Rhode Island Medicaid covers home care through three options: RIte@Home shared living, self-directed Personal Choice, and Medicaid assisted living, for adults who need long-term care. These Rhode Island Medicaid HCBS waivers work a little differently than most states' do: the state folded its former 1915(c) HCBS waivers into a statewide Section 1115 Comprehensive Demonstration, and the home- and community-based (HCBS) waiver services continue under it as part of the state's Medicaid long-term services and supports (LTSS) program.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
If you are helping a parent or spouse stay in their own home, a shared-living home, or an assisted living residence instead of moving to a nursing facility, this is how Rhode Island Medicaid can help pay for that care.
In This Guide
- What Rhode Island Medicaid HCBS Waivers Are
- The Three Home and Community Programs
- Who Qualifies for Rhode Island Medicaid HCBS Waivers
- What These Programs Cover
- How to Apply in Rhode Island
What Rhode Island Medicaid HCBS Waivers Are
Home- and community-based services (HCBS) is the Medicaid umbrella for long-term care delivered outside an institution: in your own home, in someone else's home, or in an assisted living residence, rather than in a nursing facility. Nationally, most states authorize these services through Section 1915(c) HCBS waivers, a part of federal Medicaid law that lets a state cover community care for people who would otherwise need an institutional level of care.
Rhode Island's setup has one wrinkle worth understanding up front. The state used to run its own separate 1915(c) HCBS waivers, but it consolidated them under its statewide Section 1115 demonstration, known as the Rhode Island Comprehensive Demonstration. Home- and community-based waiver services continue to be offered under that 1115 demonstration as part of the state's managed long-term services and supports (LTSS) program.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf For a family, the practical effect is the same as a traditional waiver: Medicaid pays for community-based care for people who meet the clinical and financial rules. You just apply through the state's Medicaid LTSS process rather than to a standalone waiver.
The Three Home and Community Programs
Rhode Island offers three main ways to receive Medicaid LTSS at home or in the community, and which one fits depends on where a person wants to live and how much they want to direct their own care.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
| Program | Where care happens | Who it tends to fit | Self-directed? |
|---|---|---|---|
| RIte@Home (LTSS Shared Living) | A caregiver's home, in a home-like setting | Someone who needs considerable daily help but cannot safely live alone | No |
| Personal Choice | The person's own home | Someone who wants to stay home and manage their own budget and caregivers | Yes |
| Medicaid assisted living | An assisted living residence | Someone who needs on-site personal care around the clock | No |
RIte@Home is Rhode Island's LTSS Shared Living option. It is for people who want services in a home-like setting but cannot live alone because they need considerable help with activities of daily living (ADLs) such as eating, dressing, and toileting, along with homemaker services, meals, and transportation.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
Personal Choice is the self-directed option. It is designed for people who want to keep living in their own home while managing their own service budget and hiring and directing their own caregivers.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf If having control over who provides the care matters to your family, this is the option built around that.
Medicaid assisted living covers care delivered in an assisted living residence, including on-site 24-hour personal care assistance and the supports that come with it. It fits a person who needs a residential setting with staff available at all hours rather than care that comes and goes from an outside agency.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
Who Qualifies for Rhode Island Medicaid HCBS Waivers
To receive Medicaid LTSS at home or in the community, an applicant has to clear two separate tests: a clinical level-of-care test and a financial test. You have to meet both.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
The clinical test (level of care)
Rhode Island sorts long-term-care need into levels, and the level you are assessed at determines what Medicaid will pay for. People who have the "highest" or "high" level of need can receive Medicaid LTSS in the home or community setting. Only those with the "highest" level of need qualify for Medicaid coverage in a nursing home.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf That structure is deliberate: the community programs reach people at a "high" level of need who might not yet qualify for nursing-home coverage, which is part of what lets Rhode Island support people at home before an institutional move becomes the only option.
The financial test
In 2026, for LTSS eligibility, Rhode Island sets a countable-resource (asset) limit of $4,000 for a family size of one, meaning a single individual, and a countable-income standard of up to 300% of the federal SSI rate.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf Not every asset counts toward that $4,000 limit; Medicaid programs generally exclude things like a primary home and one vehicle, so it is worth confirming which of your assets are countable before assuming you are over the line.
