Compare Rates and Save on Health Insurance

widget-location-pin
On This Page:
MoneyGeek Logo IconBestHealth InsuranceRhode Island
2023

Best Health Insurance in Rhode Island

Best Overall - NHPRI
Best for Low MOOP - NHPRI
Best Cheap - NHPRI
Best for Young Adults - NHPRI
Best for HMO - NHPRI
Best for PPO - Blue Cross Blue Shield
Best for POS - Blue Cross Blue Shield

Best Overall for Health Insurance in Rhode Island

The best health insurance provider in Rhode Island is provided by NHPRI. It received an overall score of 58 out of 100 and excelled in multiple areas, including affordability and claims denial.

For this category, we evaluated 10 Silver health maintenance organization (HMO) plans, 10 Silver point of service (POS) plans and 15 Silver preferred provider organization (PPO) plans.

NHPRI

pros

Most affordable in the state

Denies no valid claims

cons

Low MOOP score

Only offers HMO plans

COMPANY HIGHLIGHTS

Among the health insurance plans rated for Rhode Island, the majority are HMO plans, which tend to be more affordable but require staying within the provider network except in emergencies. Notably, the winner, NHPRI, offers 10 HMO plans.

Additionally, it's worth highlighting that NHPRI received a perfect claims denial score, indicating that it accepts all eligible claims. This is a significant advantage as it reflects NHPRI's commitment to providing efficient claims processing and a higher likelihood of coverage approval.

The average cost of the plans offered by NHPRI is $373, which is an important factor for individuals seeking affordable health insurance in Rhode Island. However, it's crucial to note that the average maximum out-of-pocket (MOOP) cost is $8,650, which should be considered when assessing the potential financial responsibility under the plans.

Plan Recommendations

We recommend the following plans from NHPRI:

  • Neighborhood COMMUNITY: $364 per month (MOOP of $8,500)
  • Neighborhood VALUE: $382 per month (MOOP of $8,800)

Best Health Insurance in Rhode Island for Low Out-of-Pocket Costs

The best provider for low maximum out-of-pocket (MOOP) costs in Rhode Island is NHPRI. With a score of 58 out of 100, it has affordable rates and accepts most claims.

In this category, we rated Gold and Platinum plans, including 10 HMO, 10 POS and 15 PPO Gold plans and 10 PPO Platinum plans.

NHPRI

pros

Relatively affordable rates

Doesn’t deny eligible claims

cons

Limited plan options

Poor MOOP score

COMPANY HIGHLIGHTS

With a score of 58 out of 100, NHPRI offers low rates of $383 per month and a MOOP of $6,600. It accepts all valid claims, as seen by its 0% claims denial rate, and offers 10 HMO Gold plans. Its limited plan options might be restrictive for some potential policyholders.

Even though NHPRI doesn’t have the lowest average MOOP of the insurers we reviewed, its low rates and excellent claims denial score earned it the ranking of the best insurer for low out-of-pocket costs in Rhode Island.

Plan Recommendations

We suggest the following plans from NHPRI:

  • Neighborhood ESSENTIAL: $387 per month (MOOP of $5,650)
  • Neighborhood PLUS: $379 per month (MOOP of $7,550)

Best Cheap Health Insurance in Rhode Island

The cheapest health insurance provider in Rhode Island is NHPRI. With a MoneyGeek score of 74 out of 100, it provides affordable coverage with an average monthly premium of $373. We weighted plans more heavily based on low premiums to identify the winner in this category, considering the trade-off of higher out-of-pocket costs.

The plans rated for this category were Silver plans, which offer a balance between cost and coverage. We evaluated 10 Silver HMO plans, 10 Silver POS plans and 15 Silver PPO plans.

If you're focused soley on cost, MoneyGeek also determined the cheapest health insurance in Rhode Island.

NHPRI

pros

Relatively affordable

Excellent claims management score

cons

Limited plan types

Poor MOOP score

COMPANY HIGHLIGHTS

The cheapest health insurance provider in Rhode Island is NHPRI, costing $373 per month on average, with a MOOP of around $8,650. NHPRI offers 10 Silver plans, all of which are HMO plans.

HMO plans require staying within the provider network except in emergencies, and a referral is needed to see a specialist. While HMO plans have limitations, they are generally more affordable.

It is worth noting that HNPRI’s lower denial rate is favorable, indicating that the provider approves valid claims.

Plan Recommendations

We advise evaluating the following plans from NHPRI:

  • Neighborhood COMMUNITY: $364 per month (MOOP of $8,500)
  • Neighborhood VALUE: $382 per month (MOOP of $8,800)

Best Health Insurance for Young Adults in Rhode Island

The best provider for young adults in Rhode Island is NHPRI. With a MoneyGeek score of 58 out of 100, it provides affordable coverage with an average premium cost of $218.

MoneyGeek analyzed providers offering Bronze or Catastrophic plans, which have lower premiums but higher out-of-pocket costs. Catastrophic plans are available for individuals under the age of 30. In this category, we reviewed 10 Bronze HMO and 10 Bronze PPO plans.

NHPRI

pros

Relatively affordable

Approves eligible claims

cons

Doesn’t offer many plans

Higher MOOP

COMPANY HIGHLIGHTS

The cheapest provider for young adults in Rhode Island is NHPRI, with an average premium cost of $218 and a maximum out-of-pocket cost (MOOP) of $7,725. It provides affordable coverage and 10 HMO plans.

This insurer does accept valid claims, giving policyholders the peace of mind that they will get financial protection for their medical needs. However, it does have a higher MOOP than the other insurer we evaluated in this category.

