Immigrant families have important details to consider when looking at new health insurance options under the Affordable Care Act (ACA), also known as ObamaCare. The law provides the option for lawfully present immigrants to obtain private insurance in the Marketplace, but undocumented immigrants are not included in this coverage. Knowing what documentation is needed and how to file for insurance are important elements of the Marketplace for immigrant families.

Marketplace Eligibility for Lawfully Present Immigrants

In order to be considered lawfully present, immigrants must have one of a variety of legal statuses in the United States. Marketplace eligibility for rules for immigrants also apply to Medicaid and CHIP eligibility, as well. These statuses include, but are not limited to:

  • Lawful permanent resident status / green card holder
  • Valid non-immigrant visas
  • Humanitarian statuses or circumstances, including temporary protected status, special juvenile status, asylum applicants, or must be considered victims of trafficking or torture and other cruel, inhuman or degrading treatment or punishment
  • Legal status conferred by other laws, such as temporary resident status, the LIFE Act, or family unity individuals
  • Qualified non-citizen immigration status with no waiting period

To prove these statuses, a variety of documentation may be required, including a permanent resident card (I-551), a refugee travel document (I-571), or I-94 number, among others.

For a full list of lawfully present statuses and required documentation, visit the legal status site.

Lower Insurance Costs for Lawfully Present Immigrants

Eligible immigrants qualify for additional assistance with their health insurance in the same way as other Americans. Households with an income between 100% and 400% of the federal poverty level may be eligible for tax credits to reduce monthly premiums on health insurance. In 2013, the federal poverty level was $23,550 for a family of four.  These will likely be somewhat higher in 2014.

Immigrants with an annual household income below 100% of the federal poverty level and who are otherwise ineligible for Medicaid will be eligible for tax credits and cost-sharing assistance with their insurance charges if they meet all other requirements for eligibility.

Immigrant Eligibility for Medicaid

Qualified non-citizens are still eligible for Medicaid and Children’s Health Insurance Program (CHIP) based on status and income, as they were before the ACA. As before, there is a five year (or longer) waiting period for Medicaid and CHIP benefits for most statuses. 25 states and Washington, D.C. have options to remove the five-year waiting period and cover children or pregnant women that are lawful residents of the state. To find out the options in your state, visit the lawful residence page at

It’s important that immigrants understand that getting health insurance through the Marketplace or receiving Medicaid or CHIP does not make an individual or family a public charge or otherwise affect the ability to become a lawful permanent resident or a U.S. citizen. However, those receiving long-term care in an institution at government expense may face barriers getting green-card status since they may be considered a public charge.

Health Insurance Coverage for Mixed-Status Immigrant Households

Many immigrant households will have some members who qualify as lawfully present and others who do not. These households can still apply for Marketplace health insurance or Medicaid/CHIP coverage. Individuals who are not applying for the health insurance will not be asked about their immigration status, and any disclosure of immigration status to the Marketplace or Medicaid/CHIP agencies will not be used for immigration enforcement purposes.

Marketplace insurance or Medicaid/CHIP coverage cannot be denied because non-applying household members do not disclose their immigration status.

Immigrants may have additional concerns and considerations when applying for Marketplace or Medicaid/CHIP coverage, but those who legally reside in the US and meet the income guidelines will have access to these coverage options. Knowing your options and obligations when it comes to health insurance is the first step to choosing the best coverage for you and your family.