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Neighborhood INTEGRITY (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Neighborhood INTEGRITY (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Neighborhood INTEGRITY (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Neighborhood INTEGRITY (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND available for enrollment in 2025 to people living in State of Rhode Island. The overall rating for this plan is not yet available for 2025.
It's important to know that Neighborhood INTEGRITY (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Neighborhood INTEGRITY (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Neighborhood INTEGRITY (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Neighborhood INTEGRITY (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Neighborhood INTEGRITY (Medicare-Medicaid Plan)
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Drug Coverage
The Neighborhood INTEGRITY (Medicare-Medicaid Plan) has an Enhanced Alternative drug benefit type. This plan has a $0 deductible for prescription drugs. During the initial coverage phase, you pay costs for drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Neighborhood INTEGRITY (Medicare-Medicaid Plan) offers comprehensive coverage with a focus on inpatient and outpatient services, including no copays for emergency, partial hospitalization, and ambulance services. This plan also includes benefits for primary care, preventive services like hearing and vision, and dental, with a yearly maximum for dental services. Additional benefits include home health services, dialysis, and medical equipment, all with no copay, as well as coverage for other services like a meal benefit and various supports. However, some services require prior authorization, and there are limitations on certain benefits, such as hearing aids and dental services, and some services are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered by the Neighborhood INTEGRITY plan. Additional days and non-Medicare-covered stays are covered, but upgrades for Inpatient Hospital-Acute are not covered; cost sharing details are available in the plan's full description.
Outpatient Services See details
Outpatient Services are covered, including Outpatient Hospital Services, Observation Services, Ambulatory Surgical Center (ASC) Services, and Outpatient Blood Services, with Outpatient Hospital Services and Ambulatory Surgical Center (ASC) Services requiring prior authorization. Outpatient Substance Abuse Services are partially covered, with Individual and Group Sessions for Outpatient Substance Abuse not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by this plan. There is no copay or coinsurance for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the Neighborhood INTEGRITY (Medicare-Medicaid Plan). All ambulance services are covered with prior authorization and have no copay or coinsurance, while ground and air ambulance services are not covered; transportation services to any health-related location are also not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Neighborhood INTEGRITY (Medicare-Medicaid Plan), with no copay or coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
The Neighborhood INTEGRITY (Medicare-Medicaid Plan) covers a variety of primary care services, including Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Podiatry Services, Other Health Care Professional, Physical Therapy and Speech-Language Pathology Services, and Additional Telehealth Benefits. This plan does not cover Routine Chiropractic Care, Individual or Group Sessions for Mental Health or Psychiatric Services.
Preventive Services See details
Preventive Services are covered by the Neighborhood INTEGRITY plan, but Annual Physical Exams, In-Home Safety Assessments, Medical Nutrition Therapy, Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Home-Based Palliative Care, Support for Caregivers of Enrollees, Enhanced Disease Management, Telemonitoring Services, Home and Bathroom Safety Devices and Modifications, and Counseling Services are not covered. Other covered services include Health Education, Personal Emergency Response System, Nutritional/Dietary Benefit, In-Home Support Services, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefit, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screening, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKG following Welcome Visit.
Hearing Services See details
Hearing Services include routine hearing exams and fitting/evaluation for hearing aids with no copay or coinsurance, and prescription hearing aids (all types) with a limit of one visit every three years. Prescription hearing aids - inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams, other eye exam services, and eyewear, with no deductible or coinsurance for any service. Routine eye exams are limited to one visit every two years, and other eye exam services cover medically necessary optometry services. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames are each limited to one every two years, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a maximum benefit of $1250 per year and coverage for 2 cleanings, 1 exam, 1 bitewing x-ray, 1 adult fluoride treatment annually, 1 full-mouth x-ray every 5 years, single x-rays as needed, and other benefits as needed. Orthodontic services are also covered. Some services are not covered, including oral exams, dental x-rays, prophylaxis (cleaning), fluoride treatment, and orthodontics.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Neighborhood INTEGRITY (Medicare-Medicaid Plan). This includes Medicare Part B Insulin Drugs, but Medicare Part B Chemotherapy/Radiation Drugs are not covered.
Dialysis Services See details
Dialysis Services are covered with no copay and no coinsurance.
Medical Equipment See details
The Neighborhood INTEGRITY plan covers Durable Medical Equipment (DME) with no copay or coinsurance, but requires prior authorization. Prosthetics/Medical Supplies - Non-Medicare benefits are covered with no copay or coinsurance and require prior authorization. Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Neighborhood INTEGRITY (Medicare-Medicaid Plan), but the plan does not cover Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, or Outpatient X-Ray Services. There is no copay for any covered services.
Home Health Services See details
Home Health Services are covered by the Neighborhood INTEGRITY (Medicare-Medicaid Plan) with no copay or coinsurance. The plan also covers Home Care Services, but additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, including Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, and Pulmonary Rehabilitation Services. SET for PAD Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) benefits are covered, including additional days beyond Medicare-covered and non-Medicare-covered stays. Prior authorization is required, and there is no cost sharing on the day of discharge.
Other Services See details
Other Services include a meal benefit with 14 home-delivered meals, up to twice per year, following surgery or inpatient hospitalization, and a maximum benefit of $9,999.00. Other services also include homemaker services, care management, adult day health, special medical equipment, HIV/AIDS non-medical targeted and AIDS medical case management, criminal & civil court-ordered mental health & substance abuse treatment, assertive community treatment, integrated health home, non-traditional clinical behavioral health services, respite, homemaker services (LTSS), environmental mods/home accessibility adaptations, skilled nursing services/LPN (LTSS), community transition services (LTSS), residential supports (LTSS), day supports (LTSS), supported employment (LTSS), Rite @ Home/supported - shared living arrangements (LTSS), self-directed supports and services (LTSS), senior companion/adult companion services (LTSS), assisted living (LTSS), rehabilitation services, mental health psychiatric rehabilitation residences, outpatient mental health and substance use disorder treatment, opioid treatment program (OTP) health home services, healthy food and nutrition benefit with a monthly maximum of $75.00, nursing home services, and personal care services. However, acupuncture, over-the-counter (OTC) items, tobacco cessation counseling for pregnant women, respiratory care services, family planning services, freestanding birth center services, home and community based services, self-directed personal assistance services, and case management are not covered. Additionally, some services require prior authorization, and some services have a maximum benefit coverage amount.
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1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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