Immigrant Health Insurance for Non U.S Citizens

According to the 2020 Current Population Survey data from the U.S. Census Bureau around 7% of the total U.S. population were noncitizens (~22.1 million people). These figures include lawfully present and undocumented immigrants who are often in mixed immigration status families. 

Noncitizens are significantly less likely to be insured than citizens. According to that same survey, there were also around 22.7 million naturalized citizens in the U.S. who are also less likely to have health insurance. Residual effects from the COVID-19 pandemic and the former political administrations have discouraged these groups from seeking coverage. 

While undocumented immigrants may have a difficult time finding proper healthcare, other noncitizens and naturalized citizens who are lawfully present should be eligible for some public or private plans. Other barriers, such as language and finances, should not act as a barrier to basic human health services. 

Reasons to Get Healthcare as an Immigrant

One of the benefits of being lawfully present is healthcare eligibility. New immigrants or citizens may be unfamiliar with the U.S. healthcare system. If you are curious about how it works––or why you need it—this article will answer your questions.

The basic premise of health insurance is to pay a steady fee so that if you get sick or injured, the expenses at the moment will not be devastating. You develop a contract with your insurance company in which they agree to pay a piece of your medical costs as long as you continue to buy their services. 

Medical services in the U.S. are very advanced, but they are also very expensive. If you have to visit the hospital without insurance, you could be at serious financial risk. In addition to the more extreme scenarios, health insurance also allows you and your family to attend routine checkups at the doctor’s office without high out-of-pocket expenses. 

Although there isn’t a legal penalty for not having health insurance, it can be dangerous to live uninsured. Those without insurance who do not receive regular care often neglect their physical (and/or mental) health. People of color and those in poverty are disproportionately uninsured and often suffer the most when they do get sick or injured. 

U.S. Healthcare Terms to Know

When navigating the U.S. healthcare system, you are likely to come across a variety of unfamiliar words. Especially if English is not your primary language, this can make choosing the right plan much harder to understand. 

Below are some of the common terms which have caused a problem for new immigrants in the past:

• Allowed amount: This is the maximum payment your insurance will cover. If a medical provider charges more than your allowed amount, you may have to pay the excess out of pocket. 
• Co-insurance: The percentage of costs you are required to pay for health care services after you’ve met your deductible.
• Co-payment: A fixed amount of money you will pay anytime you receive covered health care services.
• Deductible: A predetermined expense value which must be met before insurance will begin to cover any costs.
• Emergency room (ER): The part of a hospital that is dedicated to immediate treatment for illness or injury. Any serious or life-threatening medical issues that need to be taken care of quickly will be done so in the ER.
• Healthcare maintenance organizations (HMOs): These are healthcare networks which connect people to specific hospitals and doctors. If you are part of an HMO, you must go to medical providers within your HMO to receive treatment.
• Out-of-pocket maximum: The most money you can be expected to pay for one policy period before your insurance policy begins to cover 100% of the allowed amount.
• Pre-existing conditions: Pre-existing conditions are injuries or illnesses that someone suffers from before they purchase a coverage plan. If you already have one of these, you may be expected to pay a higher rate. 
• Preferred provider organizations (PPOs): PPOs allow the policyholder to see providers outside of their network.
• Primary care physicians (PCPs): A primary care physician is your point of contact for all medical interactions. They will provide referrals to other doctors in your network and must be in your HMO. 
• Urgent care: Less intense than the emergency room, an urgent care is for situations that can’t wait for a doctor’s appointment but aren’t necessarily life threatening. Urgent cares are also open outside of normal business hours and can address regular issues like a fever, allergies, or minor fractures.

If you encounter other unknown terms when reading health insurance plans, do not be afraid to look them up. Do not risk moving forward with no knowledge of what you are signing yourself up for.

Health Insurance Eligibility

U.S. immigrants who are lawfully present can receive health insurance through the Health Insurance Marketplace. The Marketplace is run by the federal government and helps people throughout the country identify and shop for health insurance plans. 

To be lawfully present, you must meet at least one of the following conditions:

• Qualified non-citizen immigrant status with no waiting period (green card holder, refugee, or asylee)
• Present on a valid non-immigrant visa
• Under humanitarian status or circumstances
• Hold legal status conferred by different laws, for example the temporary resident status
• Other immigration statuses specified by the Marketplace 

The United States also offers inexpensive health insurance plans under the Affordable Care Act (ACA). Also called the Health Care Reform Law and Obamacare, the ACA offers subsidies and discounts that make insurance policies significantly cheaper. 

Depending on your condition, you may still be able to qualify for limited emergency Medicaid services even if you don’t have eligible immigration status. However, undocumented immigrants are not eligible for Marketplace policies or Medicaid. 

Publicly Funded Programs

There are two government-funded programs that can help provide lawfully present immigrants with health insurance: Medicaid and the Children’s Health Insurance Program (CHIP). To qualify for these programs, you must meet your state’s income eligibility requirements and be in the U.S. legally.

Medicaid

Medicaid is both a federal and state program that provides low-income individuals with health insurance. Depending where you live, your coverage may differ significantly. In a general sense, the Medicaid program covers physician, inpatient and outpatient hospital, x-ray, and other laboratory services. You can qualify for Medicaid based on your income or other factors like disability or family status. 

CHIP

The Children’s Health Insurance Program, also called CHIP, is designed for families who have a higher income to qualify for Medicaid’s income requirements.. Operational at the state level, CHIP provides low-cost insurance coverage for children. Eligibility and services will change depending on where you live. 

All states offer CHIP benefits in some form, covering immunizations, routine check-ups, emergency services, and prescriptions.

Both Medicaid and CHIP can be applied for at any time of year, and you can receive immediate coverage if you qualify. Fill out a Marketplace application to determine whether or not you are eligible for Medicaid and CHIP services. Some states will require a 5-year period of being a lawfully present immigrant before you can enroll. Even if you do not qualify yet, you may still be able to receive other Marketplace programs or emergency Medicaid for serious injuries. 

Private Insurance

Other health insurance programs which are not offered by the government are referred to as private health insurance policies. Plans offered by employers are usually private insurance. Sometimes private plans can be more affordable than government-funded programs. 

Your specific status can make you eligible for different state-approved private health plans. If you are lawfully present in the U.S. on an employment-based green card, you may receive insurance through your job. 

If you do not already have coverage, you can look for private health insurance plans on the Marketplace. Any posted policies will be required to cover essential health benefits like hospitalization, emergency services, prescription drugs, and mental health services. 

Short-Term Health Insurance

If an immigrant is struggling to afford private plans that are ACA-compliant, they may benefit from a short-term health insurance plan. Although the coverage is less comprehensive and does not provide help to those with pre-existing conditions, it is often better than no coverage at all. Especially if you are only temporarily residing in the U.S., this may be the choice for you. 

However, be careful of short-term health insurance plans. These can often be used to take advantage of individuals who do not understand the healthcare system. Make sure you research a specific provider before purchasing coverage. If you have the option, it is safer to go with a comprehensive policy. 

Healthcare for Immigrants FAQ

Scott D. Pollock & Associates, P.C. Immigration Assistance

Our experienced immigration attorneys specialize in helping individuals lawfully enter the U.S. If you are struggling to find a decent health plan or worried you will not be insured when you enter the country, we can help you achieve the proper status to attain coverage. 

Our team has a comprehensive understanding of the U.S. immigration system and can assist you throughout the entire process. Sometimes you are dealing with other, more important things––like finding health insurance for your family. Do what you have to do and let us handle the rest.

Reach out to Scott D. Pollock & Associates, P.C. today for help with your immigration efforts.