Orlando Harmon
Non-US citizens can get medical insurance in the US, but their options are more limited than those of US citizens. Undocumented immigrants cannot get Marketplace coverage, but they can legally purchase private insurance. Lawfully present immigrants may qualify for Medicaid and CHIP but are subject to certain eligibility restrictions and, in many cases, a five-year waiting period. They may also qualify for premium tax credits and other savings on Marketplace plans.
| Characteristics | Values |
|---|---|
| Can non-US citizens get medical insurance? | Yes, non-US citizens can get medical insurance. |
| Who is eligible for insurance? | Lawfully present immigrants, including green card holders, asylum seekers, refugees, VAWA recipients, and trafficking victims. |
| What type of insurance can they get? | Private insurance, Medicaid, CHIP, and Marketplace coverage. |
| Are there any waiting periods? | Yes, there is usually a 5-year waiting period for Medicaid and CHIP, but some states have removed this restriction. |
| Are there any exceptions to the waiting period? | Yes, exceptions include refugees, asylees, and LPRs who used to be refugees or asylees. |
| Are there any other requirements? | Income and residency rules must be met for certain types of coverage. |
| Can undocumented immigrants get insurance? | Undocumented immigrants can legally purchase private insurance if they can afford it, but they are not eligible for Marketplace coverage. |
| Can non-citizens access healthcare without insurance? | Yes, doctors and hospitals cannot turn away uninsured non-citizens in an emergency room under the Emergency Medical Treatment & Labor Act (EMTALA). |
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What You'll Learn
Non-US citizens can legally purchase private insurance
There are several options for non-US citizens to obtain health insurance. Firstly, some new immigrants can get health insurance through their employer, which is recommended. This type of insurance usually extends coverage to immediate family members. However, it may not be sufficient to cover the high costs of doctor visits, medications, and hospital stays.
Another option is to purchase insurance from a private company. IMG, for example, offers several affordable medical insurance plans in the United States, including basic-level coverage and comprehensive benefits. The cost of health insurance for immigrants can vary depending on age, location, the insurance provider, and other factors.
Additionally, lawfully present immigrants may be eligible for government-funded programs such as Medicaid and the Children's Health Insurance Program (CHIP). To qualify, individuals must meet state income and residency requirements and have a "qualified non-citizen" immigration status. There may be a waiting period for these programs, typically five years after obtaining qualified status. However, some states have chosen to remove the waiting period and provide immediate coverage for lawfully residing children and pregnant people.
Undocumented immigrants may face challenges in obtaining health insurance. They are not eligible for Marketplace policies or Medicaid but may be able to obtain PPACA (Obamacare) insurance if their state of residence has established a program for that purpose.
Overall, it is important for non-US citizens to carefully consider their health insurance options and choose a plan that suits their specific needs and budget.
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Lawfully present immigrants can get Marketplace coverage
In the U.S., non-citizens can get medical insurance. However, they have more limited access to private coverage, and face eligibility restrictions for federally-funded coverage options. Lawfully present immigrants, on the other hand, can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans.
Who is a "Qualified Non-Citizen"?
A "qualified non-citizen" is someone who has a "qualified" immigration status. This includes:
- Humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, victims of trafficking)
- Valid non-immigrant visas
- Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals)
- Refugees, asylees, or LPRs who used to be refugees or asylees
Lawfully Present Immigrants and Marketplace Coverage
Lawfully present immigrants are eligible for coverage through the Marketplace. The term "lawfully present" includes immigrants who have a "qualified non-citizen" immigration status.
If you are a lawfully present immigrant, you may be eligible for lower costs on monthly premiums and extra savings on out-of-pocket costs based on your income. Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.
Lawfully Present Immigrants and Medicaid
Medicaid is insurance funded by federal and state governments. The program is available to U.S. citizens and lawfully present immigrants, including green card holders, asylum seekers, refugees, VAWA recipients, and trafficking victims. While Medicaid is a federal benefit, access to it varies widely among states. As an immigrant, you may face a waiting period before you become eligible for Medicaid.
State-by-State Differences
It's important to note that eligibility for coverage can vary depending on the state. For example, 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 provide Medicaid coverage to lawfully residing children and/or pregnant people without a 5-year waiting period.
Additionally, 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. These states include Alabama, Arkansas, Florida, Idaho, Indiana, Iowa, Kansas, Kentucky, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, South Carolina, South Dakota, Tennessee, Texas, and Virginia.
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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. This is due to their limited access to private coverage, as they often work in jobs that are less likely to provide health benefits. They also face eligibility restrictions for federally-funded coverage options, such as Medicaid, the Children's Health Insurance Program (CHIP), Affordable Care Act (ACA) Marketplace coverage, and Medicare. Even when they are eligible, non-citizen immigrants face enrollment barriers, including fear, confusion about eligibility rules, and language access challenges.
Undocumented immigrants are significantly more likely to be uninsured than citizens. As of 2023, half of undocumented immigrant adults reported being uninsured, compared to 6% of naturalized citizens and 8% of US-born citizens. Lawfully-present immigrants also experience higher uninsured rates than citizens, with one in five reporting a lack of insurance.
