Jeffrey Wade
Noncitizens in the US face barriers to accessing health insurance and healthcare. Undocumented immigrants are not eligible for Marketplace coverage. However, lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and savings on Marketplace plans. Lawfully present immigrants with qualified non-citizen status may be eligible for Medicaid and the Children's Health Insurance Program (CHIP) after a 5-year waiting period. They can also seek emergency medical services and primary and preventive healthcare at community health centres regardless of their immigration status.
Can non-citizens get medical insurance?
| Characteristics | Values |
|---|---|
| Lawfully present immigrants | Can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. |
| Qualified non-citizens | Eligible for coverage through Medicaid and the Children's Health Insurance Program (CHIP) if they meet state income and residency rules. |
| Lawfully present immigrants who are "qualified" for less than 5 years | Generally qualify for Marketplace coverage if otherwise eligible. |
| Refugees, asylees, or LPRs who used to be refugees or asylees | Exempt from the 5-year waiting period for Medicaid and CHIP coverage. |
| Undocumented immigrants | Cannot get Marketplace coverage. |
| Non-citizens with certain approved employment-based immigrant visa petitions | May be eligible for Marketplace coverage. |
| Non-citizens seeking emergency medical services | Hospitals with emergency rooms must screen and treat regardless of immigration status or ability to pay. |
| Non-citizens seeking primary and preventive health care | Community health centers must provide care regardless of immigration status, ability to pay, or insurance coverage. |
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What You'll Learn
Lawfully present immigrants can get Marketplace coverage
As of 2023, about half of noncitizen immigrant adults in the US were uninsured. Noncitizen immigrants are more likely to be uninsured than citizens because they have more limited access to private coverage and face eligibility restrictions for federally funded coverage options.
However, lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. The term "lawfully present" includes immigrants with "qualified non-citizen" immigration status, humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, victims of trafficking), valid non-immigrant visas, and legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals).
Qualified non-citizens who haven't had their status for five years generally qualify for Marketplace coverage if otherwise eligible. Refugees, asylees, or LPRs who used to be refugees or asylees are exempt from the five-year waiting period.
States have the option to remove the five-year waiting period and cover lawfully residing children and/or pregnant people in Medicaid or CHIP. As of 2023, 35 states, plus the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, and the U.S. Virgin Islands, have chosen to do so.
Due to a recent court order, Deferred Action for Childhood Arrivals (DACA) recipients and consumers with certain other immigration statuses living in some states are no longer eligible for Marketplace coverage.
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Qualified non-citizens can get Medicaid and CHIP coverage
In the United States, healthcare is largely privatized, and public healthcare is only provided to a small portion of the population. The federal Medicare program is only available to retirees, while the Medicaid program is reserved for the poorest citizens.
However, if you are a "qualified non-citizen," you are generally eligible for coverage through Medicaid and the Children's Health Insurance Program (CHIP), as long as you meet state income and residency rules. "Qualified non-citizen" status includes humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, and victims of trafficking), valid non-immigrant visas, and legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals). Lawful Permanent Residents, also known as green card holders, are also considered "qualified non-citizens."
To get Medicaid and CHIP coverage, many qualified non-citizens must wait five years after obtaining qualified status. However, there are exceptions to this rule. Refugees, asylees, and LPRs who used to be refugees or asylees are exempt from the five-year waiting period. Additionally, states have the option to remove the waiting period and cover lawfully residing children and/or pregnant people. As of 2023, 35 states and several US territories have chosen to do so for Medicaid, and 28 of these states also offer CHIP without a waiting period.
Medicaid provides free or low-cost medical benefits to eligible individuals and families, and CHIP covers children in families who earn too much to qualify for Medicaid. In some states, CHIP also covers pregnant people. Each state has its own eligibility requirements for Medicaid and CHIP, and income is a significant factor in determining eligibility. Even if you do not qualify for Medicaid based on income, you may qualify for your state's program, especially if you have children, are pregnant, or have a disability.
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Undocumented immigrants can't get Marketplace coverage
Non-citizens in the US face challenges in securing health insurance. Healthcare in the United States is largely privatized, with public healthcare provided only to a small portion of the population. This means that most people, including citizens, have private health plans. The federal Medicare program is available only to retirees, and the Medicaid program is reserved for the poorest citizens. New immigrants will not qualify for either of these programs.
While lawfully present immigrants may qualify for Medicaid and CHIP, they are subject to certain eligibility restrictions. To get Medicaid and CHIP coverage, many qualified non-citizens (such as Lawful Permanent Residents, also known as LPRs or green card holders) have a 5-year waiting period. There are exceptions to this rule, for example, refugees, asylees, or LPRs who used to be refugees or asylees do not have to wait 5 years.
