Long-Term Care Medicaid in Rhode Island: 2026 Guide
In Rhode Island, Medicaid is overseen by the Executive Office of Health and Human Services (EOHHS), and long-term care eligibility is handled by the Department of Human Services (DHS). Long-Term Care Medicaid, called Medicaid LTSS, can pay for nursing facility care and for home and community-based care. This guide explains the 2026 rules in plain language.
At a glance: Rhode Island 2026 figures
| Item | 2026 figure |
|---|---|
| Income limit (applicant) | $2,982 a month (above this, the medically needy route may apply) |
| Asset limit (single applicant) | $4,000 |
| Home equity limit | $752,000 |
| Spouse at home: resource allowance (CSRA) | Minimum $32,532 / maximum $162,660 |
| Spouse at home: monthly income allowance | Minimum $2,705 (from July 1, 2026) / maximum $4,066.50 |
| Personal needs allowance (nursing home) | $75 a month |
| Look-back period | 60 months (5 years) |
| Penalty divisor | $12,106 a month ($398 a day), as of April 2026 |
Figures last updated for 2026. Sources are listed at the end of this page.
Figures change periodically. Double-check current amounts with the Rhode Island Department of Human Services before relying on them.
What Long-Term Care Medicaid covers in Rhode Island
Nursing home care. Medicaid pays for care in a certified nursing facility. You pay most of your income toward the cost each month, and Medicaid pays the rest.
Levels of care. EOHHS sorts LTSS needs into levels. People at the Highest level can choose nursing facility care or home and community-based care. People at the High level can get home and community-based services but not nursing home care. Home and community services include homemaker/CNA services, home changes, medical equipment, home-delivered meals, emergency response systems, case management, senior companion, assisted living, personal care, self-directed care, respite and minor assistive devices.
If you don’t qualify for Medicaid LTSS. The Office of Healthy Aging’s At HOME Cost Share program helps people 65 and older (or 19 to 64 with Alzheimer’s or a related dementia) with in-home and adult day services. It has an income limit but no asset limit, and you pay a share of the cost.
How Medicare fits in. Medicare Part A covers skilled nursing facility care only for a limited time. You generally need a medically necessary inpatient hospital stay of at least 3 days in a row first (time under observation or in the emergency room does not count), and you must need daily skilled nursing or therapy. In 2026, Medicare charges nothing for days 1 to 20 after the Part A deductible ($1,736) is met, $217 a day for days 21 to 100, and nothing after day 100, when you pay all costs. Medicare limits this coverage to 100 days in each benefit period. Medicaid can be a way to pay for long-term nursing home care after Medicare coverage ends.
Who qualifies
A person generally must:
- be 65 or older, or blind or disabled;
- live in Rhode Island and be a U.S. citizen or qualified non-citizen;
- meet the clinical level of care, as shown by a medical evaluation submitted with the application;
- meet the income and asset rules below, as decided by RI DHS.
Income rules
EOHHS says that if your income is over a certain amount, you may have to pay toward the cost of your LTSS.
Once you are on Medicaid in a nursing facility, most of your income goes to the facility. You keep a personal needs allowance of $75 a month, and money can be set aside for a spouse at home and for health insurance premiums.
Asset rules
An individual’s countable resources may not be more than $4,000.
Countable resources include cash, bank accounts, CDs, stocks, bonds, mutual funds, retirement accounts that can be cashed in, life insurance cash value above set amounts and real estate other than the home.
Usually exempt:
- Your home (equity up to $752,000) if you live there or plan to return, or a spouse or dependent relative lives there
- One vehicle
- Household goods and personal belongings
- Burial plots and limited burial funds, within RI DHS rules
Spousal protections
- Assets: The spouse at home can keep at least $32,532 and up to $162,660 in 2026, plus the home, one car and belongings.
- Income: The spouse at home keeps their own income, and part of the applicant’s income can be set aside if their income is low, up to $4,066.50 a month. EOHHS’s 2026 sheet shows an older minimum.
Look-back and penalties
When you apply, Rhode Island looks back at the 60 months (5 years) before the application date. This is called the look-back period. The state checks whether you, or your spouse, gave away money or property, or sold something for less than it was worth, during that time.
Common examples of transfers that can cause a problem:
- Cash gifts to children or grandchildren, even small yearly gifts. (A gift that is fine for federal gift-tax purposes can still count for Medicaid.)
- Adding a child’s name to a house deed or bank account in a way that gives them part ownership.
- Selling a house or car to a relative for much less than it is worth.
- Paying a family member for care without a written agreement made at the time.
Some transfers are allowed, such as transfers between spouses, or transferring a home to a child who is blind or disabled.
How the penalty works. If the state finds a transfer that is not allowed, it does not deny Medicaid forever. Instead, it sets a penalty period: a stretch of time when Medicaid will not pay for long-term care. The state divides the amount given away by the penalty divisor ($12,106 a month ($398 a day), as of April 2026).
Example: Suppose you gave your daughter $50,000 three years before applying. $50,000 divided by $12,106 is about 4.1 months without Medicaid payment for long-term care.
The penalty period starts only once you have applied, are otherwise eligible, and are in (or need) long-term care. This is why gifts made while someone is healthy can still matter years later. If a gift is returned in full, the penalty can be removed.
