Best Ways To Get Affordable Health Insurance Rhode Island.

Although Rhode Island is small in terms of area, it is big on beauty. Surrounded by waters, the Ocean State has so many breathtaking natural views that would keep you mesmerized. 

While the average cost of living is 22% above the national average, the cost of health is below the national average. Health is wealth and securing your health is prudent.

In Rhode Island, residents are required by the Rhode Island Health Coverage Mandate to have the minimum essential coverage (except for exempted cases), or else you’d be paying a penalty fee.

There are many ways you can purchase health insurance in Rhode Island. Many employers in the Ocean state offer health insurance coverage to their employees; as a part of their benefits.

If you are unemployed or self-employed, you could also obtain yours directly from the health insurance companies or you could buy through an insurance broker or agent. These agents take care of your premiums and enrollment.

Another way which is also the cheapest source is through government-provided health care programs. However, these programs are not for everyone; it’s available to only certain individuals that meet some qualifications. Stated below are these programs and those who are eligible:


This program is free. It’s the cheapest type and it provides coverage for prescription drugs, doctors’ services, inpatient and outpatient hospital services, X-ray and laboratory services, etc. this healthcare program is for only residents in Rhode Island with income 138% below the federal poverty level.

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Unlike Medicaid, this program requires you to pay some monthly premiums for coverage. Although you are required to pay it is still more affordable than private health insurance in Rhode Island.

Medicare provides coverage to only individuals ages 65 and above and also to individuals with qualifying disabilities.

Medicare is comprised of three segments:

Part A

Part A is called hospital insurance and it is free. This part provides coverage for hospital stays, care in skilled nursing facilities, hospice care, and certain home health care services.

Part B

Part B is also known as medical insurance. Premium costs for this part are dependent on your income. It covers physician services, outpatient care, some medical supplies, and preventive services.

Part D

Part D is prescription drug insurance. The cost of premiums in this part is based on the type of plan you choose. It provides coverage for prescription drugs and vaccines.

Factors Affecting Average Cost Of Premiums In Rhode Island

Your premiums costs are affected by several factors ranging from age to healthy habits to your preferred plan type and even your occupation.

These factors are used by health insurance providers in Rhode Island to determine how much you pay for premiums. Understanding these factors would help you in your search for affordable rates.


This factor plays a major role in the amount you are required to pay for premiums in Rhode Island. Your premiums are directly proportional to your age. This means that your premium cost increases as you get older. 

Older individuals are more likely to need medical care and attention compared to younger individuals and this is why they are charged more on health insurance.

Smoking / Tobacco Use

Smokers in general, pay higher premiums on health insurance compared to non-smokers. The reason is that smokers are exposed to more dangers and challenges related to health and so would have to pay more to insure their health. 

A smoker is liable to contract diseases like heart and lung disease, chronic obstructive pulmonary disease, tuberculosis, and type 2 diabetes.

Quitting the habit of smoking can reduce your monthly cost of insurance and also improve your health in general.


Your occupation can also affect your rates. Different job descriptions come with individual risks and hazards. People who are at a higher risk of being injured or getting involved in accidents that are detrimental to health pay more on health insurance.

Body Mass Index

Residents in Rhode Island with a high Body mass index tend to pay more on health insurance. The BMI is used to estimate a person’s body fat and ascertain if an individual is of a healthy weight or not. 

A high BMI can result in diseases like osteoarthritis, diabetes, heart disease, and depression. If you are able to maintain a healthy body mass index, you should expect to pay less on health insurance.

Plan Type 

Health insurance plans have different policies. These include varying coverage, premiums, out-of-pocket maximums, and deductibles. Your premium cost would depend on the type of plan you choose.

Other factors that affect the overall average rates of premiums are past medical history, policy duration, and coinsurance features.

Private Health Insurance On The Rhode Island Marketplace

On the Rhode Island health insurance exchange, healthcare plans are divided into four metal tiers. They include bronze, silver, gold, and platinum.

These plans have varying premiums and pocket Maxes and deductibles. Let’s look at these plans to know which best suits your needs.


This is the lowest tier and it has the cheapest monthly premiums. These plans are best suited for young and healthy individuals who rarely need medical services throughout the year.

These plans cover up to 60 percent of your medical costs and although the bronze tier has really low premiums, they also have the most out-of-pocket expenses. 


The silver tier is a moderate tier. Although they are costlier than the bronze plans they are also cheaper than the gold and platinum plan.

They are a balance between the high out-of-pocket expenses of the bronze plan and the high premiums of the gold plan. Usually, silver plans cover up to 70% of your medical costs while you are left to pay 30%. 


Gold plans are more expensive than lower-tier options. They have lower out-of-pocket maximums and deductibles but also higher monthly premiums. This plan could be a great option for individuals needing regular medical care.


This is the highest tier and most expensive. The platinum plan offers the widest coverage, up to 90% of your medical costs.

While they have high monthly premiums, they equally have the least out-of-pocket maximums and deductibles.

If you have expensive prescriptions and you’re in constant need of medical care, this could be a cost-effective option for you.

Below is the average monthly premium for each tier in Rhode Island:

  • Bronze: $269
  • Silver: $422
  • Gold: $435
  • Platinum: $630

Most Affordable Health Insurance In Rhode Island By County

Rating areas are used by health insurance providers to ascertain how much residents would pay on healthcare insurance. Unlike many states, Rhode Island has only one rating area across its 5 counties.

The most affordable Silver plan in Providence, the most populous county in Rhode Island is Neighborhood COMMUNITY, provided by NHPRI, at an average of $328 per month.

Most Affordable Health Insurance In Rhode Island With High Out-of-Pocket Maxes

Residents in Rhode Island who do not need medical care often like young people often opt for plans with low premiums and high out-of-pocket deductibles.

The most affordable plan with the highest out-of-pocket costs in Rhode Island is the Bronze Neighborhood Innovation plan offered by NHPRI at an average of $189 per month for a 26-year-old.

Most Affordable Health Insurance In Rhode Island With Low Out-of-Pocket Maximums

For residents that expect high medical costs, a high premium plan with low out-of-pocket maximums could be the best choice for you. 

The most affordable plan with low out-of-pocket maximums is a Platinum VantageBlue Direct Plan 750/1500 Modified from BCBSRI. It costs $629 per month on average.

Most Affordable HMO/PPO/POS Health Insurance Plan In Rhode Island

While searching for the most affordable plans, it is important to put your needs and preferences at heart. In Rhode Island, there are three plan types available; HMO, PPO, and POS.

HMO (Health Maintenance Organisation) plans are the cheapest plan type. Members of this plan are required to stay within their provider network to access healthcare services. And also with HMO, you’d need a referral to see a specialist.

PPO(Preferred Provider Organisation) plans are more expensive than HMO plans but they have wider network coverage and better flexibility.

POS (Point Of Service) plan has the widest coverage; in and out of your network. However, the cost is usually higher out of your network. 

The most affordable Silver plans for each plan type on average are:

  • HMO: The Neighborhood Community plan offered by NHPRI costs $329 per month for the average 40-year-old.
  • PPO: The BlueSolutions for HSA Direct 4100/8200 plan offered by BCBSRI costs$456 per month for the average 40-year-old.
  • POS: The BlueCHiP Direct Advance 4650/9300 plan offered by BCBSRI costs $401 per month for the average 40-year-old.

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