Health Care Benefits: Rhode Island

Federal law and guidance on this subject should be reviewed together with this section.

Author: Patricia A. Morley, Research and Writing Associates

Summary

• Rhode Island chose to establish a state-based Marketplace under the Affordable Care Act. See Health Insurance Marketplaces Under the ACA.
• Rhode Island has an individual health insurance mandate. See Individual Health Insurance Mandate.
• Same-sex marriage is legal nationwide. Rhode Island also recognizes out-of-state civil unions. See Same-Sex Partner Benefits.
• Group health plans in Rhode Island must include coverage for certain maternity and dependent coverage. See Maternity and Dependent Coverage.
• Health plans in Rhode Island must include coverage for mental health and substance use treatments and provide mental health and substance use parity. See Mental Health and Substance Use Coverage.
• Group health plans must provide coverage for specified providers. See Specified Providers.
• Health plans that cover mastectomies must also cover reconstructive breast surgery. See Mastectomy and Reconstructive Breast Surgery.
• Group health plans that provide coverage for obstetric and gynecological care on an expense-incurred basis must provide coverage for hysterectomy or myomectomy treatment. See Hysterectomy or Myomectomy Treatement.
• Health plans must provide coverage for certain illnesses, diseases, services, and medical and surgical procedures. See Diabetes; Bone Marrow Testing; Tobacco Cessation; Contraceptive Services; Lyme Disease, Home Health and Ambulance; Enteral Nutrition Products.
• Group health plans issued in Rhode Island must provide coverage for particular types of medical devices and prostheses. See Medical Devices and Prostheses.
• Certain coverage with regard to children and dependents is mandatory. See Coverage for Children and Dependents.
• Group health plans in Rhode Island that provide coverage for pregnancy services must cover fertility treatments. See Fertility Coverage
• Health plans in Rhode Island must cover certain forms of cancer screening and coverage for new cancer treatments under investigation. See Mandatory Cancer Screening and Cancer Treatments.
• Most group health plans in Rhode Island must provide coverage for treatment for autism spectrum disorders. See Autism Spectrum Disorders.