The high uninsured rates among non-citizen immigrants can lead to worse health outcomes in the long term. Research shows that uninsured individuals often delay or go without needed care, which can result in more complex and expensive health issues over time. Non-citizen immigrants are more likely to report barriers to accessing healthcare and skipping or postponing care due to cost. They also tend to have lower healthcare expenditures than US-born citizens, reflecting their younger age, better health, and the barriers they face in accessing care.
While non-citizen immigrants face challenges in obtaining insurance, there are options available. They can legally purchase private insurance if they can afford it and may be eligible for federal and state benefits to make healthcare more affordable. Lawfully-present immigrants may qualify for Medicaid and CHIP but are subject to eligibility restrictions and waiting periods. Some states have expanded coverage options for lawfully-present immigrants, and 14 states provide fully state-funded coverage for income-eligible children regardless of immigration status.
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Lawfully present immigrants may qualify for Medicaid and CHIP
Lawfully present immigrants in the US may qualify for Medicaid and the Children's Health Insurance Program (CHIP). However, they are subject to certain eligibility restrictions. In general, lawfully present immigrants must have a "qualified" immigration status to be eligible for Medicaid or CHIP. This includes most lawful permanent residents or "green card" holders, who are typically subject to a five-year waiting period after obtaining qualified status before they can enrol.
Some immigrants with qualified status, such as refugees, asylees, and citizens of Compact of Free Association (COFA) nations, are exempt from the five-year waiting period. Additionally, states have the option to waive the waiting period and provide immediate coverage to lawfully residing children and/or pregnant women. As of 2022, 35 states, the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, and the US Virgin Islands have opted to do so.
The eligibility criteria for Medicaid and CHIP vary among states. To qualify for Medicaid, individuals must meet specific income and residency rules, and the program is typically available to low-income individuals and families. CHIP, on the other hand, provides low-cost health coverage to children in families with incomes above the level covered by Medicaid.
Lawfully present immigrants can also purchase health insurance through the ACA Marketplaces and may be eligible for premium tax credits and other savings on their plans. These tax credits are typically available to individuals with incomes starting from 100% of the federal poverty level (FPL) who are not eligible for other affordable coverage.
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Non-immigrant status holders can qualify for Medi-Cal
Non-US citizens can get medical insurance in the US, with options available to people of all statuses. Lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans.
To be eligible for Medicaid, a non-citizen must have a "qualified" immigration status. This includes Lawful Permanent Residents (LPRs) or green card holders, refugees, asylees, asylum seekers, VAWA recipients, and victims of trafficking. LPRs must usually wait five years after obtaining qualified status before they can enrol, but this is not the case for refugees and asylees. States can choose to remove the waiting period and cover lawfully residing children and pregnant people.
In California, non-citizens can qualify for full-scope Medi-Cal if they have low incomes (up to 138% of the Federal Poverty Level), are physically present in the state with the intention to remain, and fall into one of four categories:
- U.S. citizens
- Lawful Permanent Residents (LPRs) or green card holders
- Refugees, asylees, asylum seekers, VAWA recipients, and victims of trafficking
- PRUCOL (Permanently Residing in the U.S. Under Color Of Law) immigrants
PRUCOL is a category used solely for Medi-Cal and not for immigration purposes. An immigrant may claim to be PRUCOL if they have a good-faith belief that US Citizenship and Immigration Services (USCIS) knows of their presence in the US and does not intend to deport them. This includes immigrants who have applied for legal status and are awaiting a response.
Restricted Medi-Cal, also known as "Emergency" Medi-Cal, provides limited healthcare coverage for emergency and pregnancy-related services. It is available to low-income California residents, regardless of legal immigration status. Immigrants who do not qualify for full-scope Medi-Cal due to their immigration status are also eligible for My Health LA, a program that allows participants to access free medical care at health clinics.
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Frequently asked questions
Yes, non-US citizens can get medical insurance in the US. Lawfully present immigrants may qualify for Medicaid and CHIP but are subject to certain eligibility restrictions. They can also get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. All immigrants, documented or undocumented, can legally purchase private insurance in the US if they can afford it.
The process of getting medical insurance for non-US citizens can vary depending on their immigration status and the state they reside in. To get Medicaid and CHIP coverage, many qualified non-citizens (such as lawful permanent residents or green card holders) have a 5-year waiting period. However, 35 states have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant people without a 5-year waiting period. Lawfully present and not lawfully present individuals can apply through Covered California to see if they are eligible for a health plan.
Non-US citizens should consider the eligibility requirements for different insurance options, such as income limits and residency rules. They should also consider the costs associated with the plan, including the monthly premiums and out-of-pocket expenses, as well as coinsurance. Coinsurance determines how much your insurance covers after you meet your deductible and is usually expressed as a percentage. For example, if your coinsurance is 25%, you will need to pay 25% of your covered medical bills, and your plan will cover the remaining 75%.
