Jane Dotson
As a green card holder, you have several options for getting affordable health coverage in the United States. You can access health insurance through your employer, the Marketplace, Medicare, or private insurers, depending on eligibility. Green card holders are eligible for Medicare once they have had qualified permanent resident status for at least five years and meet other requirements based on age or disability. They may also qualify for Medicaid (free or low-cost health coverage) if they meet income and residency requirements. To get Medicaid and CHIP coverage, many qualified non-citizens (such as lawful permanent residents) have a five-year waiting period. However, there are exceptions for specific groups, such as refugees and asylees.
| Characteristics | Values |
|---|---|
| Eligibility | Lawful permanent residents (green card holders) aged 65 or older |
| Waiting period | 5 years after getting approved immigration status |
| Options | Marketplace coverage, Medicare, Medicaid, CHIP, or private insurers |
| Cost | Depends on age, number of days of coverage, policy maximum, and deductible |
| Benefits | Preventative care, doctor visits, prescription drugs, virtual care, hospital stays, medical evacuation, and repatriation |
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What You'll Learn
Eligibility for Medicare, Medicaid, and CHIP
Lawfully present immigrants, including green card holders, may qualify for Medicaid and CHIP but are subject to certain eligibility restrictions. Generally, to be eligible for Medicaid or CHIP, non-citizens must have a "qualified" immigration status and meet state income and residency rules. Many lawful permanent residents, or green card holders, are subject to a five-year waiting period, meaning they must wait five years after obtaining qualified status before they can enrol in Medicaid or CHIP. However, some immigrants with qualified status, such as refugees, asylees, and citizens of Compact of Free Association (COFA) nations, are not subject to the five-year waiting period. For children and pregnant people, states can eliminate the five-year wait and extend coverage to some lawfully present immigrants without qualified status.
In addition, lawfully present immigrants can qualify for Medicare, but there are restrictions. To qualify for premium-free Medicare Part A, immigrants must have sufficient work history. If they lack sufficient work history, they may still qualify if they are lawful permanent residents and have resided in the U.S. for five years immediately prior to enrolling, although they must pay premiums to enrol in Part A. Undocumented immigrants are not eligible to enrol in federally-funded coverage programmes such as Medicare.
Applying for or receiving Medicaid, CHIP, or savings for Marketplace health coverage does not affect one's chances of becoming a Lawful Permanent Resident or U.S. citizen. The only exception is for people receiving long-term care in a government-funded institution, such as a nursing facility, who may face barriers in obtaining a green card.
As of January 1, 2024, adults in California between the ages of 26 and 49 will be allowed to qualify for Medi-Cal, regardless of their immigration status, although all other eligibility rules, including income limits, will still apply.
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Employer-sponsored health insurance
If you are a green card holder, you can get health insurance through your employer. Many employers offer health insurance coverage to their employees, and you may be able to add your spouse to your plan, regardless of their citizenship, as long as they have a valid Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN). This is known as an employer-sponsored plan.
If you are a "qualified non-citizen", you are generally eligible for coverage through government programs like Medicaid and the Children's Health Insurance Program (CHIP). To get Medicaid and CHIP coverage, many qualified non-citizens (including green card holders) have to wait five years after getting "qualified" immigration status. However, there are exceptions to this rule. Refugees, asylees, or those who used to be refugees or asylees, don't have to wait five years.
If you are a green card holder and are not yet eligible for Medicaid or CHIP, you may qualify for Marketplace coverage. The Marketplace was established by the ACA to help individuals and families access affordable health insurance. It allows you to compare plans based on insurer, price, benefits, and networks. While the federal government operates the Marketplace in most states, some states run their own marketplaces and have their own eligibility criteria.
It's important to note that applying for or receiving benefits from Medicaid or CHIP does not make you a "public charge", which means it won't affect your chances of becoming a Lawful Permanent Resident or U.S. citizen. The only exception is for people receiving long-term care in a government-funded institution, such as a nursing facility.
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Private insurance companies
As a green card holder, you have several options for purchasing health insurance from private insurance companies. These companies offer plans specifically tailored to meet the needs of immigrants, providing essential coverage as they integrate into the American healthcare system.
