Rhode Island Medicaid Planning

10/19/2026

Medicare’s annual open enrollment period began October 15, and beneficiaries need to pay attention to their plan and enrollment options.

Market contractions cut across Medicare Advantage, the privately run alternative to traditional government-run Medicare, and stand-alone Part D drug plans that pair with traditional Medicare. About one million Medicare Advantage members are in plans that are being discontinued for 2027. The number of stand-alone Part D drug plans nationwide will fall to 316 next year from 360, according to KFF, a health policy nonprofit.

While most of the nation’s 64 million Medicare recipients will still have plenty of options to choose from, these changes underscore the importance of shopping during open enrollment. Through December 7, beneficiaries can pick a new stand-alone Part D drug plan or a new Medicare Advantage plan, or switch from traditional Medicare into Medicare Advantage or vice versa. (Medigap supplement policies are largely regulated at the state level and aren’t part of open enrollment.) Any coverage changes made during this period will go into effect January 1, 2027.

While most of the nation’s 64 million Medicare recipients will have plenty of options, some changes underscore the importance of shopping during open enrollment.

10/17/2026

Can you own a second home and qualify for Medicaid benefits?

Vega v. Executive Office of Health and Human Services, C.A. No. PC-2025-03316 (R.I. Super. Ct., filed Oct. 6, 2026; Judge William E. Carnes Jr.; Lawyers Weekly No. 61-072-26).

Holding and Key Facts
The Superior Court upheld the denial of Gregoria Moreno Vega’s LTSS Medicaid application. DHS had counted her co-owned Puerto Rico residence toward the resource limit, putting her over the $4,000 LTSS resource limit under 210 RICR 50-00-6.5. The EOHHS appeals officer (Robert Pelosi) affirmed the denial after a hearing; the court affirmed under the APA (G.L. 1956 § 42-35-15).

Residency vs. Countable Resource
The decision draws a clear distinction on residency status:
• Personal residency eligibility: The hearing officer correctly found Mrs. Vega is a Rhode Island resident with no intent to return to Puerto Rico (based on her daughter’s representations). She was therefore not disqualified from Medicaid on residency grounds. Under 210 RICR 40-00-3.6.5(A)(1)(a)(5) (2024), an applicant who declares an out-of-state residential property as a home to return to is not considered a Rhode Island resident for eligibility purposes, and the property is countable. That did not apply here.
• Out-of-state residence as a countable resource: Even for a confirmed Rhode Island resident, an out-of-state residence is countable unless a regulatory exception applies. Residences are countable under the LTSS resource rules unless excluded.

Exceptions Rejected
The appellant argued for the spouse or dependent-child exception in 210 RICR 50-00-6.5.3(B)(2)(e) (2021), which excludes the entire value of a home (regardless of equity and without intent-to-return) if certain relatives live there:
• Spouse: Not applicable. The husband (Carmelo Rodriguez Vazquez) resides in Rhode Island with intent to remain there (and only might return to Puerto Rico after Mrs. Vega’s death). He does not reside at the Puerto Rico property.
• Children: Not applicable. No evidence the children living on the property were under 21, blind, or permanently and totally disabled. Statements confirmed residency but not the statutory criteria.
The hearing officer also found no evidence establishing low value, unsellability, or hardship sufficient to exclude the property (despite claims of Hurricane Maria damage, family occupancy, and an uninhabitable house). The court deferred to the officer’s valuation inference that the family-sized residence and surrounding land exceeded $4,000, as a “reasonable mind” could accept that conclusion on the limited record.

Practical Takeaway
Confirming Rhode Island residency (intent to remain) protects against a pure residency bar, but an out-of-state residence remains a countable resource for LTSS eligibility unless a specific exception in the resource regulations is proven with evidence. The $4,000 resource limit is strict, and courts give substantial deference to the agency on factual findings supported by legally competent evidence.

The nine-page decision is available as Superior-PC-2025-3316.pdf on the Rhode Island courts site. This is a recent (October 2026) administrative appeal; it is not a Supreme Court ruling and does not create broad new precedent beyond applying the existing regulations.

10/06/2026

Most eligible seniors will receive a $90 direct deposit payment in early October, according to a White House fact sheet. The payments are separate from the $500 refund checks the administration is sending to Obamacare enrollees.

Most eligible beneficiaries will receive a direct deposit on or around Oct. 8, according to a fact sheet from CMS. Qualifying seniors without direct deposit will receive a check at their mailing address on file with Medicare. Those checks will be sent later in October, according to CMS.

The White House announced on Friday that it plans to send one-time payments to Medicare Part B beneficiaries to help them pay for their premiums.

