There’s no easy way to get around the US healthcare system — particularly for immigrants. Medical insurance is essential because it allows you and your family to get the care you need and keeps you out of the medical bills. Here we’ll show you the ins and outs of immigration healthcare, how it is separated into publicly financed programs and private insurance, and also what you’ll see or hear, like “primary care physician” and “PPO”.
Medical Services for Immigrants
No one intends to be ill or injured but accidents and diseases can strike any of us. Health insurance, when they do, can be life and death.
Health insurance is like a contract between you and an insurer. You buy a health plan and the insurance company is responsible for a portion of your medical costs. This can pay for everything from emergency room visits to prescription medications and preventative care for you and your family.
Under the Affordable Care Act (ACA), most Americans and lawfully present immigrants are already covered at a minimum level. But there is no tax if you do not have health insurance.
That being said, research indicates that uninsured people have worse health than insured ones.
Blacks and Latinos have less health insurance than whites, according to the Kaiser Family Foundation. It’s a major problem because uninsured individuals have trouble getting healthcare and often wind up with huge, expensive bills when they need care.
Healthcare Options for Immigrants
In the United States, many people have insurance through their company. But not all companies provide insurance and not all insurance is the same, or doesn’t cover you or your family as much. It’s why people go public with things such as Medicaid and CHIP (Children’s Health Insurance Program), or they get private coverage. This is what you have: Here’s how it works:
Is It Possible For Me To Have Health Insurance?
Health insurance:
If you are a lawfully present immigrant, you can compare plans in the Health Insurance Marketplace. A federal government-run resource for finding and enrolling in health insurance.
“Lawfully present” is if you’re a legal resident of the U.S. This includes:
- Green card holders (permanent residents)
- Refugees and asylum seekers
- People with valid non-immigrant visas
- Indefinite residents or legal residents with different rights.
- Affordable Care Act (ACA) — Obamacare Subsidies help you get insurance for lower cost, depending on your income.
Undocumented residents:
You may be ineligible for health insurance through the Marketplace, but — depending on your state — you may be eligible for Medicaid emergency services. The federal government does not cover undocumented immigrants through Medicaid or the Marketplace.
Publicly Funded Health Insurance Programs
If you are an authorized immigrant and have income requirements that your state accepts, then you are likely eligible for two important state-funded health insurance programs, Medicaid and CHIP.
Medicaid
Medicaid is an integrated federal-state health program that gives low-income people free or reduced health coverage. Medicaid coverage varies by state. Medicaid is Medi-Cal in California and Apple Health in Washington State, for instance.
Medicaid will generally pay for things such as:
- Hospitalization (both hospital inpatient and hospital outpatient)
- Doctor’s visits
- Lab tests and X-rays
- Mental health services
- Prescriptions
You are different depending on the state where you live, so if you are not meeting income guidelines, there are other reasons you may be eligible, such as disability, pregnancy, or family size.
CHIP (Children’s Health Insurance Program)
If you earn too much to get Medicaid, you could still get CHIP. CHIP offers kids low-cost health insurance, and it covers things such as:
- Routine check-ups
- Immunizations
- Emergency services
- Prescription medications
- CHIP is universal, but not all states offer it and coverage differs.
You can apply for Medicaid or CHIP any time of year, and if you are approved coverage starts right away. However, in some states, legally present immigrants have to wait five years to qualify for these programs.
Private Health Insurance
It’s not the government that provides private health insurance. Rather, they’re sold by private companies or your boss. You can purchase them on the Health Insurance Marketplace where you can also get government-subsidized plans.
Private insurance can be flexible (as opposed to Medicaid or CHIP), but also expensive. If you’re on a fixed income, the good news is you could qualify for subsidies that make private health insurance less expensive.
And if you want private insurance, look on the Marketplace for plans that provide the Essential Health Benefits of the ACA like:
- Emergency services
- Hospitalization
- Mental health care
- Prescription drugs
Remember that you can only buy private health insurance at certain times of year (Open Enrollment) if you have an eligible life event (such as getting married or moving to a new state).
Medical Terminology Glossary of Us Medical Terms
You might see a lot of healthcare terms that you don’t know when you are searching for insurance. Here’s a primer on some of the most ubiquitous ones:
- Co-insurance: After you hit your deductible, co-insurance is the amount of medical bills you still need to cover.
- Co-payment (Co-pay): A one-time payment you make for a health service such as a doctor’s appointment or prescription.
- Deductible: The amount you are responsible for before your coverage kicks in.
- Hospital Emergency Room (ER): Hospital unit for a hospital emergency case such as an injury or chest pain.
- HMO (Health Maintenance Organization): An insurance plan that limits you to a network of doctors and hospitals.
- Out-of-Pocket Limit: How much you’ll pay for health services in a plan year. Once you get this number, 100% of your care will be paid by insurance.
- PPO (Preferred Provider Organization): An open plan that lets you see any doctor within or without your network, without getting a referral.
- Your Primary Care Physician (PCP): Your primary care physician. For people on an HMO plan, your PCP will refer you to specialists.
- Urgent Care: For non-emergency conditions that need urgent attention but are not life-threatening (like a sprain or a fever).
Frequently Asked Questions (FAQs)
Here are the most frequently asked immigration questions about healthcare in the U.S.:
What is my immigration status if I apply for health insurance?
No. When you get health insurance, immigration will never know your identity. You won’t get anything out of it except to determine your eligibility.
Is there a consequence of receiving public benefits (such as Medicaid) that I will not qualify for US citizenship?
No. Getting health benefits such as Medicaid won’t influence your eligibility for US citizenship or lawful permanent residence.
Where can I get health insurance?
It depends on where you’re from as far as immigration goes. Apply with something such as your green card, work permit, or passport. Visit the Health Insurance Marketplace for a full requirements list.
What healthcare programs do I need to know about in my state?
Healthcare.gov is a place to look for health plans and get information about the plans in your state. And they also provide help in 150+ languages at the 24/7 toll-free number:
- 1-800-318-2596. Community health centers and immigration agencies can also help you access healthcare in your region.
Other Helpful Resources
- National Immigration Law Center: Gives you access to healthcare options as an immigrant.
- National Health Law Program: Advocacy for healthcare rights for the low-income and underserved.
- Families USA: Supports quality affordable healthcare for all.
- Neighborhood Groups: Search for non-profit groups in your community offering immigration health services like the Community Health Network of Washington and Latino Coalition for a Healthy California.
Healthcare in the US can be confusing for an immigrant, but with a little knowledge and support, you can have affordable insurance to ensure your health and happiness. Be it the government (Medicaid, CHIP) or private coverage, they have something to cover you. If you have any doubts or want guidance, there are companies such as Law and Visas who will assist you in the process.
