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Can Immigrants and Refugees Get Public Health Insurance?


Immigrants make up a large portion of the U.S. population. Just under 14% of people living in the United States were born internationally. While some move to the United States for opportunities available, others are fleeing violence, living in poverty or want to make a better life for themselves and their loved ones.

Moving to the U.S. comes with many challenges. Getting the legal right to remain in the country isn’t certain, and finding stable employment and housing are key obstacles for immigrants. Access to medical care can be another challenge since the U.S. healthcare system is extremely complex and often difficult to navigate.

Public health insurance, including marketplace plans, Medicare and Medicaid, have various requirements for eligibility. Do immigrants qualify for these plans? The answer is: sometimes.

Public Healthcare Options in the United States

Public healthcare options are limited in the United States. Most people get their health insurance through employer-sponsored private insurance. With the passing of the Affordable Care Act, a healthcare marketplace for buying private insurance is now available for those who qualify.

The public healthcare options are Medicare and Medicaid. Medicare is a federal healthcare system for people over the age of 65 and certain people with disabilities. Most people pay into the Medicare system throughout their working lives and enroll when they are eligible.

Medicaid is a government-sponsored program for low-income Americans. States pay some of the costs for Medicaid, with the federal government providing additional funds. Eligibility depends on income and choices are limited for where Medicaid recipients can get their healthcare.

What Plans Can Immigrants Qualify For?

Healthcare plan eligibility for immigrants depends on a number of different factors, including:

  • Documentation
  • Length of time spent living and working in the United States
  • Refugee status

To qualify for marketplace plans, there are 4 basic eligibility requirements:

  • A legal resident of the United States
  • Currently living in the U.S.
  • Not incarcerated
  • Not covered by Medicare

This means that most immigrants who are living in the U.S. legally can use the healthcare marketplace to shop for plans during the open enrollment period. They are also eligible for government subsidies on these marketplace plans.

New immigrants cannot apply for Medicare, regardless of their immigration status. However, they can be eligible for Medicare Part A if they have worked in the United States for 10 years and paid Medicare taxes.

Medicaid is available to eligible immigrants who have had a qualified status for more than 5 years. There are some exceptions for veterans and active duty service members, however. Public assistance is subject to income eligibility and other requirements.

Undocumented immigrants are not eligible for marketplace plans, regular Medicare or Medicaid. However, they can be eligible for emergency Medicaid in certain situations. They can also apply for healthcare on behalf of someone with documentation.

Health Insurance for Refugees

Refugees have different designations from other immigrants. Upon arrival in the U.S., they are typically eligible for a special type of medical insurance known as Refugee Medical Assistance (RMA). This can last for up to 8 months.

Once RMA runs out, refugees have other options. They might be able to get Medicaid coverage or use the healthcare marketplace to shop for insurance. Refugees are exempt from the requirement of 5 years of qualifying status.

Why Are So Many Immigrants Uninsured or Underinsured?

Immigration has been in the spotlight over the last decade. There have been many attempts to restrict people from coming into the country or from receiving federal and state benefits once they are living in the United States. That has resulted in obstacles for immigrants who need healthcare benefits.

Because of the difficulties involved in emigrating legally and remaining in the United States, many people are concerned about applying for benefits or believe they aren’t eligible. This means that they frequently miss out on subsidies they are eligible to claim or special enrollment periods for health plans.

Since undocumented immigrants are not eligible for most benefits and many are worried about the possibility of deportation, they are especially reluctant to reach out for help when they need it. Some states do offer healthcare for children and pregnant women, however.

The consequence of this is that many immigrants go without much-needed healthcare, leading to long-term health problems that become serious and difficult to treat.

Legal immigrants should know that they do have healthcare options, although many of them involve private coverage.