09/09/2026

In-Home Continuing Care Retirement a Growing Trend

“Continuing care at home,” provided through a continuing care retirement community, blends the expertise of those communities with support for members staying in their own homes. Members of these programs can move into the facility they contract with, if they need to, with the assurance of containing future costs.

About 75% of American adults in a 2024 AARP survey said they hoped to stay in their longtime homes, or “age in place,” as long as possible, with only 29% of older adults in the survey saying the traditional continuing care model was a likely choice. That model not only involves moving but requires a hefty entry fee and monthly fees to live onsite, where residents can transition to higher levels of care as their needs dictate. The at-home model has been operated by a few communities for decades, creating enough of a track record for the long-term-care industry to adopt it more widely.

This option is offered by only 37 of the country’s 1,911 continuing care retirement communities, or CCRCs, according to industry group LeadingAge, up from 26 a decade ago.

Continuing care retirement communities are widening their scope to help retirees age in place, with measured supports and a way to cap the soaring costs of aging.

08/31/2026

Rhode Island's Medicaid administrators are expecting $24.4 million in savings in the federal fiscal year that begins on Oct. 1 – and $32.5 million the following year – from new "citizenship verification" requirements.

On Aug. 11, EOHHS posted an advisory on its website that said: "Starting October 1, 2026, only the following groups of non-citizens will be eligible for Medicaid." The list included:

Children under 19; and pregnant or post-partum people

Lawfully permanent residents (Green Card holders) after the five-year wait, if it applies

Cuban/Haitian entrants and people from Micronesia, the Marshall Islands, and Palau

It's not yet clear how many Medicaid enrollees would have to be dropped or excluded from the program to achieve the projected savings.

06/29/2026

When the nation was founded in 1776, life expectancy was around 35 to 40 years old, historians estimate. However, someone who survived childhood in colonial America often lived into their 60s or even 70s.

Today, the average lifespan is about 79 years old, according to data from the Centers for Disease Control and Prevention.

Planning for longevity and making sure you don't outlive your resources is of critical importance. Planning to protect assets for you and your spouse is more important than ever.

Make sure you talk with your estate planning attorney and financial advisor to ensure you have a plan in place.

U.S. life expectancy has doubled since 1776 thanks to vaccines, antibiotics, sanitation and clean water that reduced infectious disease deaths.

05/14/2026

Medicaid is a joint federal and state program that provides payment for medical care for persons unable to afford to pay. Medicaid covers physicians’ services, hospital care, supplies and other necessary services once a person has been made eligible for the program. It also pays for the expenses of long-term care in a nursing home.

It is also a program that is of critical importance to know the rules of eligibility so as to advise estate planning clients how to qualify when needed as as to preserve their assets for themselves and their heirs.

Medicaid: What it is and What you need to know The Issue Medicaid is a joint federal and state program that provides payment for medical care for persons unable to...

03/08/2026

🚨 Rhode Island Seniors: Long-Term Care Costs Are Skyrocketing! 🚨
Did you know the average cost of a nursing home in RI is over $14,000/month for a semi-private room and $16,500 for private? Assisted living? Around $6,000/month. Home care can run $7,500+/month for full-time help.

These expenses can wipe out a lifetime of savings in years. That's why planning ahead is crucial—long-term care insurance, asset protection strategies, and Medicaid qualification can safeguard your future.

To qualify for RI Medicaid LTSS: Must be 65+, need nursing-level care, income under ~$9,100/month, assets ≤$4,000 (single). But with proper planning (e.g., 5-year lookback), you can protect assets for spouses/heirs.

Don't wait—plan now! As an estate planning law firm that represent seniors, we help families navigate planning for this phase of life. Contact Us or visit rimedicaidplanning.com for a consult.

03/08/2026

Publicly funded LTSS (mainly via Medicaid) is available for eligible people who require a certain level of ongoing care. Services can be provided in various settings:
• Home (e.g., in one’s own residence or a family member’s home)
• Community (e.g., assisted living, shared living, adult day programs)
• Institutional (e.g., nursing homes, intermediate care facilities, hospitals)

The focus is on person-centered care to optimize health, independence, and quality of life, with services that may be episodic or ongoing.

02/18/2026

State income tax quietly shapes real estate choices because it changes what your home actually costs to keep, not just to buy. In high tax states like California or New York, a big raise, a bonus year, or a strong investment portfolio can make the “same” lifestyle feel meaningfully more expensive year after year, which pushes some buyers toward lower tax states like Florida or Texas, especially when they can work remotely. For others, the math cuts the other way: they accept higher state taxes because the city, schools, network, and long term appreciation potential are worth the premium, and they focus their search on neighborhoods and property types that hold value best. Either way, taxes turn a location decision into a cash flow decision, and that’s why smart buyers look past the list price and ask, “What does living here cost me every year?”