Health Insurance Eligibility for Immigrants

If you are an immigrant in the United States, it is important to know your rights to access health insurance.

The table provided in this brochure includes the most common immigration statuses, common documentation for those statuses, and corresponding health insurance eligibility for Medicaid, NC Health Choice (CHIP) and the Federal Health Insurance Marketplace.

More information available at LSSP.org/immigrant-health

For free, in-person help with your Medicaid or Marketplace application, please call 1-855-733-3711 or schedule online at gcaconnector.org.

GENERAL ELIGIBILITY INFORMATION

For both Marketplace and Medicaid/CHIP eligibility:

• A Social Security number is not required for immigrants who are ineligible to receive one.
• To qualify for coverage, applicants must attest that they reside in the state of application. Intent to remain indefinitely in the state is not required.

Medicaid/CHIP

Medicaid and NC Health Choice (CHIP) eligibility is based on three main factors: 1) being in an eligible category, 2) being below the income level for that category and 3) having a qualifying immigration status. Eligible Medicaid categories generally include children, pregnant women, caretakers of young children, disabled adults and individuals over age 65. Non-disabled, childless adults in North Carolina cannot qualify for Medicaid no matter how low their income is. For certain immigrants, there a 5-year waiting period before you can qualify for Medicaid. See inside chart for a list of eligible immigration categories.

Marketplace

Most* lawfully present immigrants can purchase private health insurance in the Marketplace. Financial help is also available for individuals with incomes from 100-400% of the federal poverty line. If a lawfully present immigrant is ineligible for Medicaid based on their immigration status, they may qualify for financial help in the marketplace even if their income is below the poverty line. For marketplace coverage, there is no waiting period to purchase insurance or receive financial assistance. * Individuals with Deferred Action for Childhood Arrivals (DACA) status are ineligible for Marketplace coverage or Medicaid/CHIP.

Mixed Status Families

Parents who are not eligible for benefits based on their immigration status can still apply for their eligible children. If only one family member is applying for insurance or assistance, only the applicant(s) must provide immigration status information or their social security number. Other family members who are not applying do not have to provide immigration information.

Public Charge

Many immigrants know of the “public charge” rule stating that those who receive government benefits may not qualify for a green card. This rule does not apply to immigrants receiving insurance in the Marketplace with subsidies and most Medicaid/ CHIP cases. Immigrants who are receiving financial help to purchase insurance can still qualify for a green card.

Emergency Care

Immigrants who are not eligible for Marketplace insurance or full Medicaid/ CHIP coverage may still qualify to receive payment from Medicaid for treatment of emergency medical conditions including labor and delivery.