Medicaid plans › Rhode Island
Rhode Island Medicaid Managed-Care Plans for Providers
Enrollments are billed 50% at the start and 50% at submission; everything else 100% at the start.
Rhode Island Medicaid is run by the Rhode Island Executive Office of Health and Human Services. 267,202 people were enrolled in its 3 managed-care plans in 2024. To see their patients, a provider enrolls with Rhode Island Medicaid through the Rhode Island Medicaid Healthcare Portal (Gainwell), then applies to each plan separately.
| Plan | Members (2024) | Share | Parent |
|---|---|---|---|
| Neighborhood Health Plan of Rhode Island | 169,483 | 63.4% | In-state |
| UnitedHealthcare of Rhode Island Community Plan | 81,964 | 30.7% | UnitedHealth Group |
| Tufts Health Public Plans | 15,755 | 5.9% | Point32Health |
How Joining Works in Rhode Island
First the state: Rhode Island Medicaid enrollment through the Rhode Island Medicaid Healthcare Portal (Gainwell), which gives you the Medicaid ID every plan asks for. Then the plans: each takes its own participation request and credentials you from your CAQH ProView (DataSpring) profile. 2 parent companies run plans here, and plans owned by the same company still contract state by state.
How to Join Each Rhode Island Plan
UnitedHealthcare of Rhode Island Community Plan (UnitedHealth Group): UnitedHealthcare Community Plans use UnitedHealthcare's provider onboarding: a participation request on the UnitedHealthcare provider site, credentialing from your CAQH ProView (DataSpring) profile, then a state-specific Community Plan agreement.
Neighborhood Health Plan of Rhode Island, Tufts Health Public Plans: This plan is run in-state rather than by a national carrier, so participation requests go to the plan's own provider relations or contracting team, listed on its provider website.
Also in Rhode Island: Medicare, Rhode Island Medicaid and commercial credentialing.
Questions
Which Rhode Island Medicaid plan is the largest?
Neighborhood Health Plan of Rhode Island, with 169,483 members in 2024, 63.4% of the 267,202 people enrolled in Rhode Island's Medicaid managed-care plans.
Do I have to join every Rhode Island Medicaid plan?
No. Each plan is a separate contract. Practices usually start with the two or three largest plans in their county, then add others as patients ask for them. All of them require Rhode Island Medicaid enrollment first.
Membership from KFF, Medicaid MCO Enrollment by Plan and Parent Firm, 2024. Plans change when the state rebids its contracts; we confirm the current list on every file.