Haris Ashley
Immigrant seniors in the United States face unique challenges when it comes to accessing healthcare and obtaining adequate medical insurance. While undocumented immigrants and lawfully present immigrants have some options for health coverage, they often encounter barriers such as restricted eligibility, language access, and higher uninsured rates. In recent years, states like California, Connecticut, Vermont, and Illinois have expanded their health coverage programs to include undocumented immigrants, low-income children, and pregnant women, regardless of their immigration status. For seniors specifically, programs like the Health Benefits for Immigrant Seniors (HBIS) in Illinois provide coverage for qualifying individuals aged 65 and over, regardless of their immigration status. At the federal level, the Affordable Care Act (ACA) has made it possible for seniors who are not eligible for Medicare, including lawfully present immigrants, to purchase guaranteed-issue private health insurance in the ACA marketplace and receive income-based premium subsidies. However, Medicare and Medicaid have five-year waiting periods for legal immigrants, although a few states have relaxed these guidelines. Overall, the availability and accessibility of medical insurance for immigrant seniors vary across states, and each state has its own eligibility requirements and coverage options.
| Characteristics | Values |
|---|---|
| Best medical insurance for immigrant seniors in the USA | Health Benefits for Immigrant Seniors (HBIS) program in Illinois |
| California's Medicaid program | |
| Private health insurance in the exchange (Marketplace) | |
| Travel insurance | |
| Health insurance through an employer | |
| Health insurance through a small business owned by the family | |
| Vermont's Immigrant Health Insurance Plan | |
| Connecticut's HUSKY (Medicaid/CHIP) program | |
| Colorado's Medicaid program | |
| Maryland's health insurance exchange | |
| Insurance for immigrant seniors in other countries | N/A |
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What You'll Learn
Health Benefits for Immigrant Seniors (HBIS) program
In 2020, the state of Illinois launched the Health Benefits for Immigrant Seniors (HBIS) program as part of its mission to advance healthcare equity. The program provides medical coverage for seniors aged 65 and over, regardless of their immigration status. HBIS is a Medicaid-like health insurance program with $0 premiums and $0 co-payments for emergency services. It covers a wide range of healthcare services, including doctor and hospital care, lab tests, rehabilitative services, mental health and substance use disorder services, dental and vision services, and prescription drugs.
The HBIS program was established to address the healthcare needs of immigrant seniors who are not eligible for Medicaid under federal law. By providing access to healthcare coverage, HBIS ensures that immigrant seniors can identify and treat illnesses early, receive consistent preventative care, and afford necessary medications. In the first 18 months of the program, more than 11,000 Illinois immigrant seniors from 59 Illinois counties enrolled in coverage, speaking 42 different preferred languages.
Under the HBIS program, co-payments and cost-sharing can only be charged for certain non-emergency services. These include a $250 co-payment per stay for non-emergency inpatient hospitalizations and 10% of what the Illinois Department of Healthcare and Family Services (HFS) would pay the provider for non-emergency hospital outpatient services or ambulatory surgical treatment. However, no co-payment or cost-sharing can be charged for emergency services needed to evaluate or stabilize an emergency medical condition.
The HBIS program is expected to continue operating and providing coverage for eligible seniors aged 65 and over. The proposed FY26 budget preserves the current level of services for HBIS enrollees, and eligibility requirements are expected to remain the same. HBIS is a vital program that ensures vulnerable immigrant seniors maintain their healthcare coverage and access to high-quality healthcare services. For more information about the program and enrollment, individuals can contact the Office of Welcoming Centers for Refugee and Immigrant Services at (312) 793-7120 or email [email protected].
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Lawfully present immigrant status
Lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. This includes immigrants with "qualified non-citizen" immigration status, humanitarian statuses or circumstances (including Temporary Protected Status, asylum applicants, victims of trafficking), valid non-immigrant visas, and legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals).
In the United States, as of 2023, 18% of lawfully present immigrant adults reported being uninsured. This is due to limited access to private coverage, eligibility restrictions for federally funded coverage options, and enrollment barriers such as confusion about eligibility rules and language access challenges.
To address these challenges, some states have expanded access to health coverage for immigrants. For example, 35 states have chosen to provide Medicaid coverage to lawfully residing children and pregnant people without a 5-year waiting period. Additionally, lawfully present immigrants with a “qualified non-citizen" status are generally eligible for coverage through Medicaid and the Children's Health Insurance Program (CHIP) if they meet state income and residency rules.
In California, adults aged 26 to 49 can qualify for Medi-Cal regardless of their immigration status, and Deferred Action for Childhood Arrivals (DACA) recipients can enroll in a health plan through Covered California.
In summary, lawfully present immigrants have access to Marketplace coverage and may qualify for savings and subsidies. However, they may face challenges due to varying state regulations and eligibility requirements. To confirm their specific options, immigrants should refer to the regulations of the state in which they reside.
