Eligibility & How to Apply

Long Term Services and Supports (LTSS) involves a variety of services designed to meet a person’s health or personal care needs. These services help people live as independently and safely as possible when they can no longer perform everyday activities on their own.

Am I eligible? 

Individuals must meet both the financial and clinical level of care requirements in order to qualify for Medicaid & LTSS.

Basic Eligibility Requirements

1. Residency:  You must reside in Rhode Island
2. Financial:  LTSS will assess the income and assets of applicant and their spouse. You may be asked to provide verification of income, property, resources and other necessary information if requested
   1. Your countable resources may not exceed $4,000 for an individual
3. You must meet the Level of Care

For information on choosing the right setting for you or your family member, click here.

What if I am not eligible?

Older adults who do not qualify for Medicaid LTSS may be eligible for in-home supports, adult day health programming and/or assisted living services, including the @Home Cost Share, a program administered by the Office of Healthy Aging, a division of DHS. Learn more about all of these and more by going here. 

How Do I Apply For LTSS?

For all LTSS forms to apply, please see your respective section or visit the EOHHS page here for more information on LTSS. The documents you will find include the Application for Assistance Cover Sheet when applying for health coverage, contact information for staff, and agencies that can support and answer questions for those applying.

Remember: When printing the appropriate application and instructions (if needed), fill it out as completely as possible.

Please mail the completed application to the RI Department of Human Services, P.O. Box 8709, Cranston, RI 02920-8787.

What Are My LTSS Delivery Options?

If you meet the clinical and financial criteria for Medicaid-funded long term care, your care will be delivered through one of the following options:

• Managed long term care: "Rhody Health Options,” PACE or "Connect Care Choice Community Partners."
• Fee-for-service: You can get your LTSS through a fee-for-service system. Under this system, you may choose the agency or provider who delivers the service(s).
• Self-direction: You and/or your family can purchase home and community-based services on your own through a self-direction service delivery system. Under this option, you will receive help to develop a budget for the services in your authorized plan of care. You will then be connected to an agency – a "fiscal intermediary" – that will help you pay for your needed services.

How do I find a Medicaid provider? 

The Executive Office of Health and Human Services (EOHHS) has a Provider Search that can be used to find doctors or other health care professionals who are Medicaid Providers. However, this list does not guarantee that the Medicaid provider is currently accepting new patients. If you are enrolled in a health plan, please contact your health plan's Member Services department for participating providers. Go here to use the provider search. 

How do I Report A Change?

If you need to report a change, please fill out the most appropriate form and return it to the address listed at the top of the form.

Other Forms

For more information...

Call (401) 574-8474