Updated: January 28, 2026
Advertising & Editorial Disclosure
Medicare Advantage plans in Rhode Island include HMO-POS and PPO. Two plans charge $0 monthly, with premiums increasing to $59 for enhanced benefits.
Blue Cross Blue Shield leads HMO-POS plans at $27 monthly with 4 stars, while Aetna offers top PPO coverage at $13 per month.
Verify provider network participation for your doctors, examine prescription drug formularies for your medications and calculate total annual costs to choose the right plan.
We evaluated Rhode Island's best Medicare Advantage plans using CMS star ratings, premiums, maximum out-of-pocket costs and coverage features. Blue Cross Blue Shield leads HMO-POS plans with a $27 average monthly premium, $6,000 average MOOP and a 4-star rating.
Aetna tops PPO options at $13 monthly with a $5,900 MOOP limit and 4.5-star rating. Residents get affordable premiums and broad benefits from both providers.
| HMO-POS | Blue Cross Blue Shield | 4.00 | $27 | $6,000 | BlueCHiP for Medicare Access (HMO-POS) |
| PPO | Aetna | 4.50 | $13 | $5,900 | Aetna Medicare Signature (PPO) |
Medicare Advantage plans differ from Original Medicare by bundling hospital, medical and prescription drug coverage through private insurers. These Part C plans must match Original Medicare's benefits while adding dental, vision and hearing coverage.
Best HMO-POS
CMS Star Rating
Plan Types
Best PPO
CMS Star Rating
Plan Types
HMO-POS Medicare Advantage plans in Rhode Island show strong quality ratings, with seven of eight earning 4 CMS stars and none rated at 3 stars. Three providers offer these eight coverage options, and half don't charge monthly premiums. Maximum out-of-pocket costs reach $5,512, ranging from $4,500 to $6,750.
| Blue Cross Blue Shield | 4.00 | $27 | $6,000 | 4 | 5.00 |
| UnitedHealthcare | 4.00 | $12 | $5,367 | 3 | 4.47 |
| Aetna | 3.50 | $0 | $4,500 | 1 | 4.44 |
HMO-POS plans cost less than PPOs while giving residents more flexibility than standard HMOs. You can visit out-of-network specialists when needed. Those appointments cost more, but you can go for out-of-network care if your network lacks a certain specialist or you travel and need care.
Rhode Island keeps PPO Medicare Advantage simple with just 3 plans available. Monthly premiums run $0 to $26, and half the plans charge nothing. Out-of-pocket maximums fall between $5,900 and $6,700, around $6,167. Two plans earned 4.5-star ratings, while one scored 3.5 stars. PPO plans cost more than HMOs but let you see specialists without referrals.
| Aetna | 4.50 | $13 | $5,900 | 2 | 4.25 |
| UnitedHealthcare | 3.50 | $0 | $6,700 | 1 | 4.00 |
PPO plans work best for Rhode Island residents who value provider choice and may require specialized services from various health care professionals. You'll pay higher premiums, but you can see any doctor without referrals and access out-of-network specialists when needed, though staying in-network reduces your out-of-pocket costs.
Medicare Advantage coverage in Rhode Island works best when your plan matches your health situation and financial limits.
Contact your doctors and hospitals to verify they're in the plan's network, not just with the insurance company generally. Each plan from the same insurer can have different provider networks.
Plans with no premium may carry higher out-of-pocket costs through copays and deductibles. Factor in your expected medication expenses and specialist visits when calculating annual costs.
Review the drug list to verify your prescriptions are included and check which tier they're in. You'll pay more for higher-tier medications, and some drugs need prior approval from the plan.
Pick an HMO plan type for the lowest premiums and coordinated care through your primary doctor. HMO-POS works if you want occasional out-of-network flexibility. PPO suits frequent travelers or those wanting unrestricted specialist access.
Star ratings measure plan quality, service and member satisfaction on a 1-5 scale. Higher-rated plans—especially those with 4 or 5 stars—deliver superior care and customer service.
Plans often add benefits like dental coverage, vision care, fitness memberships and allowances for over-the-counter health items.
Out-of-pocket maximums protect you from excessive medical expenses by capping what you pay annually. Plans with lower caps offer stronger financial protection but charge higher monthly premiums.
Plan type impacts Medicare Advantage costs across Rhode Island. HMO-POS plans average $30 monthly with a median of $14, but they offer lower out-of-pocket maximums averaging $5,513. PPO plans have $0 median premiums and $9 average monthly costs, yet their out-of-pocket maximums average $6,167, much higher than HMO-POS options. PPOs charge more overall because they let you see out-of-network providers and access specialists without referrals.
| HMO-POS | $14 | $30 | $5,513 |
| PPO | $0 | $9 | $6,167 |
Get answers about how to enroll in Medicare Advantage, what's covered and enrollment timing for residents.
Enroll in Medicare Part A and B first, then compare plans on Medicare.gov, contact insurers directly, or work with a licensed agent during enrollment periods or other qualifying periods.
Medicare Advantage plans cover everything Original Medicare does, plus most include prescription drugs and extra benefits like dental, vision, and fitness memberships.
Medicare Advantage replaces Original Medicare with bundled coverage from private insurers, while Medicare Supplement (Medigap) works alongside Original Medicare to cover deductibles and copays.
Rhode Island Medicare Advantage open enrollment runs Oct. 15 through Dec. 7 annually. Current enrollees also get another opportunity from Jan. 1 to March 31.
Our analysis of Medicare Advantage plans uses a scoring methodology and three key factors:
This scoring system helps you compare plans objectively while accounting for what matters most: what you'll pay and the quality of care you'll receive.
About Mark Fitzpatrick
Mark Fitzpatrick, a Licensed Property and Casualty Insurance Producer, is MoneyGeek's resident Personal Finance Expert. He has analyzed the insurance market for over five years, conducting original research for insurance shoppers. His insights have been featured in CNBC, NBC News and Mashable.
Fitzpatrick holds a master’s degree in economics and international relations from Johns Hopkins University and a bachelor’s degree from Boston College. He's also a five-time Jeopardy champion!
He writes about economics and insurance, breaking down complex topics so people know what they're buying.
