Rhode Island Medicaid Income Limits

Updated August 2026

Rhode Island's pregnant women and children income thresholds are among the higher ones in the Northeast. Adults qualify at the standard ACA expansion level of 138% FPL.

Rhode Island Medicaid income limits by coverage group (2026)

Coverage group	FPL %	Monthly limit (household of 1)	Monthly limit (household of 4)
Adults ages 19–64 (ACA expansion)	138% FPL	~$1,732/mo	~$3,564/mo
Pregnant women	253% FPL	~$3,175/mo	~$6,531/mo
Children (Medicaid and RIte Care CHIP)	Up to 261% FPL	~$3,276/mo	~$6,737/mo

Adults ages 19–64 (ACA expansion)

FPL %: 138% FPL
Monthly limit (household of 1): ~$1,732/mo
Monthly limit (household of 4): ~$3,564/mo

Pregnant women

FPL %: 253% FPL
Monthly limit (household of 1): ~$3,175/mo
Monthly limit (household of 4): ~$6,531/mo

Children (Medicaid and RIte Care CHIP)

FPL %: Up to 261% FPL
Monthly limit (household of 1): ~$3,276/mo
Monthly limit (household of 4): ~$6,737/mo

No asset test for standard Rhode Island Medicaid

Rhode Island does not use an asset test for MAGI-based Medicaid, which covers adults 19–64, children, and pregnant women. Savings, vehicles, and home equity do not affect eligibility.

Long-term care Medicaid — for seniors needing nursing facility or home-based care — does apply asset limits. Rhode Island's Community Choice Waiver and nursing facility programs follow federal spousal impoverishment rules. Contact EOHHS or a Rhode Island elder law attorney for long-term care eligibility details.

How Rhode Island counts income for Medicaid

Rhode Island uses MAGI methodology for most Medicaid categories, counting income in the same way as a federal tax return — with a few modifications.

Wages, salaries, tips, and self-employment income count
Social Security benefits count for most adult categories
Unemployment benefits count
Child support received counts as income
A 5% income disregard applies to the adult expansion group at 138% FPL
Gifts, inheritances, and one-time lump sums generally do not count as income under MAGI
Household size follows IRS tax dependency rules, not just who lives in the home

Rhode Island's pregnant women coverage: 253% FPL

Rhode Island's 253% FPL income limit for pregnant women is one of the higher thresholds in the country — well above the federal minimum of 133% FPL. This means many Rhode Island women who would not qualify for standard adult Medicaid (138% FPL) can still get comprehensive prenatal, delivery, and postpartum coverage through Medicaid while pregnant. Pregnancy Medicaid includes prenatal care, delivery, postpartum care through 60 days after delivery, and access to behavioral health services — all through the same managed care plans as standard Rhode Island Medicaid.

Medicare Savings Programs (QMB) in Rhode Island

"Rhode Island QMB income limits" is a frequent search among Medicare beneficiaries trying to lower their monthly costs, and QMB is indeed the most generous of Rhode Island's three Medicare Savings Programs, administered by the Executive Office of Health and Human Services (EOHHS) alongside Rhode Island Medicaid.

Program	Situation	Monthly income limit
QMB	Individual	$1,350/mo
QMB	Married couple	$1,824/mo
SLMB	Individual	$1,616/mo
SLMB	Married couple	$2,184/mo
QI	Individual	$1,816/mo
QI	Married couple	$2,455/mo

QMB

Situation: Individual
Monthly income limit: $1,350/mo

QMB

Situation: Married couple
Monthly income limit: $1,824/mo

SLMB

Situation: Individual
Monthly income limit: $1,616/mo

SLMB

Situation: Married couple
Monthly income limit: $2,184/mo

QI

Situation: Individual
Monthly income limit: $1,816/mo

QI

Situation: Married couple
Monthly income limit: $2,455/mo

Qualified Medicare Beneficiary (QMB) is available in 2026 to an individual with income up to $1,350/mo, or a married couple up to $1,824/mo, with resource limits of $9,950 and $14,910. QMB pays the Part A premium if one is owed, the full Part B premium ($202.90/mo in 2026), and all Medicare deductibles, coinsurance, and copayments — and federal law prohibits any provider from billing a QMB enrollee for that cost-sharing, no matter how the claim is submitted.

Specified Low-Income Medicare Beneficiary (SLMB) and Qualifying Individual (QI) reach higher incomes but pay only the Part B premium: SLMB up to $1,616/mo individual ($2,184/mo couple), QI up to $1,816/mo individual ($2,455/mo couple), using QMB's resource limits. QI funding is capped annually and awarded first-come, first-served, so enrollees must reapply every year.

All three tiers carry automatic Extra Help enrollment, limiting what you pay for covered Part D drugs to $12.65 per prescription in 2026. Apply for a Medicare Savings Program through HealthSource RI at healthyrhode.ri.gov, by calling 1-855-697-4347 (1-855-MY-RIDHS), or in person at a Rhode Island Department of Human Services office — the same channels used to apply for the Medicaid programs described above.