Healthcare

Coverage for lawfully present immigrants

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Certain lawfully present immigrants can get Marketplace coverage.

Due to a law change, only people with certain immigration statuses can qualify for savings on their Marketplace plan costs (starting January 1, 2027) or be eligible for full Medicaid or Children's Health Insurance Program (CHIP) coverage:
  • Lawful Permanent Resident (LPR, Green Card holder).
  • Cuban or Haitian entrant.
  • Compact of Free Association (COFA) migrant.
  • Medicaid/CHIP only: In certain states, "lawfully residing" pregnant women and children. Get details for your state.
Other immigration statuses may be eligible for Marketplace coverage, but not savings.

The term “lawfully present” includes immigrants who have:

  • “Qualified non-citizen” immigration status (see details below)
  • Humanitarian statuses or circumstances (including Temporary Protected Status, Special Immigrant Juvenile Classification, refugees and asylees, Convention against Torture, victims of trafficking)
  • Valid non-immigrant visas
  • Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals)

Get 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 get Marketplace coverage. Starting January 1, 2027, you may qualify for lower costs on monthly premiums and extra savings on out-of-pocket costs based on your income if you're a:

  • Lawful Permanent Resident (LPR, Green Card holder)
  • Cuban or Haitian entrant
  • Compact of Free Association (COFA) migrant

The federal poverty level (FPL) is a measure of income used to decide your eligibility for certain programs and benefits. This could include savings on Marketplace health insurance, and Medicaid and Children's Health Insurance Program (CHIP) coverage.

If your annual income is between 100% and 400% of the FPL, you may qualify for the premium tax credit and extra savings on Marketplace health coverage.

Immigrants and Medicaid & CHIP

You're generally eligible for free or low-cost coverage through Medicaid and CHIP if you:

  • Meet state income and residency rules, and
  • Have one of these immigration statuses:

You're generally eligible for Medicaid and CHIP 5 years after you get your "qualified non-citizen" status—this is called the 5-year waiting period. You don't have a 5-year waiting period if you're a Lawfully Permanent Resident who used to have certain other immigration statuses, like a refugee or asylee.

If you're in your 5-year waiting period, you might be able to get Marketplace coverage, if otherwise eligible. Starting January 1, 2027, only certain immigration statuses qualify for savings on their Marketplace plan costs.

“Qualified noncitizen” 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
  • Citizens of the Marshall Islands, Micronesia, and Palau who are living in one of the U.S. states or territories (referred to as Compact of Free Association or COFA migrants)

Children and pregnant immigrants

States have the option to remove the 5-year waiting period for Medicaid or CHIP if you’re pregnant or a child and are “lawfully residing” in the U.S. Check if your state removed the 5-year waiting period.

What does it mean to be lawfully residing?

Getting emergency care

Medicaid may cover treatment of an emergency medical condition if you meet all Medicaid eligibility criteria in the state (such as income and state residency) but don’t have an eligible immigration status.

Medicaid, CHIP, & "public charge" status

A “public charge” is someone who’s likely to rely mostly on government help in the future. This could be by getting public cash assistance for basic needs or long-term care at government expense, like in a nursing facility.

If you’re applying for a visa or entry to the U.S, or in the process of applying to become a Lawful Permanent Resident (LPR or Green Card holder), there’s new guidance on how the Department of Homeland Security (DHS) determines if you’re likely to become a “public charge." Learn more about this "public charge" update before you apply for coverage through the Marketplace, Medicaid, or the Children's Health Insurance Program (CHIP).

Learn more about "public charge" status from the U.S. Citizenship and Immigration Services.