Navigating Health Care Access for Immigrants

If you’re an immigrant in the United States trying to access affordable health care, you may experience unique barriers due to your immigration status, lack of insurance or financial constraints. However, both documented and undocumented immigrants have access to certain health services and coverage options. The federal government supports various public health programs that offer services regardless of ability to pay or immigration status. Knowing your rights and available financial aid can help you access essential health care services.

Immigrants in the United States have access to health care services through various programs, supported by federal grants and public health initiatives, designed to ensure necessary care regardless of the ability to pay. These services include hospital emergency departments, hospital charity care programs, federally qualified health centers, free clinics and additional public health programs. These programs collectively provide services from emergency care to preventive health, ensuring comprehensive care for immigrant populations.

Federal law requires hospitals with emergency departments to screen and provide stabilizing treatment to all patients with emergency conditions, regardless of their ability to pay. This mandate, established under the Emergency Medical Treatment and Active Labor Act (EMTALA), ensures that uninsured individuals, including immigrants, receive necessary emergency care. While hospitals can bill patients for services provided under EMTALA, they cannot deny emergency care due to inability to pay.

Many hospitals offer charity care programs, providing free or discounted care based on patients' financial needs. Hospitals seeking federal tax-exempt status must meet community benefit standards, which often include offering charity care. These programs can be a source of uncompensated or reduced care for immigrants who lack access to other forms of health coverage. The extent of charity care varies by hospital, but it typically considers patient income and provides substantial support to low-income individuals.

Federally qualified health centers (FQHCs) provide comprehensive primary care services, including dental and behavioral health care, to everyone, regardless of their financial capabilities. These centers are funded through federal grants under Section 330 of the Public Health Service Act. They must provide a sliding fee scale for uninsured patients with incomes below 200% of the federal poverty level. FQHCs serve as a critical health care access point for immigrant populations, providing care without considering immigration status. Find an FQHC near you.

Free clinics offer medical services at no cost or reduced rates. They primarily provide primary care services and are often supported by donations and volunteer staff. By offering accessible health care services without charging for care, free clinics can serve uninsured and underinsured populations, including immigrants.

Immigrants can access various types of health coverage, although the extent and availability may differ based on their immigration status and state of residence.

Documented immigrants in the U.S. have access to several health coverage options. These include federally funded programs like Medicaid and CHIP, ACA Marketplace coverage, Medicare and private health insurance. The availability and extent of coverage can vary, but lawfully present immigrants can generally find comprehensive health insurance solutions through these programs.

Medicaid is a joint federal and state program that provides health coverage to low-income individuals, including some lawfully present immigrants. Eligibility varies by state but generally includes legal permanent residents (LPRs) who have been in the U.S. for at least five years, refugees and asylees who may qualify without the waiting period. Medicaid covers a broad range of health services, such as doctor visits, hospital care and long-term services and supports, ensuring access to necessary medical care for eligible immigrants.

However, many must wait five years after obtaining their qualified status to become eligible. Exceptions to this waiting period include refugees, asylees and certain other categories. Additionally, 35 states — plus the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa and the U.S. Virgin Islands — have opted to provide Medicaid coverage to lawfully residing children and pregnant women without the five-year waiting period.

The Children's Health Insurance Program (CHIP) offers low-cost health coverage to children in families that earn too much to qualify for Medicaid but not enough to afford private insurance. Lawfully present immigrant children and pregnant women are eligible for CHIP, and similar to Medicaid, some states waive the five-year waiting period for these groups. CHIP guarantees essential health care services for children and expectant mothers. These services include doctor visits, routine check-ups, immunizations, prescriptions, dental and vision care, laboratory and X-ray services, hospital care (inpatient and outpatient), treatment for chronic conditions and emergency care.

The Affordable Care Act (ACA) Marketplaces enable lawfully present immigrants to purchase health insurance and potentially receive tax credits to help pay premiums and cost-sharing. These subsidies are generally available to those with incomes between 100% and 400% of the federal poverty level (FPL). The ACA requires all health plans to cover essential health benefits, including preventive services, maternity and newborn care, mental health and substance use disorder services, prescription drugs and more.

