Get an Instant Quote

* Fields marked with an asterisk are required.

2. Enter all of the family members and dependents you wish to cover. *

Applicant *

Spouse, domestic partner or civil union partner

Dependent 1

Dependent 2

Dependent 3

Dependent 4

Dependent 5

Dependent 6

Dependent 7

Dependent 8

Dependent 9

Dependent 10

Dependent 11

Dependent 12

Dependent 13

Dependent 14

Eligibility for your dependents is subject to age restrictions:

  • Dependents may not be eligible for medical coverage if she/he is over the age of 26. If a dependent is over age 26 and disabled please contacting us at (401) 459-5550 or 1-855-690-2583.
  • Dependents may not be eligible for dental coverage if she/he is over the age of 19. They may be eligible for their own plan and can apply online or by contacting us at (401) 459-5550 or 1-855-690-2583.

BCBSRI can only sell insurance to the following:

  • Residents of Rhode Island
  • To those who do not have the option to purchase medical insurance through their employer
    (however, we can sell dental insurance to those on employer-sponsored medical plans).
  • To those currently insured who are expecting to lose coverage

Please note the following:

  • All plan premiums are estimates.
  • All premiums estimates are monthly and expire on December 31, of that calendar year.
  • For your security, information gathered about your family will not be stored and will be cleared after 15 minutes of inactivity.

BCBSRI can only sell insurance to the following:

  • Residents of Rhode Island
  • To those who do not have the option to purchase medical insurance through their employer
    (however, we can sell dental insurance to those on employer-sponsored medical plans).
  • To those currently insured who are expecting to lose coverage

Please note the following:

  • All plan premiums are estimates.
  • All premiums estimates are monthly and expire on December 31 of that calendar year.
  • For your security, information gathered about your family will not be stored and will be cleared after 15 minutes of inactivity.