Orlando Harmon
New immigrants, including those who gain citizenship or lawful permanent residency, can obtain health insurance from various sources. Lawfully present immigrants may qualify for Medicaid and CHIP but are subject to specific eligibility requirements, such as having a “qualified” immigration status and meeting state income and residency rules. In most states, a non-incarcerated, lawfully present resident can enroll in a health plan through the exchange in their state during the open enrollment period. Additionally, immigrants in New York have more health insurance options than in many other states, including free or low-cost insurance plans like Child Health Plus and the Essential Plan.
| Characteristics | Values |
|---|---|
| Lawfully present immigrants | Can qualify for Medicaid and CHIP |
| Lawfully present immigrants | Must have a "qualified" immigration status to be eligible for Medicaid or CHIP |
| Lawful permanent residents | Must wait 5 years after obtaining qualified status to enroll in Medicaid or CHIP |
| Refugees, asylees, and citizens of Compact of Free Association (COFA) nations | Do not have to wait 5 years to enroll in Medicaid or CHIP |
| Lawfully present immigrants | Can qualify for Medicare if they have sufficient work history |
| Lawful permanent residents | Can qualify for Medicare if they have resided in the U.S. for 5 years prior to enrolling |
| Undocumented immigrants | Ineligible for Medicaid, CHIP, or Medicare |
| Immigrants in New York | Have more health insurance options than in many other states |
| Immigrants in New York | Can qualify for Essential Plan if they have a valid visa or deferred action status |
| Immigrants in California | Adults ages 26-49 can qualify for Medi-Cal regardless of immigration status as of Jan 1, 2024 |
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What You'll Learn
Lawful permanent residents' access to Medicaid
Lawful permanent residents, also known as LPRs or green card holders, can access Medicaid, but they are subject to certain eligibility restrictions. Generally, to be eligible for Medicaid, LPRs must have a "qualified" immigration status and meet state income and residency rules. Many LPRs have a 5-year waiting period after obtaining their "qualified" immigration status before they can enrol in Medicaid. However, there are exceptions to this waiting period. Refugees, asylees, and LPRs who previously held refugee or asylee status are exempt from the 5-year wait.
In states like California, Colorado, Illinois, Minnesota, New York, Oregon, and Washington, D.C., income-eligible adults can access fully state-funded coverage regardless of their immigration status. In New York, for instance, immigrants with valid visas or deferred action status can qualify for the Essential Plan, which offers free or very low-cost insurance for adults with low incomes who do not qualify for Medicaid. Similarly, all children in New York can enrol in Child Health Plus, regardless of their immigration status or income.
Lawful permanent residents who are pregnant may have additional options. In some states, such as New York, pregnant individuals can obtain Medicaid regardless of their immigration status, as long as they meet other requirements. Furthermore, states that have expanded coverage for pregnant people, regardless of immigration status, have seen improved prenatal care and better outcomes, including increased average gestation length and birth weight among newborns.
It is important to note that applying for or receiving Medicaid benefits does not impact an individual's chances of becoming a Lawful Permanent Resident or U.S. citizen. However, there is an exception for people receiving long-term care in a government-funded institution, such as a nursing facility, who may encounter obstacles in obtaining a green card.
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CHIP coverage for permanent residents
The Children's Health Insurance Program (CHIP) is a federal-state initiative that provides health coverage to children in families with incomes too high to qualify for Medicaid but too low to afford private or group health plans. CHIP coverage is available to US citizens and certain qualified non-citizens, such as lawful permanent residents.
To be eligible for CHIP, individuals must meet state income and residency rules. Many qualified non-citizens, including lawful permanent residents, are subject to a 5-year waiting period after obtaining qualified immigration status before they can enrol in CHIP. However, some qualified non-citizens, such as refugees, asylees, and victims of trafficking, are exempt from this waiting period.
CHIP eligibility is also limited by age and pregnancy status. Most states offer CHIP coverage to children under the age of 19, and some states extend coverage to pregnant women. Additionally, children who are inmates of a public institution or patients in an institution for mental diseases are generally not eligible for CHIP. Furthermore, children covered by a state health benefits plan due to a family member's employment with a public agency are typically ineligible for CHIP unless the state qualifies for specific exceptions.
CHIP provides comprehensive insurance coverage, including medically necessary orthodontics for dental problems that interfere with speaking, eating, or breathing. The cost of CHIP varies based on income, and some families may qualify for free coverage. Even families with higher incomes can access CHIP with low monthly premiums and co-pays.
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Medicare eligibility for permanent residents
Lawfully present immigrants in the U.S. may qualify for Medicare, but they are subject to certain restrictions. Generally, to be eligible for premium-free Medicare Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.