Plan Recommendations

We suggest reviewing the following plans from NHPRI:

  • Neighborhood ECONOMY: $219 per month for 26-year-olds and $195 for 18-year-olds (MOOP of $6,900)
  • Neighborhood INNOVATION: $216 per month for 26-year-olds and $193 for 18-year-olds (MOOP of $8,550)

Best Health Insurance by Plan Type in Rhode Island

Insurance providers in Rhode Island offer different plan types to meet the diverse needs of consumers. Among HMO plans, NHPRI emerges as the best overall provider, scoring 100 out of 100. Blue Cross Blue Shield offers the best POS and PPO plans, scoring 100 out of 100.

For these recommendations, we focused on Silver plans, which strike a balance between premiums and out-of-pocket costs. In Rhode Island, there are 10 HMO plans, 10 POS plans and 15 PPO plans available in the Silver tier. These options provide a range of choices for individuals seeking comprehensive coverage in the state.

Best for HMO: NHPRI

NHPRI
COMPANY HIGHLIGHTS

NHPRI offers 10 HMO Silver plans in Rhode Island. With an average rate of $373 per month and an average MOOP cost of $8,650, this plan provides comprehensive coverage within a designated provider network. It is a cost-effective option for individuals seeking lower monthly payments and readily available in-network providers for their health care needs. However, you must stay in network and get referrals to see specialists with HMO plans.

Plan Recommendations

Consider reviewing these HMO plans from NHPRI:

  • Neighborhood COMMUNITY: $364 per month (MOOP of $8,500)
  • Neighborhood VALUE: $382 per month (MOOP of $8,800)

Best for PPO: Blue Cross Blue Shield

Blue Cross Blue Shield
COMPANY HIGHLIGHTS

Blue Cross Blue Shield offers 15 PPO Silver plans in Rhode Island. With an average rate of $469 per month and an average MOOP cost of $7,467, this plan provides a wider network of providers and greater flexibility in choosing health care services.

While PPO plans offer more out-of-network coverage, they come with slightly higher monthly premiums. These plans are ideal for individuals who prioritize the freedom to see specialists and health care providers of their choice.

Plan Recommendations

These plans from Blue Cross Blue Shield are worth considering:

  • BlueSolutions for HSA Direct 4100/8200: $450 per month (MOOP of $5,700)
  • BlueBasic Direct 5500/11000: $480 per month (MOOP of $7,800)

Best for POS: Blue Cross Blue Shield

Blue Cross Blue Shield
COMPANY HIGHLIGHTS

Blue Cross Blue Shield offers 10 POS Silver plans in Rhode Island. With an average rate of $409 per month and an average MOOP cost of $7,350, this type of plan combines flexibility and cost savings. It allows members to receive coverage both in and out of the network, although out-of-network costs may be higher. It is suitable for those who desire a balance between in-network affordability and the ability to see providers outside the network.

Plan Recommendations

We recommend the following plans from Blue Cross Blue Shield:

  • BlueCHiP Direct Advance 4950/9900: $379 per month (MOOP of $7,200)
  • BlueCHiP Direct 5000/10000: $438 per month (MOOP of $7,500)

How to Find the Best Health Insurance for You in Rhode Island

Finding the best health insurance in Rhode Island depends on balancing your health care needs and your budget preferences. If you prioritize lower monthly premiums or prefer to pay less when you need care, it's essential to understand the coverage provided by different plan types available in Rhode Island.

  • doctor icon

    Understand when a health insurance plan will cover you

    Different plan types have varying networks of health care providers. In-network providers have negotiated rates with the insurance company, resulting in lower out-of-pocket costs for policyholders. Out-of-network providers may result in higher costs, and coverage levels can vary. In Rhode Island, there are 30 HMO, 20 POS and 50 PPO plans available.

  • money2 icon

    Weigh the cost of premiums vs. the cost of care

    When you are determining how to get health insurance, remember that lower monthly premium plans often come with higher out-of-pocket costs, such as deductibles, copayments and co-insurance. Comparing the rates between NHPRI and Blue Cross Blue Shield demonstrates this. With a Silver HMO from NHPRI, you’ll pay an average of $373 monthly and have a MOOP of $8,650. With a Silver PPO from Blue Cross Blue Shield, your monthly premiums will run around $469 with a MOOP of $7,467.

Consider Rhode Island Medicare or Medicaid if You’re Eligible

Medicare eligibility is based on age or certain qualifying conditions. Individuals aged 65 and older are generally eligible for Medicare coverage. Additionally, individuals under 65 who have specific illnesses or disabilities may also qualify for Medicare.

Medicare typically includes:

  • Part A: Provides coverage for home medical offerings like hospice services and inpatient hospitalizations.
  • Part B: Covers visits to the doctor, outpatient treatment, medical equipment and preventative services.
  • Part D: Pays for prescribed medications and suggested vaccinations.

Medicaid eligibility is generally based on income levels, with low-income individuals and families meeting the criteria for coverage. Additional qualifiers may exist, and the state's Medicaid page can provide specific guidance on eligibility requirements.

Frequently Asked Questions About Health Insurance in Rhode Island

For individuals seeking health insurance, it's common to have questions regarding costs and availability. We answered some frequently asked questions to help you find the right coverage for your needs.

About Mark Fitzpatrick

Mark Fitzpatrick headshot

Mark Fitzpatrick is a senior content director at MoneyGeek with over five years of experience analyzing the insurance market, conducting original research and creating content that can be personalized for every buyer. He has been quoted on insurance topics in several publications, including CNBC, NBC News and Mashable.

Mark earned a master’s degree in Economics and International Relations from Johns Hopkins University and a bachelor’s degree from Boston College. He is passionate about using his economics and insurance knowledge to bring transparency around financial topics and help others feel confident in their money moves.