Undocumented immigrants are not eligible to enroll in federally-funded coverage, including Medicaid, CHIP, or Medicare, or to purchase coverage through the ACA Marketplaces. This means that undocumented immigrants cannot get Marketplace coverage.
However, some states have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant people without a 5-year waiting period. For example, in New York, immigrants can qualify for the Essential Plan right after moving to the state, as long as they have a valid visa or deferred action status. They can also purchase private plans on the NY State of Health Marketplace, where financial help is available.
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Non-citizen immigrants are more likely to be uninsured
Non-citizen immigrants in the US are more likely to be uninsured than citizens. As of 2023, about half of undocumented immigrant adults reported being uninsured, compared to 6% of naturalized citizens and 8% of US-born citizens. This disparity is due to several factors, including limited access to private coverage, eligibility restrictions on federally funded programs, and enrollment barriers such as confusion, fear, and language challenges.
Undocumented immigrants are ineligible for federally funded programs like Medicaid and the Children's Health Insurance Program (CHIP) and cannot purchase coverage through the Affordable Care Act (ACA) Marketplaces. Lawfully present immigrants, on the other hand, may qualify for Medicaid and CHIP but face eligibility restrictions and waiting periods. For example, many must wait five years after obtaining "qualified" immigration status before becoming eligible for these programs.
State-level initiatives have helped expand coverage for immigrants. As of April 2025, 14 states and Washington, DC, provide fully state-funded coverage for eligible children regardless of immigration status, and seven states plus DC offer similar coverage to some eligible adults. These expansions have been associated with lower uninsured rates among immigrants, improved healthcare access, and better health outcomes.
Despite these efforts, non-citizen immigrants continue to face significant barriers to healthcare coverage and are more likely to be uninsured than their citizen counterparts. This disparity contributes to delays in accessing necessary healthcare, which can lead to worse long-term health outcomes and increased costs for both individuals and the healthcare system.
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Non-citizens can get emergency medical services
Non-citizens can face challenges in accessing healthcare in the US due to their limited access to private coverage and eligibility restrictions for federally-funded programs. However, it is important to note that non-citizens do have the right to receive emergency medical services regardless of their immigration status. Under federal law, hospitals with emergency rooms are required to screen and treat individuals in need of emergency care without considering their immigration status, financial situation, or insurance coverage. This means that if a non-citizen requires emergency medical attention, they can go to a hospital with an emergency room and receive the necessary treatment.
Additionally, non-citizens can seek primary and preventive healthcare services at community health centers, regardless of their ability to pay or their insurance status. These community health centers provide a valuable safety net for non-citizens who may otherwise face barriers to accessing regular healthcare services.
While undocumented immigrants are generally unable to obtain Marketplace health coverage, certain categories of non-citizens with specific immigration statuses may be eligible for health insurance plans. Lawfully present immigrants, including those with valid non-immigrant visas, humanitarian statuses, or temporary resident status, can enroll in Marketplace coverage and may even qualify for lower costs and savings on their plans.
Qualified non-citizens, such as lawful permanent residents (LPRs) or green card holders, may also be eligible for Medicaid and the Children's Health Insurance Program (CHIP). However, there is typically a five-year waiting period for qualified non-citizens to access these programs, although exceptions exist for certain vulnerable groups, such as refugees, asylees, and victims of trafficking.
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Frequently asked questions
Non-citizens can get medical insurance in the US, but their options are more limited than those of citizens. Lawfully present immigrants can get Marketplace coverage and may qualify for lower costs and savings on Marketplace plans. Undocumented immigrants cannot get Marketplace coverage. However, under federal law, hospitals with emergency rooms must screen and treat you regardless of your immigration status, how much money you have, or whether you have insurance.
Non-citizens can get coverage through Medicaid and the Children's Health Insurance Program (CHIP) if they meet state income and residency rules and have had a "qualified" immigration status for at least 5 years. There are exceptions to the 5-year waiting period, including for refugees, asylees, and victims of trafficking.
The process for applying for medical insurance as a non-citizen in the US will vary depending on the type of insurance and the state you are applying in. You can find information on eligibility and the application process on the HealthCare.gov website.
Yes, some non-citizens may be eligible for coverage through the Affordable Care Act (ACA) Marketplaces. Additionally, community health centers provide primary and preventive health care regardless of immigration status, ability to pay, or insurance coverage.
