RI Medicaid Income Limits: MAGI, Long-Term Care, and MSPs

Rhode Island Medicaid income limits depend on which group you fall into. Most working-age adults qualify at or below 138% of the Federal Poverty Level, which comes out to roughly $22,025 per year for a single adult in 2026.¹ Children and pregnant applicants can qualify at much higher incomes. Seniors and people with disabilities follow a different set of rules that include asset limits alongside income caps.

Adults Aged 19 to 64

Non-disabled adults between 19 and 64 qualify if household income falls at or below 138% of the Federal Poverty Level. Rhode Island expanded Medicaid under the Affordable Care Act, so this group covers adults without dependent children as well as parents and caretakers.² Using the 2026 poverty guidelines, 138% of the FPL breaks down as follows:¹

Single adult: about $22,025 per year
Household of two: about $29,863 per year
Household of three: about $37,702 per year
Household of four: about $45,540 per year

These figures are evaluated under the Modified Adjusted Gross Income (MAGI) method, the standard income-counting approach for most non-elderly, non-disabled applicants. No asset test applies to this group. Savings, vehicles, and property do not count against you.

Children and Pregnant Applicants

Rhode Island sets much higher thresholds for children and pregnant applicants. Children under 19 qualify with household incomes up to 266% of the FPL, which for a family of three in 2026 comes to roughly $72,671 per year.¹ Many middle-income families with children can still qualify at that level.

Pregnant applicants qualify with incomes up to 253% of the FPL.² For a single pregnant applicant in 2026, that works out to about $40,379 per year. Both groups are evaluated using MAGI rules with no asset test.

Seniors and People with Disabilities

Eligibility for Rhode Islanders 65 and older, and for people with disabilities, works differently from the MAGI categories above. These groups face both an income limit and an asset limit, and the state uses a methodology tied to Supplemental Security Income (SSI) rules rather than tax-based MAGI.

Community Medicaid

Seniors and adults with disabilities who live at home can qualify through community Medicaid if countable income stays at or below 100% of the FPL and countable assets stay below $4,000 for a single person or $6,000 for a married couple.² In 2026, 100% of the FPL for one person is $15,960 per year, or $1,330 per month.¹

Long-Term Services and Supports

If you need nursing home care or other long-term services and supports (LTSS), Rhode Island applies a higher income cap of 300% of the federal SSI benefit rate. The 2026 SSI rate for an individual is $994 per month, which puts the LTSS income cap at $2,982 per month for a single applicant.³ For a married couple where both spouses are applying, the combined limit is $5,964 per month. The asset limit for LTSS is $4,000 per applicant.⁴

Once you qualify for LTSS Medicaid, nearly all of your monthly income goes toward the cost of care. You keep a personal needs allowance of $75 per month, and the state may protect a portion of income for a non-applicant spouse.

Medically Needy Spend-Down

Rhode Island runs a Medically Needy pathway for people whose income exceeds these limits but who have significant medical expenses. You qualify by spending down income on medical bills until countable income falls to or below the Medically Needy Income Limit. For 2026, that limit is approximately $1,200 per month for one person and $1,232 per month for a couple. The spend-down calculation covers a six-month period, and Rhode Island counts only unpaid medical expenses you have actually incurred or expect to incur.⁵

Medicare Savings Programs

If you have Medicare, you may qualify for a Medicare Savings Program that helps cover premiums, deductibles, and copays even if you do not qualify for full Medicaid. The most common is the Qualified Medicare Beneficiary (QMB) program. For 2026, QMB monthly income limits are $1,350 for one person and $1,824 for a couple. Resource limits are $9,950 for one person and $14,910 for a couple.⁶ These programs can save hundreds of dollars a month in Medicare costs and are worth applying for on their own.

How Rhode Island Counts Your Income

For adults, children, pregnant applicants, and parents or caretakers, Rhode Island uses the Modified Adjusted Gross Income (MAGI) method. MAGI starts with your adjusted gross income from your tax return and adds back items like tax-exempt interest and certain foreign income. It counts wages, self-employment earnings, Social Security benefits, pensions, and investment income.

What MAGI leaves out matters just as much. Child support you receive is excluded. Scholarships and grants used for tuition and educational fees are excluded. Veterans’ benefits and workers’ compensation payments are generally excluded. Household size follows federal tax filing rules, so the people you claim as dependents typically form your Medicaid household.

For seniors and people with disabilities, Rhode Island uses SSI methodology instead. It applies different income exclusions and imposes asset limits. Some property does not count: a primary home, one vehicle, and personal belongings typically fall outside the asset cap.⁷

Spousal Protections When One Spouse Needs Long-Term Care

When one spouse enters a nursing home and applies for LTSS Medicaid, federal law protects the other spouse from impoverishment. The spouse who stays at home, called the community spouse, can keep a share of the couple’s combined assets under the Community Spouse Resource Allowance. In 2026, this allowance ranges from a minimum of $32,532 to a maximum of $162,660, depending on the couple’s total countable resources at the time of application.

The community spouse can also keep a Monthly Maintenance Needs Allowance, a portion of the institutionalized spouse’s income set aside so the at-home spouse has enough to live on. These protections apply automatically during the eligibility determination, though planning ahead of the application can help maximize what the community spouse keeps.

Non-Financial Requirements

Meeting the income and asset limits is not enough on its own. You must also be a Rhode Island resident, meaning you live in the state voluntarily with the intention of making it your home.⁸ There is no minimum length of residency. You must also be a U.S. citizen or have a qualifying immigration status. Qualified non-citizens may face a five-year waiting period before enrolling.⁹

One exception is worth flagging: children under 19 in Rhode Island are not subject to citizenship or immigration status requirements.¹⁰ A child living in Rhode Island can qualify regardless of documentation status.

How to Apply

Rhode Island offers four ways to submit a Medicaid application:¹¹

Online through the HealthyRhode portal at healthyrhode.ri.gov
By phone at 1-855-697-4347 (1-855-MY-RIDHS); deaf and hard-of-hearing callers can dial 7-1-1
By mail to RI Department of Human Services, P.O. Box 8709, Cranston, RI 02920-8787
In person at any DHS regional office

Federal rules require the state to process most MAGI-based Medicaid applications within 45 days. Applications that need a disability determination can take longer. Rhode Island verifies much of your information electronically through data matching with the IRS, the Social Security Administration, and other agencies, so you may not need to submit paper documentation for every detail.¹²

1
ASPE. 2026 Poverty Guidelines: 48 Contiguous States
2
Rhode Island General Assembly. Rhode Island Medicaid Program Overview
3
Social Security Administration. SSI Federal Payment Amounts for 2026
4
Cornell Law School. Rhode Island Code 210-RICR-50-00-2.5 – Medically Needy Eligibility Determination Process
5
Cornell Law School. Rhode Island Code 210-RICR-40-05-2.3 – Spenddown Calculation
6
Social Security Administration. Medicare Savings Programs Income and Resource Limits
7
Cornell Law School. Rhode Island Code 210-RICR-40-15-1.7 – Medicaid Affordable Care Coverage (MACC) MAGI-Eligible Adults
8
Cornell Law School. Rhode Island Code 218-RICR-10-00-1.5 – Residency Requirements
9
Cornell Law School. Rhode Island Code 210-RICR-10-00-3.7 – Citizenship and Immigration Status
10
Cornell Law School. Rhode Island Code 210-RICR-30-00-1.7 – MACC Group General Eligibility Requirements
11
Rhode Island Department of Human Services. Apply for DHS Benefits
12
Medicaid.gov. Rhode Island MAGI-Based Eligibility Verification Plan