One option is to purchase a plan from a private insurance company that caters specifically to green card holders. These companies offer plans that are designed to cover expenses for medical evacuation and repatriation, as well as hospitalizations and small bills from doctor visits due to accidental injuries or illnesses. They also often provide access to a broad network of providers and coverage for pre-existing conditions. Examples of companies offering these plans include Visitors Insurance and Safe Travels USA. However, it is important to note that Safe Travels USA Comprehensive is not available to green card holders who have been residing in the United States for more than 365 days prior to their effective date.
Another option is to purchase a major medical insurance plan from companies such as Blue Cross Blue Shield, Aetna, Anthem, Cigna, or UnitedHealthCare. These plans are available to green card holders who have permanently settled in the USA and are under a certain age.
Additionally, green card holders can also access health insurance through their employer or their family member's employer. These plans often provide comprehensive coverage, and the employer typically shares in the costs, making them an affordable choice.
When choosing a health insurance plan, it is important to carefully compare the different options and consider factors such as age, the number of days you need coverage, the policy maximum, and the deductible. This will help you select a plan that balances cost with coverage, protecting your health and financial well-being.
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Age, residency, and income requirements
To get medical insurance as a green card holder, you must be a "qualified non-citizen" and meet state income and residency rules. Typically, there is a 5-year waiting period for green card holders to get Medicaid and CHIP coverage, but this can vary by state. For example, 35 states and the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, and the U.S. Virgin Islands have removed the 5-year waiting period for lawfully residing children and pregnant people to receive Medicaid coverage. Twenty-eight of these states also offer CHIP coverage without the waiting period.
In terms of income requirements, the Department of Health and Human Services (HHS) issues a measure of income every year to determine eligibility for certain programs and benefits, including savings on Marketplace health insurance and Medicaid and CHIP coverage. Federal poverty levels are used to assess eligibility, and individuals may still qualify for premium tax credits to lower their monthly premium.
To be considered a "qualified non-citizen," you must be a Lawful Permanent Resident (LPR) or fall into one of the following categories: refugee, asylee, or LPR who used to be a refugee or asylee, victim of trafficking, or an individual with a pending application for a victim of trafficking visa.
It is important to note that applying for or receiving Medicaid, CHIP benefits, or savings for Marketplace health coverage does not make you a "public charge," meaning it will not affect your chances of becoming a Lawful Permanent Resident or U.S. citizen. The only exception is for individuals receiving long-term care in an institution at government expense, such as a nursing facility.
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Marketplace coverage and premium tax credits
Lawfully present immigrants, including green card holders, 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, valid non-immigrant visas, and legal status conferred by other laws.
To be eligible for premium tax credits, individuals must not be eligible for public coverage—including Medicaid, the Children's Health Insurance Program (CHIP), Medicare, or military coverage—and must not have access to health insurance through an employer. There is an exception in cases where the employer plan doesn't provide a minimum level of coverage, or if the employee share of the premium exceeds 9.02% of the employee's income.
If your annual household income is below 100% of the Federal Poverty Level (FPL), you will qualify for premium tax credits and other savings on Marketplace coverage if you meet all other eligibility requirements. If your annual income is between 100% and 400% FPL, you may qualify for premium tax credits and other savings on Marketplace health coverage.
Green card holders who are not eligible for Medicaid may still qualify for income-based health insurance subsidies that help individuals and families with lower incomes save on healthcare costs. There are two types of health insurance subsidies available: Advanced Premium Tax Credits and Cost Sharing Reductions (CSRs).
Applying for or receiving Medicaid or CHIP benefits, or getting savings for Marketplace health coverage, does not make you a "public charge". This means it won't affect your chances of becoming a Lawful Permanent Resident or U.S. citizen.
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Frequently asked questions
Green card holders can get medical insurance through their employer, the ACA Health Insurance Marketplace, or private insurers. They may also qualify for Medicare, Medicaid, or the Children's Health Insurance Program (CHIP).
Green card holders typically have to wait five years after getting approved immigration status to enrol in Medicare, Medicaid, or CHIP.
The premium for immigrant health insurance depends on the age of the green card holder, the number of days of required coverage, the policy maximum, and the deductible.
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