Immigration and Health Insurance Coverage: What Are Your Options?
If you’re an immigrant, getting healthcare in the United States may seem complicated. It may also be hard to get health insurance, which can help you pay for the healthcare you and your family need. It can be harder still if you’re one of the country’s millions of undocumented immigrants. Many members of the US undocumented population choose not to see a doctor or go to a hospital for fear of having their immigration status questioned. Additional barriers to care include difficulty communicating in English, low incomes that make it hard to pay for healthcare or jobs that don’t offer health insurance coverage. These obstacles can prevent many people from getting—and paying for—the healthcare they need.
This guide will show how immigrants can get health insurance coverage and healthcare. It also tells you about where you can go for help. It’s divided into sections for:
If You’re a Documented Immigrant
If you’re a US citizen or a “lawfully present” immigrant and have the papers to prove it, this section is for you. Lawfully present immigrants include green card holders, or lawful permanent residents of the United States. They also include those who have been granted asylum (known as asylees), refugees and people with certain other immigration statuses. Unless particular exemptions apply to you, you must have health insurance coverage. If you aren’t insured, you will be required to pay a fee on your taxes, plus you will have to pay out of pocket for your healthcare expenses.
If your state runs its own exchange, use theirs; if not, use the US federal exchange at www.healthcare.gov. To find out if your state has an exchange, visit www.healthcare.gov/marketplace-in-your-state.
When you apply for and enroll in Marketplace coverage, you may need papers to prove that you are a documented resident. According to the US government, facts about your immigration status will be used only to check if you’re eligible for coverage.
You can sign up for a health plan in the Marketplace during the open enrollment period. Open enrollment typically runs from November 1 to January 31 of the year for which you’re seeking coverage. Before or after the open enrollment period, you may qualify for a special enrollment period in case of special events, such as if you have a baby or lose your other health coverage.
In some cases you may be eligible for government programs such as Medicaid or the Children’s Health Insurance Program (CHIP) that are designed for low-income people. Eligibility rules, benefits and costs can differ for each state.
US citizens and qualified non-citizens (people such as green card holders, asylees, refugees and others) are generally eligible for Medicaid or CHIP. But, many qualified non-citizens may have to wait five years after getting their qualified imigration status before they can get Medicaid or CHIP.
There are exceptions. For example, refugees or asylees, or green card holders who used to be refugees or asylees, don’t have to wait five years. States also can choose to remove the five-year waiting period and cover lawfully residing children or pregnant women in Medicaid or CHIP. To find out if your state has made this choice, click here.
You can apply for Medicaid or CHIP in two ways. One is by applying for coverage through the Health Insurance Marketplace. If someone in your household may qualify for Medicaid or CHIP, your information will be sent to your state Medicaid agency. You can also apply directly to your state Medicaid agency. For more information and links to state Medicaid agencies, click here.
You aren’t eligible for Medicare if you haven’t been lawfully present for at least five years. Even so, you can buy health insurance through the Marketplace as long as you’re currently lawfully present.
If You’re an Undocumented Immigrant
If you aren’t lawfully present in the United States, it’s hard to get health insurance. Under the law, people who aren’t lawfully present are exempt from the requirement to have health insurance, which means that you won’t have to pay a penalty for not having it. But, trying to get it is a good idea, so that you don’t have to cover the full cost of healthcare on your own.
Some states permit a category of undocumented immigrants known as Permanently Residing under Color of Law (PRUCOL) to qualify for Medicaid or other healthcare benefits. Those are immigrants who don’t otherwise qualify for public benefits but who plan to stay in the United States. The US Citizenship and Immigration Service knows about their undocumented status but is not trying to deport them.
Some states offer low-income, pregnant women access to CHIP through a State Plan Amendment. That lets an undocumented immigrant enroll her unborn child in CHIP. That way, she can get coverage for pre-birth care and labor and delivery services. Those women also may be covered by other state or local programs. Some states and cities also offer coverage to undocumented children. Check in your own city or state to see what kind of help is available.
If Your Family Members Have Different Immigration Statuses
Immigrant families often include members with different immigration statuses. Some family members may be lawful permanent residents, some US citizens and some neither. Are you applying to the Health Insurance Marketplace, Medicaid or CHIP for healthcare coverage for a child or other person who relies on you for financial support? Then, you only need to state the immigration status of that person who would be covered. If you are not applying for coverage for yourself, you don’t have to tell your own immigration status. So, if you’re an undocumented immigrant but your child is a US citizen, you can apply for healthcare coverage just for your child, not for yourself.
For All Immigrants
Whether or not you’re lawfully present in the United States, and whether or not you can afford healthcare, there are ways to get healthcare.
How can you pay for this emergency care? Even if you aren’t eligible for Medicaid because of your immigration status, you can get emergency Medicaid benefits as long as you meet the other requirements for Medicaid, such as income level and state residency. In such cases, emergency Medicaid will cover your emergency care.
Migrant health centers are like FQHCs, except that they serve migrant and seasonal farm workers and their families. The Migrant Clinicians Network can help you find one through the National Health Centers Directory.
Public and nonprofit hospitals may also offer free or low-cost care to low-income patients, regardless of immigration status. You can find many such hospitals on this state-by-state list.
Various state and local programs may also help. A national group, the National Alliance for Hispanic Health, offers free health information in Spanish and English. It also helps guide callers through the health system. Contact them at Su Familia, the National Hispanic Family Health Helpline, at 866-Su-Familia (866-783-2645) or SuFamilia@hispanichealth.org.
Your Action Plan: Getting Healthcare and Insurance Coverage as an Immigrant
If you’re an immigrant, here are key steps to follow to get health insurance coverage and care: