Different metal tiers of health insurance are available in Rhode Island with varying deductibles, premiums and maximum out-of-pocket (MOOP) limits. NHPRI is the cheapest for the Bronze, Silver and Gold tiers. Blue Cross Blue Shield offers the lowest cost for the Platinum tier, PPO and POS plans.
The baseline plan type in Rhode Island is HMO. The costs associated with plans can vary based on factors such as age, income level and coverage amount.
If you are looking to balance monthly premiums with quality claims and coverage, MoneyGeek analyzed the best health insurance in Rhode Island.
Most Affordable Health Insurance in Rhode Island
Cheapest Health Insurance in Rhode Island by Metal Tier
Neighborhood COMMUNITY from NHPRI is the most economical option among health insurance plans in the Silver tier, at around $364 a month. MoneyGeek compiled the cheapest options for each tier in the state:
- Bronze: Neighborhood INNOVATION from NHPRI ($270 per month)
- Silver: Neighborhood COMMUNITY from NHPRI ($364 per month)
- Gold: Neighborhood PLUS from NHPRI ($379 per month)
- Platinum: VantageBlue Direct Plan 750/1500 Modified from Blue Cross Blue Shield ($623 per month)
Higher-value metal tiers often come with increased premiums and lower out-of-pocket maximums, but they provide more comprehensive coverage. That’s why you need to assess your needs carefully when selecting a plan to ensure a balance between cost and coverage.
Metal tiers serve as classifications for health insurance plans within the exchange, simplifying comparisons between options. A plan's value corresponds to its metal (for example, Gold surpasses Silver in value), with higher-value metals typically demanding higher premiums but offering reduced out-of-pocket expenses.
Young individuals or those who don't foresee needing regular care may opt for less valuable metals, while those with the financial means or who are anticipating medical expenses in the long run might prefer more valuable metal tiers. Silver plans offer the most balanced approach between premiums and coverages. For those with lower incomes, this plan type may also offer the chance to reduce deductibles, making them even more attractive.
Cheapest Silver Plans in Rhode Island
NHPRI’s Neighborhood COMMUNITY stands out as the most affordable Silver health insurance plan in Rhode Island. This plan provides a great balance between cost (around $364 per month) and coverage. The cheapest options in this tier are:
- Neighborhood COMMUNITY from NHPRI: $364 per month
- Neighborhood VALUE from NHPRI: $382 per month
The Silver metal tier finds a middle ground between cost-effective premiums and extensive coverage. It boasts reduced out-of-pocket expenses in comparison to Bronze plans, but its premiums tend to be higher. Conversely, it provides less coverage compared to Gold or Platinum plans, which generally come with higher premiums.
Since the most accessible plan in Rhode Island is an HMO, we focus our recommendations in this section on this type.
Cheapest Gold Plans in Rhode Island
Neighborhood PLUS from NHPRI emerges as the most budget-friendly Gold health insurance plan available, costing approximately $379 per month. The top three affordable options are:
- Neighborhood PLUS from NHPRI: $379 per month
- Neighborhood ESSENTIAL from NHPRI: $387 per month
- BlueCHiP Direct Advance 2300/4600 from Blue Cross Blue Shield: $404 per month
The Gold metal tier offers more comprehensive coverage and lower out-of-pocket costs than Silver plans but at the expense of higher premiums. While it might be ideal for those who have higher health care costs, it might not be the most cost-effective choice for individuals with fewer health needs.
Cheapest Bronze Plans in Rhode Island
Neighborhood INNOVATION from NHPRI distinguishes itself as the premier budget-friendly choice among Bronze plan health insurance options. Its average monthly premium stands at around $270. The most affordable options in this tier include:
- Neighborhood INNOVATION from NHPRI: $270 per month
- Neighborhood ECONOMY from NHPRI $274 per month
- BlueSolutions for HSA Direct 6300/12600 Modified from Blue Cross Blue Shield: $322 per month
Compared to other tiers, the Bronze metal tier offers lower monthly premiums but higher out-of-pocket costs and less comprehensive coverage. It can be a suitable choice for young individuals or generally healthy people with limited health care needs.
Cheapest Platinum Plans in Rhode Island
VantageBlue Direct Plan 750/1500 Modified from Blue Cross Blue Shield is the most affordable choice within the Platinum tier options. You can expect to pay around $623 per month with this plan. The cheapest options in this tier are:
- VantageBlue Direct Plan 750/1500 Modified from Blue Cross Blue Shield: $623 per month
- VantageBlue Direct Plan 750/1500 from Blue Cross Blue Shield: $625 per month
The Platinum metal tier, while priced expensively, offers the advantage of lower out-of-pocket costs and extensive coverage for health care services. It ensures that you receive the best coverage despite the higher monthly premiums.
