210 R.I. Code R. 210-RICR-40-10-1.1
Program | Rhody Health Partners | Medicare-Medicaid Plan | PACE |
Population | Elders and Adults with Disabilities who do not have Medicare or other third-party coverage; Persons without Medicare who are receiving LTSS in the home or community-based service setting, are enrolled in RHP for essential primary care services only. | Elderly and non-elderly adults who have full Medicare (Parts A, B, and D) coverage and Medicaid Health Coverage | Medicaid beneficiaries age 55 and older who qualify for a nursing home level of care |
Mandatory/ Voluntary Enrollment | Mandatory | Voluntary | Voluntary |
Covered Services | Medicaid | Medicaid and Medicare Parts A, B, and D | Medicaid and Medicare Parts A, B, and D (if eligible) |
Participation Criteria | Age 21 and older; and Eligible for Medicaid Health Coverage on the basis of the SSI income standard (IHCC group) | Age 21 and older; Eligible for Medicaid Health Coverage on the basis of the SSI income standard (IHCC group) or the MAGI income standard (MACC group); and Enrolled in Medicare Part A, enrolled in Medicare Part B, and eligible to enroll in Medicare Part D | Age 55 years and older; Meet criteria for high or highest need for a nursing facility level of care; and Meet all other requirements for LTSS |
210 R.I. Code R. 210-RICR-40-10-1.1