What Immigrants Need to Know about Health Insurance

by Ronald Shapiro

America is home to more than 21 million non-citizen immigrants, according to Kaiser Health News, and for many of these immigrants, health coverage is a top concern. Given that the health care landscape has undergone significant changes in light of the recent enactment of the Affordable Care Act (commonly referred to as Obamacare), many immigrants are left confused and uncertain about their health coverage rights and options.

If you are an immigrant and your employer does not offer health care insurance, there are several things that you need to know about health coverage. First, in order to buy private health insurance through the Marketplace, you must be a U.S. citizen or “lawfully present” in the United States through one of the following ways:

  • “Qualified non-citizen” immigration status without a waiting period
  • 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 (such as temporary resident status, LIFE Act, or Family Unity individuals)

If you are a lawfully present immigrant, you can purchase private health insurance on the Marketplace and you may be eligible for lower costs on monthly premiums and lower out-of-pocket costs if your income falls below the following thresholds:

  • If your annual income is 400% of the federal poverty level (about $45,960 for an individual or $94,200 for a family of 4) or below, you may be eligible for tax credits that can be used immediately to reduce monthly premiums for insurance bought in the Marketplace.
  • If your annual household income is below 100% of the federal poverty level (about $11,490 for an individual or $23,550 for a family of 4), and you are not otherwise eligible for Medicaid, you will be eligible for tax credits and lower out-of-pocket costs for private insurance through the Marketplace if you meet all other eligibility requirements.

If you are one of the following “qualified non-citizens” immigrants, you will generally be eligible for Medicaid and Children’s Health Insurance Program (CHIP) coverage, if you meet your state’s income eligibility rules:

  • Permanent Residents (Green Card Holders)
  • Asylees
  • Refugees
  • Cuban/Haitian entrants
  • Immigrants paroled into the U.S. for at least one year
  • Conditional entrants granted before 1980
  • Battered non-citizens, spouses, children, or parents
  • Victims of trafficking and spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa
  • Immigrants granted withholding of deportation
  • Immigrants who are members of a federally recognized Indian tribe or American Indian born in Canada

In order for most green card holders to get Medicaid or CHIP coverage, however, there is five-year waiting period unless they meet certain exceptions, such as refugees or asylees.

If you are part of a “mixed status” family, with members having different immigration/citizenship statuses and some taxpaying members who cannot buy health insurance through the Marketplace, you can apply for a tax credit or lower out-of-pocket costs for private insurance for your dependent family members who are eligible for coverage in the Marketplace or for Medicaid and CHIP coverage.

If you are a “lawfully present” immigration purchasing private insurance on the Marketplace, it is important to know that, while Health Insurance Marketplaces and state Medicaid and CHIP agencies can require you to disclose the Social Security Numbers (SSNs) of applicants, recipients of benefits, and certain people whose income is needed for computing tax credits, they cannot require you to provide information about the citizenship or immigration status of any household members who are not applying for coverage. Moreover, states cannot deny benefits to you because a non-applicant family member refuses to disclose his or her citizenship/immigration status.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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