If your income sits above the 300%-of-SSI standard, you are not automatically shut out. Rhode Island runs a medically needy pathway that can extend eligibility to adults with countable income above that standard, up to the average private-pay rate for the applicable institutional level of care.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf One more rule to plan around: Rhode Island applies a five-year (60-month) look-back to asset transfers, so gifts or transfers made in the five years before you apply can affect eligibility.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf If large transfers are part of your family's recent history, talk with the state or a qualified elder-law professional before you apply.
What These Programs Cover
The home- and community-based services these Rhode Island programs provide are the everyday supports that make staying out of a nursing facility possible. Covered services include on-site personal care assistance, homemaker and chore services, medication management, therapeutic, social, and recreational activities, and health-related transportation.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf Under RIte@Home, that also includes hands-on help with the activities of daily living, eating, dressing, and toileting, plus homemaker services, meals, and transportation delivered in a shared-living home.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
The mix a given person receives depends on their assessed needs and the program they enroll in. Someone in Personal Choice directs their own budget toward the supports they need most, while someone in assisted living receives care from the residence's staff. In every case, the goal of the coverage is the same: enough support to live safely in the community.
How to Apply in Rhode Island
Medicaid LTSS in Rhode Island is administered by the Rhode Island Executive Office of Health and Human Services (EOHHS) together with the Department of Human Services (DHS). You apply through the state's Medicaid LTSS application process, which handles both the financial determination and the referral for the clinical level-of-care assessment.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf
Here is what to expect. You submit an LTSS application, the state reviews your income and assets against the financial rules, and a clinical assessment establishes your level of need. If you qualify, you then work with the state to enroll in the delivery option that fits, RIte@Home, Personal Choice, or Medicaid assisted living. Because there are two determinations happening, it helps to gather financial documents (bank statements, proof of income, information on any recent transfers) before you start.
Federal rules put an outer limit on how long the state can take to decide. Under 42 CFR 435.912, a Medicaid eligibility determination may not exceed 45 calendar days for most applicants, and 90 calendar days for applicants who apply on the basis of disability, measured from the date of application, except in unusual circumstances.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf If your case runs past those windows without a good reason, that is worth raising with the agency.
Frequently Asked Questions
Is there a waiting period or interest list for these programs?
Enrollment runs through the state's Medicaid long-term services and supports (LTSS) process: you apply, the state confirms both your financial eligibility and your clinical level of need, and then you enroll in the delivery option that fits.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf Timelines and current availability can change, so the Rhode Island Executive Office of Health and Human Services (EOHHS) is the right place to confirm where things stand for your situation before you plan around a specific date.
Do I have to move out of my own home to get help?
Not with every option. Personal Choice is the self-directed program built specifically around staying in your own home and directing your own budget and caregivers. RIte@Home and Medicaid assisted living, by contrast, deliver care in a different living arrangement, a caregiver's shared-living home or a staffed residence.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf If remaining in your own home is the priority, Personal Choice is the option designed for that.
Can I get Medicaid to pay for care at home instead of a nursing home?
Yes. That is the purpose of Rhode Island's home- and community-based services. People assessed at the "highest" or "high" level of need can receive Medicaid LTSS in the home or community, while nursing-home coverage is limited to those with the "highest" level of need.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf So a person can qualify for home and community care at a level of need that would not yet qualify them for Medicaid in a nursing facility.
Does the five-year look-back apply to home care, or only to nursing homes?
It applies to home care too. The five-year (60-month) look-back is part of Rhode Island's financial-eligibility rules for Medicaid long-term services and supports (LTSS), and those rules govern home- and community-based coverage the same way they govern nursing-home coverage.Centers for Medicare & Medicaid Services. (n.d.). Rhode Island Comprehensive Demonstration Fact Sheet — Medicaid.gov (CMS). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ri/ri-global-consumer-choice-compact-fs.pdf So a transfer you made in the five years before applying can affect a home-care application, not just a nursing-home one, which is why it is worth getting advice before you apply if your family has made large gifts recently.
Learn More
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.