For permanent residents who are 65 or older, they must have sufficient work history to qualify for premium-free Medicare Part A. If they do not have sufficient work history, they may qualify if they have resided in the U.S. for five years immediately prior to enrolling in Medicare, although they must pay premiums to enrol in Part A.
Legal immigrants (non-citizen permanent residents) under 65 with disabilities may also qualify for Medicare, but they must first meet the same eligibility requirements for SSDI (disability benefits) that apply to citizens. These requirements are based on work history, paying Social Security taxes on income, and having enough years of Social Security taxes accumulated to equal between 20 and 40 work credits (5-10 years).
Undocumented immigrants are not eligible to enrol in Medicare. Applying for or receiving Medicaid or CHIP benefits, or getting savings for Marketplace health coverage, does not affect an immigrant's path to becoming a permanent resident or U.S. citizen.
In New York, immigrants can qualify for the Essential Plan, which provides free or very low-cost insurance for adults with low incomes who don't qualify for Medicaid. Immigrants can qualify for this plan as soon as they arrive in New York, as long as they have a valid visa or deferred action status.
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Health insurance options for permanent residents in NYC
Permanent residents in NYC have multiple health insurance options. Firstly, lawfully-present immigrants in the US may qualify for Medicaid and CHIP, subject to certain eligibility criteria. These include income and state residency rules, and in some cases, a five-year waiting period after obtaining a "qualified" immigration status. However, exceptions exist for specific groups, such as refugees, asylees, and citizens of Compact of Free Association (COFA) nations, who are not subject to the waiting period.
In the state of New York, all children can benefit from Child Health Plus, regardless of their immigration status or income. Additionally, Medicaid is available for New Yorkers with low incomes, and it can also be obtained regardless of immigration status if you are pregnant, as long as you meet other requirements. If you are undocumented and not pregnant, emergency services may still be covered by Medicaid if you meet the necessary conditions.
For adults who do not qualify for Medicaid, the Essential Plan provides free or very low-cost insurance for those with low incomes. Immigrants can qualify for this plan immediately after moving to New York, provided they have a valid visa or deferred action status. DACA individuals are not eligible for this plan.
Private/Qualified Health Plans are also available on the NY State of Health Marketplace, where financial assistance is provided. Anyone can also purchase private health insurance directly from an insurance company.
Furthermore, the Family Planning Benefit Program offers free and confidential family planning services for qualifying adults and teens. The Family Planning Extension Program is designed for individuals who had Medicaid coverage during their pregnancy but no longer qualify after giving birth.
It is important to note that applying for or receiving health insurance or benefits will not affect your immigration status or your chances of becoming a lawful permanent resident or US citizen.
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Health insurance for permanent residents in California
California has a range of health insurance options for permanent residents. The state health insurance exchange, Covered California, is a popular choice for many residents. Both lawfully present and not lawfully present individuals can apply through Covered California to see if they are eligible for a health plan. There is no waiting period or five-year bar for this. Lawfully present residents enrolling in Covered California are required to show proof of lawful presence.
There are also other options for permanent residents in California. Lawful permanent residents, also known as green card holders, can qualify for Medicaid and CHIP but must usually wait five years after obtaining qualified status before they can enrol. However, there are exceptions to this rule, such as for refugees, asylees, or LPRs who used to be refugees or asylees.
Additionally, permanent residents in California can purchase a health plan privately by enrolling through an insurance agency like Health for California Insurance Center. Some insurance companies that offer plans include Kaiser, Blue Shield, Anthem Blue Cross, and Health Net.
California also has some specific rules regarding health insurance for immigrants. For example, as of January 1, 2024, adults in California ages 26 to 49 can qualify for Medi-Cal, regardless of their immigration status. Furthermore, a 2016 expansion to cover low-income children regardless of immigration status resulted in a 34% decline in uninsurance rates.
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Frequently asked questions
Yes, the new immigrant insurance law applies to permanent residents, also known as green card holders.
Permanent residents can obtain health insurance from employer-sponsored plans, the individual/family market, and health plans marketed specifically for immigrants. They may also qualify for Medicaid, CHIP, and Medicare, subject to certain eligibility criteria and restrictions.
Yes, there is often a five-year waiting period for permanent residents to enroll in Medicaid and CHIP after obtaining their “qualified” immigration status. However, there are exceptions for certain groups, such as refugees, asylees, and citizens of COFA nations.
No, applying for health insurance will not affect your immigration status or your chances of becoming a permanent resident or U.S. citizen.
Yes, New York has additional insurance options for immigrants. Immigrants in New York can qualify for the Essential Plan, which offers free or very low-cost insurance for adults with low incomes who don't qualify for Medicaid, as long as they have a valid visa or deferred action status.