Estate recovery in Rhode Island
Rhode Island’s estate recovery program is run by the state. The LTSS application packet includes a Liens and Recovery Notice.
- What is recovered: Medicaid paid for long-term care and related services received at age 55 or older, and for some people of any age in a nursing facility.
- When it is put off: federal rules prevent recovery while a spouse is alive, or if there is a child under 21 or a child who is blind or disabled.
- Hardship waivers: the state must have a way to waive recovery when it would cause undue hardship. Ask RI DHS for the current rules.
- Family members and personal representatives can contact RI DHS with questions.
How to apply
- Online: through the HealthSource RI customer portal, using the DHS Application for Assistance and the supplemental LTSS forms. See the EOHHS Medicaid LTSS Application page.
- By mail: download the packet and mail it to DHS (the address is on the DHS application page).
- The packet includes a Medical Evaluation of Applicant for Level of Care form and a waiver choice form.
Applying for a spouse or parent. If you are applying for someone else, you may need legal authority to act for them, or you can be named as an authorized representative on the application. Gather statements for every account, not just the main one, and write down when the person’s care needs began. If the person is already in a nursing home, ask the facility’s business office or social worker which Medicaid forms they need from you and when, and tell the agency if any requested document is hard to get, since agencies can often give extra time when you ask before the deadline.
After you apply. RI DHS will send you a written notice saying whether you qualify, from what date, and how much of your income goes toward your care each month. If you disagree with a decision, you have the right to ask for a fair hearing (appeal). The notice explains how to ask and the deadline for asking. Keep copies of everything you send and receive, and report changes in income, assets or address when they happen.
Gather what you can before you apply. The caseworker may ask for:
- Photo ID, Social Security card and Medicare card
- Proof of age and of U.S. citizenship or immigration status
- Proof that you live in the state (for example, a utility bill or lease)
- Proof of all income: Social Security award letter, pension statements, annuity statements
- Bank, credit union and investment statements (often for the full 60-month look-back period)
- Deeds, property tax bills and the value of any real estate
- Life insurance policies (showing cash value) and prepaid funeral or burial contracts
- Vehicle titles
- Health insurance cards and long-term care insurance policies
- Power of attorney or guardianship papers, if someone is applying for you
- For a spouse at home: their income and assets too, since both spouses’ assets are counted at the start
If you cannot find a document, apply anyway and tell the caseworker. They can explain what else is accepted.
Free public help in Rhode Island
- RI DHS and EOHHS: applications and eligibility.
- MyOptionsRI and the Office of Healthy Aging: information on LTSS and At HOME Cost Share.
- SHIP (State Health Insurance Assistance Program): free Medicare counseling.
- Long-Term Care Ombudsman Program: free advocates for residents of nursing homes and other long-term care settings.
Recent and upcoming changes
A 2025 federal law (Public Law 119-21) makes two changes that affect Long-Term Care Medicaid in every state, including Rhode Island:
- Retroactive coverage gets shorter on January 1, 2027. Today, Medicaid can pay bills from up to 3 months before the month you apply, if you would have qualified then. For applications from January 1, 2027, this window shrinks to 2 months for older adults and people with disabilities. In plain terms: from 2027, it matters more to apply soon after care starts, so that earlier bills are not left unpaid.
- Home equity cap on January 1, 2028. States will no longer be able to set a home equity limit above $1,000,000 (except for some farm property). Rhode Island’s 2026 home equity limit, $752,000, is already below the new cap, so this change is not expected to affect Rhode Island’s limit.
The federal amounts that change each year (for example, the allowances for a spouse at home) will be updated on this page for 2027 once they are published.
State programs
Each program below has its own page with who qualifies, services, how to apply and waiting lists:
- Rhode Island Medicaid Long-Term Services and Supports
- Rhode Island Medicaid Preventive Services
- Rhode Island RIte @ Home
Frequently asked questions
What is Medicaid LTSS? Rhode Island’s name for Long-Term Care Medicaid, covering nursing facility and home and community-based care.
Can I get home care if I don’t need a nursing home? Possibly. People at the High level of care can get home and community-based services but not nursing home care.
How much can my spouse keep? In 2026, at least $32,532 and up to $162,660 in assets, plus the home, a car and belongings.
How long is the penalty for a gift? Divide the gift by $12,106 to get the number of months. A $20,000 gift would mean about 1.7 months without Medicaid payment for long-term care.
Will the state take my home after I die? RI DHS can seek repayment for long-term care paid after age 55, which can include the home. Recovery is put off while a spouse or a young or disabled child survives, and hardship waivers exist.
Figures change periodically. Double-check current amounts with the Rhode Island Department of Human Services before relying on them.
Sources
- EOHHS, CY2026 SSI and spousal impoverishment updates
- 210-RICR-50-00-6
- 210-RICR-50-00-8 (PNA)
- EOHHS, Long-Term Services and Supports
- EOHHS, Medicaid LTSS Application
- RI DHS, LTSS Eligibility and How to Apply
- Office of Healthy Aging, At HOME Cost Share
- Medicare.gov, Skilled nursing facility care
- CMS, 2026 SSI and spousal impoverishment standards
- Public Law 119-21 (2025)
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.