Services Covered by Medical Assistance Only

These services are not covered by Neighborhood but are covered by Medical Assistance if you are eligible and you see an approved provider. The providers will be paid directly by the State and your Medical Assistance card will be needed for these services.  Though not covered by Neighborhood, we can assist you in arranging for these services:

• Adolescent Pregnancy and Parenting Services Network for social and educational case management to women under age 20.
• AIDS - Non-medical case management. Court-ordered mental health services in which the court order specifies a non-network provider.
• Dental Services - routine check-ups and treatment for adults and children.
• Special Education services as defined in the child’s Individual Education Plan (IEP) for children with special health needs or development delays.
• Lead Program home assessment and non-medical case management provided by the RI Department of Health or Lead Centers for lead poisoned children.
• Non-medical case management for Head Start children.

The following services are not covered by the Rhode Island State Medicaid Plan, but are Medicaid covered services as defined by the Social Security Act. They are covered if medically necessary for RIte Care eligible children under age 21. You will need to get prior approval from the State. These services include:

• Chiropractic Services.
• Residential substance abuse treatments services for adolescents aged 13 to 17.
• Residential treatment for children ordered by DCYF; covered benefits exclude room and board except in a JCAHO-accredited facility.
• Children’s Intensive Services (CIS)-administered by DCYF.
• Comprehensive Emergency Services (CES)-administered by DCYF.
• Child sexual abuse evaluations parent/child evaluations, and DCYF-ordered emergency room evaluations prior-approved by the State.
• Intensive community-based treatment prior approved by the State (administered by DCYF).
• Early Start Program (administered by DCYF).
• Other services not covered by Rhode Island Medical Assistance that are medically necessary (as determined and prior-authorized by the State) to treat a sickness that is discovered during an EPSDT screen.