Health insurance in the United States can be a highly difficult system to navigate. From figuring out if your employer provides health coverage, to what company and plan best suits your needs, trying to understand health insurance is not for the faint of heart. Of course, being a newly-arrived immigrant does not simplify this process either. Trying to adapt can be overwhelming at times, not only to a new country, but also to a new health system.
There are a lot of misconceptions around insurance. Some say that immigrants do not receive any sort of coverage for their health, while others highlight the high costs around it. But the reality is much more nuanced.
Unlike popular belief, there are a variety of options for immigrants to receive health insurance or, at the very least, some sort of coverage to ensure their health and wellness. That is why we have compiled a comprehensive list on what you need to know as you navigate the health insurance system.
What Challenges do Immigrants Face to Access Insurance?
Immigrants can be eligible for health insurance depending on their legal status. However, many often remain uninsured because of a range of enrollment barriers, including fear, confusion about eligibility policies, difficulty navigating the enrollment process, and language and literacy challenges. Experts believe these fears were exacerbated by policy changes made by the Trump Administration in Medicaid and CHIP.
Newly-arrived immigrants also often tend to work in lower wage jobs and industries that are less likely to offer health coverage, leading to lower rates of private coverage and higher uninsured rates. Similarly, noncitizen immigrants may also face restrictions on eligibility for federally funded coverage. Nevertheless, options are still available for immigrants who meet certain requirements.
What is your Immigration Status and How Does it Affect Your Coverage?
Immigration status is one of the main factors on whether or not health insurance you can get, as well as what type. In short, depending on your specific status, you may be eligible for certain types of U.S. health insurance.
- Green Card holders, for instance, become eligible for Medicaid and the Children's Health insurance Program, or CHIP (federal health care services) after five years of residence if they meet the rest of the programs' criteria.
- Non-U.S. citizens can also get medical insurance. There are different options available for this group. Most people with lawful status purchase private health insurance through a state or federal marketplace. However, low-income immigrants, pregnant women, and children are sometimes eligible for state or federal benefits as well.
- Undocumented immigrants are not eligible for federal health insurance plans. However, they may be eligible for other programs such as emergency medical assistance under Medicaid or services through federally qualified health centers or public health programs.
You can get more information about what insurance programs you may qualify for, by clicking here.
Health Insurance for Lawfully Present-Immigrants
In 2010, the U.S. government passed the Affordable Care Act (ACA), often referred to as Obamacare. The ACA established marketplace healthcare benefits and extended eligibility for these programs to lawfully present immigrants.
For the health administration, lawfully present immigrants are those who have:
- Qualified non-citizen immigration status (see details below).
- 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
If you are a lawfully present immigrant, you may qualify for lower costs on monthly premiums and extra savings on out-of-pocket costs based on your income. The federal poverty level (FPL) is a measure of income used to decide your eligibility for certain programs and benefits. This could include savings on Marketplace health insurance, or Obamacare, and Medicaid and CHIP coverage.
Health Insurance for Qualified Non-Citizens
If you're a qualified non-citizen, you're eligible for coverage through Medicaid and CHIP, if you meet state income and residency rules.
To get Medicaid and CHIP health coverage, many qualified non-citizens have a five-year waiting period. This means they must wait 5 years after getting "qualified" immigrant status before they can get Medicaid and CHIP coverage. However, there may be exceptions. For instance, refugees, asylees, or LPRs who used to be refugees or asylees don't have to wait five years.
Qualified non-citizens who haven't yet had their status for five years generally qualify for Marketplace coverage (Obamacare), if otherwise eligible.
The term "qualified non-citizen" includes:
- Lawful Permanent Resident.
- Asylees.
- Refugees.
- Cuban/Haitian entrants.
- Paroled into the U.S. for at least one year.
- Conditional entrant granted before 1980.
- Battered non-citizens, spouses, children, or parents.
- Victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa.
- And more.
Health Insurance for Undocumented Immigrants
Undocumented immigrants cannot receive federal benefits, which include plans on the federal marketplace exchanges and Medicare. However, undocumented immigrants can buy private insurance from certain companies.
Children who are eligible based on income can receive state-funded health insurance in California, New York, Illinois, Massachusetts, Washington, D.C., Oregon and Washington State. They may receive this insurance regardless of their immigration status.
Lawfully present children of undocumented immigrants may be eligible for certain federal and state benefits. Virginia, Texas, Maryland and several other states also grant pregnant women Medicaid regardless of their immigration status.
What is 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, health coverage and access to these services varies vastly among states. As an immigrant, you may also face a waiting period before you become eligible for Medicaid.
CHIP
The Children's Health Insurance Program (CHIP) provides low-cost health coverage to some children. Eligibility depends on household income. CHIP enrollment covers children in families with incomes above the level covered by Medicaid.
CHIP has similar eligibility requirements to Medicaid for immigrant families. CHIP welcomes qualified immigrants who are lawfully present in the United States. To qualify, you should meet the five-year residency requirement. However, some states make exceptions for lawfully present children and pregnant women.
Bottom Line
It is no secret that navigating health insurance and health coverage plans can be a lengthy, nuanced and frustrating process. However, it is still important to know the basics of these federal programs to see what benefits may be available for you, depending on your status and income.
For more information on how to enroll in these programs and checking your eligibility, click here.
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