurance plans.
If you have employees – usually, workers whose income you report on a W-2 at the end of the year -- you’re considered an employer. In that case, you can learn about purchasing health insurance for yourself and your employees through the SHOP Marketplace.
The difficulties of unemployment are often compounded by the lack or loss of health insurance. But millions of Americans who are currently without both a job and health coverage may find relief under Obamacare. That's because low-cost coverage options may be available to you through Health Source RI, the health insurance marketplace serving Rhode Island.
All plans available through the marketplace offer essential medical benefits, including preventive care, emergency services, and prescription drug coverage. You can't be turned away if you have a pre-existing medical condition and, as an unemployed person, you probably qualify for significant cost-saving subsidies.
When you sign up for a marketplace health plan, your coverage can start within a few weeks. Usually, you must sign up during an open enrollment period. But leaving your job and losing job-based health insurance makes you eligible for a special enrollment period. That means you'll have 60 days to sign up for a new health plan.
When registered domestic partners or civil union partners apply for coverage at an Affordable Care Act health insurance marketplace, there’s one question that almost always arises: Do we apply based on our separate incomes, or must we include all the income we make as a couple?
The answer depends on the state where you live.
States other than California, Nevada, or Washington. In almost all states, registered domestic partners or civil union partners who apply for insurance via the state’s health insurance exchange must do so separately. Each partner includes only his or her separate income, and this amount determines health plan costs and eligibility for cost-saving subsidies. It works this way because domestic partners are not considered married for federal tax purposes. (If you registered first and got legally married later, this article doesn't apply to you. You must apply as a married person and report your combined income.)
If you’re over the age of 65, your health insurance options under the Affordable Care Act depend on whether or not you’re covered by Medicare or another insurance plan. To find out what, if anything, you need to do, find the situation below that applies to you.
You have Medicare. If you’re already enrolled in Medicare, you’re considered covered under the ACA, and you don’t have to do anything. In fact, it’s illegal for someone who knows you have Medicare to try to sell you a plan through a health care marketplace.
The Affordable Care Act enhances your existing Medicare coverage in a couple of important ways:
When Obamacare first launched, the federal and state health insurance marketplaces (also called “exchanges”) were plagued by technical troubles. Many people who tried to sign up for new health insurance plans online in the early days were unable to complete their applications.
Because of these difficulties, some individuals and application assistants turned to the old-school way of getting health insurance -- paper applications.
Applying on Paper May Not Be Better or Faster
When facing a slow or broken online health insurance exchange, using a paper application may seem tempting -- at least it would provide the feeling of getting something done. However, paper forms may not speed up the process at all. On the contrary, they could slow down your application even more.
The worker who reviews your paper application must manually enter the information from your forms into the same system you would use online at your state’s exchange. It won’t work any faster for them than it does for you. Plus, using a paper application opens up more opportunity for error by putting more people between you and your goal of getting insurance.
It’s still best to apply online if you can. That said, if you feel that you’re unlikely to come back and apply for health insurance later, you may want to go ahead and complete a paper application now.
To get a paper application, call the Health Source RI customer service center and let them know you want to apply on paper. They'll point you to a downloadable application or send you one in the mail. For detailed Health Source RI contact information, see How To Sign Up for Obamacare in Rhode Island.