For individuals who qualify for premium tax credits, there is another potential cost-saving option in the form of cost-sharing reductions (CSRs) on Silver plans. While CSRs do not affect the monthly premiums, they can significantly lower out-of-pocket expenses associated with health care, such as deductibles, copayments and out-of-pocket maximums.
CSRs can be particularly beneficial for those with ample health care needs. By taking advantage of both premium tax credits and CSRs, individuals can further reduce their health care expenses and obtain optimal coverage for their medical needs.
Cheapest Health Insurance in Rhode Island by Plan Type
Health Maintenance Organization (HMO) plans are the most common plan type in Rhode Island, but there are also other options available through the exchange, including Point of Service (POS) and Preferred Provider Organization (PPO).
For these plans, our top recommendations for those who want the cheapest costs include:
- POS: BlueCHiP Direct Advance 4950/9900 from Blue Cross Blue Shield ($379 per month)
- PPO: BlueSolutions for HSA Direct 4100/8200 from Blue Cross Blue Shield ($450 per month)
- HMO: Neighborhood COMMUNITY from NHPRI ($364 per month)
When selecting a plan type, individuals must weigh the trade-offs between network limitations and cost, as well as the degree of flexibility in accessing health care providers.
Rhode Island offers various health insurance plan types to cater to diverse needs. These are HMO, POS and PPO plans.
- HMO plans have a limited network of providers and require you to stay within it to be covered unless it’s an emergency. Referrals are necessary for specialists.
- PPO plans provide greater flexibility in choosing health care providers, with no referral needed for specialists. They come with higher premiums and out-of-pocket costs but have a larger network of providers.
- POS plans allow for out-of-network care but with higher out-of-pocket costs. These might be a good option for those who want to combine the flexibility to see any provider with the ability to get cheaper coverage for in-network services.
Cheapest Health Insurance in Rhode Island by County
Note that the availability of health insurance plans can vary across Rhode Island. Rates for these plans may also fluctuate based on your location, with differences even seen between counties within the state. That’s why it’s crucial to compare various plans to identify the most suitable option for your needs.
The table below displays the prices of available Silver plans by county. Use it to explore and select the ideal plan for your particular location.
Health Insurance Costs in Rhode Island by Age and Metal Tier
The average monthly expenses for health insurance in Rhode Island can experience considerable variations depending on the chosen metal tier. Each metal tier signifies distinct levels of coverage and cost-sharing, with higher tiers typically providing superior coverage at a greater cost.
For a 40-year-old living in Rhode Island, the average monthly premium for each metal tier are as follows:
- Bronze: $297 per month
- Silver: $417 per month
- Gold: $443 per month
- Platinum: $624 per month
Higher-tier metal plans offer better coverage but come with increased premiums. The trade-off is paying more upfront, potentially saving you money if you require extensive medical care.
Health insurance costs typically rise with age due to increased health needs. For example, average Silver plan premiums for 18-year-olds are $298 per month, while 60-year-olds pay $886 per month.
What to Know About Rhode Island Health Insurance
We analyzed private health insurance data to discover the most cost-effective options. Typically accessible during open enrollment, these plans cater to various coverage requirements and financial circumstances. However, individuals with low income might qualify for Medicaid, while seniors and those with disabilities could be eligible for Medicare. These alternatives could provide more pocket-friendly and tailored options for those specific demographics.
Private Health Insurance in the Rhode Island Marketplace
Rhode Island residents can enroll in, re-enroll in or change health plans during open enrollment, which starts on November 1 and ends on January 15.
However, to get coverage that starts on January 1, you need to enroll or change plans by December 15 and pay your first premium. Waiting until after that date may result in a later start date for coverage.
After January 15, enrollment or changes to health plans are only allowed if you qualify for a special enrollment period. Eligibility for this is based on specific life events, such as getting married, having a baby, losing other health coverage, moving or becoming a U.S. citizen. You need to prove that you have experienced one of these events to qualify for special enrollment.
Medicaid in Rhode Island
Medicaid, a government-sponsored initiative, offers health insurance to low-income residents and families in Rhode Island. Income levels determine eligibility for Medicaid, and the program encompasses various health care services such as physician appointments, hospitalizations, prescription medications and additional care.
Medicare in Rhode Island
Medicare is a comprehensive federal health insurance program that provides coverage to individuals who are 65 years old or older or those who have certain disabilities or medical conditions.
Medicare has three parts:
- Part A covers hospital stays, skilled nursing facility care, hospice care and specific home health care services.
- Part B provides coverage for select doctors' services, outpatient care, certain medical supplies and preventive services.
- Part D functions as the prescription drug benefit, encompassing vaccines and various prescribed medications.
Rhode Island Health Insurance Frequently Asked Questions
For individuals seeking health insurance, we answered the most prevalent questions about pricing and availability in Rhode Island.
About Mark Fitzpatrick
- HealthCare.gov. "Special Enrollment Period (SEP)." Accessed April 25, 2023.