Coverage for lawfully present immigrants

Lawfully present immigrants are eligible for coverage through the Health Insurance Marketplace®.

The term “lawfully present” includes immigrants who have:

  • “Qualified non-citizen” immigration status without a waiting period (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 (temporary resident status, LIFE Act, Family Unity individuals) See 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 buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.

  • If your annual income is 400% of the federal poverty level or below: You may be eligible for premium tax credits and other savings on Marketplace insurance.
  • If your annual household income is below 100% federal poverty level: If you’re not otherwise eligible for Medicaid you’ll be eligible for premium tax credits and other savings on Marketplace insurance, if you meet all other eligibility requirements.

Immigrants and Medicaid & CHIP

Immigrants who are “qualified non-citizens” are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules.

In order to get Medicaid and CHIP coverage, many qualified non-citizens (such as many LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after receiving "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.

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

Medicaid & CHIP Coverage for Lawfully Residing Children and Pregnant Women

States have the option to remove the 5-year waiting period and cover lawfully residing children and/or pregnant women in Medicaid or CHIP. A child or pregnant woman is "lawfully residing" if they’re "lawfully present" and otherwise eligible for Medicaid or CHIP in the state. Learn how someone is defined as lawfully present.

Twenty-nine states, plus the District of Columbia and the Commonwealth of the Northern Mariana Islands, have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant women without a 5-year waiting period. Twenty-one of these states also cover lawfully residing children or pregnant women in CHIP. Find out if your state has this option in place.

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, and “public charge” status

On February 24, 2020, new U.S. Citizenship and Immigration Services (USCIS) regulations apply to the definition and factors for “public charge” status. These regulations outline how USCIS will determine whether applications for admission to the United States or applications for adjustment to immigration status will be denied because the applicant is likely at any time to become a public charge.

Use of public benefits could be considered a negative factor in a public charge inadmissibility determination. This means it could affect your chances of admission or adjustment of status.

  • Enrollment in a Marketplace plan (with or without premium tax credits) is not a public benefit under the public charge final rule.
  • For children under age 21 and pregnant women, enrollment in Medicaid or the Children’s Health Insurance Program (CHIP) won’t be considered to be a public benefit under the public charge rule.

But for some foreign national adults, enrollment in Medicaid may be considered a negative factor in a public charge inadmissibility determination.

If you think this might impact you, contact USCIS directly before continuing your Marketplace application. It’s important to understand how these changes might affect you. For more information on what it means to be a public charge, visit USCIS’s website or call U.S. Citizenship and Immigration Services at 1-800-375-5283. If you would like to, read USCIS’s public charge final rule (PDF, 1.5 MB).