Health coverage for lawfully present immigrants (2024)

Coverage for lawfully present immigrants

Lawfully present immigrants can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans.

The term “lawfully present” includes immigrants who have:

• “Qualified non-citizen” immigration status (see details below).
• Humanitarian statuses or circ*mstances (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 (temporary resident status, LIFE Act, Family Unity individuals). Get a full list of immigration statuses eligible for Marketplace coverage.

Lawfully present immigrants and Marketplace savings

If you’re a lawfully present immigrant, you can get Marketplace coverage. You may qualify for lower costs on monthly premiums and extra savings on out-of-pocket costs based on your income.

• If your annual income is above 400% of the

  A measure of income issued every year by the Department of Health and Human Services (HHS). Federal poverty levels are used to determine your eligibility for certain programs and benefits, including savings on Marketplace health insurance, and Medicaid and CHIP coverage.

  Refer to glossary for more details.

  : You may still qualify for premium tax credits that lower your monthly premium.
• If your annual income is between 100% and 400% FPL: You may qualify for premium tax credits and other savings on Marketplace health coverage.
• If your annual income is at or below 150% FPL and you’re not eligible for Medicaid or the Children’s Health Insurance Program (CHIP): You may be able to enroll in or change Marketplace coverage through a

  A time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you’ve had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

  Refer to glossary for more details.

  . Check if you can get health coverage.
• If your annual household income is below 100% FPL: If you’re not otherwise eligible for Medicaid, you’ll qualify for premium tax credits and other savings on Marketplace coverage if you meet all other eligibility requirements.

Immigrants and Medicaid & CHIP

If you're a “qualified non-citizen,” you're generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if you meet state income and residency rules.

To get Medicaid and CHIP coverage, many qualified non-citizens (such as many Lawful Permanent Residents, also known as LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after getting "qualified" immigration status before they can get Medicaid and CHIP coverage. There are exceptions. For example, refugees, asylees, or LPRs who used to be refugees or asylees don’t have to wait 5 years. Qualified non-citizens who haven’t yet had their status for 5 years generally qualify for Marketplace coverage, if otherwise eligible.

The term “qualified non-citizen” includes:

• Lawful Permanent Residents (LPR/Green Card Holder)
• 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
• Granted withholding of deportation
• Member of a federally recognized Indian tribe or American Indian born in Canada
• Citizens of the Marshall Islands, Micronesia, and Palau who are living in one of the U.S. states or territories (referred to as Compact of Free Association or COFA migrants)

Children and pregnant people

States have the option to remove the 5-year waiting period and cover lawfully residing children and/or pregnant people in Medicaid or CHIP, rather than only those who are "qualified non-citizens." A child or pregnant person is "lawfully resident" if they’re "lawfully present" and otherwise eligible for Medicaid or CHIP in the state. Learn what immigration statuses are considered lawfully present.

• 35 states, plus the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, and the U.S. Virgin Islands, have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant people without a 5-year waiting period.
• 28 of these states also cover lawfully residing children or pregnant people in CHIP.

Getting emergency care

Medicaid provides payment for treatment of an emergency medical condition for people who meet all Medicaid eligibility criteria in the state (such as income and state residency), but don’t have an eligible immigration status.

Medicaid, CHIP, & "public charge" status

Applying for or getting Medicaid or CHIP benefits, or getting savings for Marketplace health coverage doesn't make you a "public charge". This means it won’t affect your chances of becoming a Lawful Permanent Resident or U.S. citizen.

There's one exception for people getting long-term care in an institution at government expense, like in a nursing facility. These people may face barriers getting a green card.