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Medicaid and CHIP coverage
In the United States, Medicaid and the Children's Health Insurance Program (CHIP) provide free or low-cost health coverage to some low-income individuals, families, children, pregnant women, the elderly, and people with disabilities. Lawfully present immigrants who meet the Medicaid and CHIP program requirements, such as income and state residency, can enrol in Medicaid or CHIP after they have been in the United States with qualified status for five years or more. However, some groups, including refugees, asylees, and other humanitarian immigrants, are exempt from this waiting period.
Undocumented immigrants may not enrol in Medicaid or CHIP, although some states provide coverage to pregnant people regardless of immigration status by covering the "unborn child". Additionally, some states use state-only funds to cover some groups of immigrants regardless of their immigration status. For example, the State of Illinois offers the Health Benefits for Immigrant Seniors (HBIS) program, which provides coverage for qualifying individuals aged 65 and over, regardless of their immigration status.
Medicaid benefits vary across states. Some Medicaid programs pay for care directly, while others use private insurance companies to provide coverage. All states provide comprehensive coverage, and some have expanded their Medicaid programs to cover all people below certain income levels. In all states, CHIP provides low-cost health coverage to children in families who earn too much to qualify for Medicaid, and in some states, CHIP covers pregnant people.
To apply for Medicaid and CHIP, individuals can apply through their state agency, which will determine eligibility. If an individual is deemed ineligible by their state agency, they may still qualify for Marketplace coverage, which offers premium tax credits and cost savings on health insurance plans. However, a Marketplace health plan typically costs more than Medicaid and may not offer additional coverage or benefits.
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Emergency Medical for Noncitizens
For immigrant seniors in the United States, securing health insurance can be challenging. While health coverage is not mandatory for most immigrants, it is essential to have adequate protection for yourself and your family, given the high costs of healthcare in the US.
If you're a "qualified non-citizen", you may be eligible for coverage through the Medicaid program and the Children's Health Insurance Program (CHIP). However, there is typically a five-year waiting period for many qualified non-citizens, such as Lawful Permanent Residents (LPRs) or green card holders. This waiting period has been waived in 35 states, the District of Columbia, and several US territories, which now provide immediate Medicaid coverage to lawfully residing children and pregnant people.
For those who don't meet the criteria for Medicaid or CHIP, there are other options. Lawfully present immigrants can enrol in Marketplace coverage and may qualify for lower costs on monthly premiums and extra savings based on their income. Additionally, some states offer specific programs for immigrant seniors. For example, the State of Illinois provides the Health Benefits for Immigrant Seniors (HBIS) program, which serves qualifying individuals aged 65 and over, regardless of their immigration status.
If you're planning to stay in the US for a shorter period, a travel medical plan or international health plan might be more suitable. These plans typically cover accidents, illnesses, pharmaceutical care, and translation services. They can help shield you from the high costs of unexpected medical emergencies, especially if you have pre-existing conditions.
To summarise, the best medical insurance for immigrant seniors depends on their unique circumstances, including age, health status, and length of stay in the US. It's important to carefully review the different options, eligibility criteria, and coverage details to make an informed decision.
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Private health insurance options
Private carriers now offer coverage to people who are 65 or older, as long as they are not enrolled in Medicare. The ACA also ensures that older enrollees pay a maximum of three times the premiums of younger enrollees.
Lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. This includes immigrants with "Qualified non-citizen" immigration status, humanitarian statuses, or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, and victims of trafficking).
Qualified non-citizens, such as Lawful Permanent Residents (LPRs) or green card holders, generally have a five-year waiting period for Medicaid and CHIP coverage. However, there are exceptions for refugees and asylees, and some states have removed the waiting period for lawfully residing children and pregnant people.
Undocumented immigrants face more challenges, with higher uninsured rates and more limited access to private coverage. They also face eligibility restrictions for federally funded options and enrollment barriers due to confusion, language access, and immigration-related fears.
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Frequently asked questions
The Health Benefits for Immigrant Seniors (HBIS) program provides coverage for qualifying individuals aged 65 and over, regardless of their immigration status. The program is administered by the State of Illinois and offers high-quality healthcare coverage to eligible noncitizens aged 65 and above who are not eligible for Medicaid under federal law.
Seniors who are not eligible for Medicare, including lawfully-present immigrants, can purchase private health insurance in the exchange (Marketplace) due to the Affordable Care Act (ACA). They may also be eligible for income-based premium tax credits to offset costs.
Some states have relaxed guidelines for Medicaid, removing the five-year waiting period for lawfully residing individuals. States like Connecticut, Vermont, Colorado, and Hawaii have expanded coverage for undocumented children, pregnant women, and individuals.
Noncitizen immigrants often face eligibility restrictions for federally funded programs like Medicaid, CHIP, ACA Marketplace coverage, and Medicare. They may also encounter enrollment barriers due to fear, confusion about rules, and language access challenges, resulting in higher uninsured rates and delayed healthcare.
Yes, contacting organizations like Protecting Immigrant Families, the Immigrant Family Resource Program, and the Office of Welcoming Centers for Refugee and Immigrant Services can provide further assistance and answer specific questions about enrollment and immigration status.