Medicare is a federal health insurance program primarily for people aged 65 and older and some younger individuals with disabilities. Medicare has different parts that cover hospital insurance (Part A), medical insurance (Part B), Medicare Advantage (Part C) and prescription drug coverage (Part D). Lawfully present immigrants with sufficient work history can qualify for premium-free Medicare Part A, which covers hospital care and other services. Those without sufficient work history may also be eligible if they have resided in the U.S. for five years, though they must pay premiums.

Lawfully present immigrants can access private health insurance through employer-sponsored or individual market plans. Employer-sponsored insurance is available to those working in jobs that offer health benefits. Meanwhile, individual market plans are an option for those who can afford private insurance without subsidies. Private insurance plans vary in coverage options, costs and provider networks but generally offer comprehensive health benefits.

Undocumented immigrants are generally ineligible for federally funded programs like Medicaid and Medicare. However, they have some options through Emergency Medicaid, state-funded programs and private coverage through community health centers and clinics.

Emergency Medicaid covers emergency medical conditions, including labor and delivery, regardless of immigration status. This ensures undocumented immigrants can receive critical care during medical emergencies without needing to be eligible for full Medicaid benefits, preventing severe health outcomes from untreated emergencies.

Some states have implemented programs that provide affordable health coverage for children and pregnant women regardless of immigration status. Eleven states (California, Connecticut, Illinois, Maine, Massachusetts, New Jersey, New York, Oregon, Rhode Island, Vermont and Washington) and Washington, D.C., have Medicaid look-alike programs for children. Vermont has also implemented a similar program for pregnant individuals. Additionally, five states (Connecticut, Maine, Massachusetts, New York and Washington) offer look-alike programs for postpartum care.

These state-funded initiatives ensure that vulnerable groups, including children and pregnant women, access essential health care services. These services encompass routine check-ups, immunizations and prenatal care, which promote public health and help reduce health disparities.

Undocumented immigrants also have options such as community health centers and clinics that offer primary care, preventive care and chronic disease management regardless of a person's ability to pay. These facilities are often funded by federal grants and state programs, providing a safety net for undocumented immigrants who might otherwise go without essential medical services.

Undocumented immigrants can purchase private health insurance directly from insurance companies. This off-exchange option provides access to various plans but is often expensive because undocumented immigrants are not eligible for government subsidies that lower premium costs.

Private insurance plans cover primary care, specialist visits, hospital stays and prescriptions. However, without subsidies, individuals must pay the full premiums, deductibles and out-of-pocket expenses, making it less affordable. Undocumented immigrants should research and compare plans and consider consulting an insurance broker to find the best fit.

Health care expenses can quickly add up, from routine health screenings and medications to unexpected emergencies and hospital stays. By planning and utilizing available resources, you can better manage these expenses and protect your financial well-being. Here are some tips to help you save for health care costs and ensure you have the funds needed for medical care when needed.

The following list includes valuable programs and organizations that provide guidance, support and direct services to ensure immigrants receive the necessary health care.

• Department of Health and Human Services (HHS): Offers numerous health programs and resources, including information on health care access for immigrants. Their website includes guides on accessing health care services and understanding health coverage options.
• National Immigration Law Center (NILC): The NILC works to protect and advance the rights of low-income immigrants. It provides resources and information on health care access, including state-specific health care programs for immigrants and policy updates that impact health coverage.
• HealthCare.gov: Provides information on health insurance options under the Affordable Care Act (ACA). It offers guidance on eligibility, enrollment and subsidies, helping immigrants understand and access available health coverage.
• Centers for Medicare and Medicaid Services (CMS): CMS oversees the nation's key health care programs, including Medicare, Medicaid and the Children's Health Insurance Program (CHIP). Its website offers comprehensive information on eligibility and benefits for these programs, including specific provisions for immigrants.
• National Association of Free and Charitable Clinics (NAFC): NAFC supports free and charitable clinics across the U.S. These clinics provide medical, dental, pharmaceutical and behavioral health services at no cost or a reduced rate. It is a vital resource for immigrants who lack health insurance.
• Health Resources and Services Administration (HRSA): Provides health care to people who are geographically isolated and economically or medically vulnerable. HRSA programs provide resources and services to improve access to health care for uninsured, isolated or medically vulnerable individuals, including immigrants.
• MedlinePlus: Offers reliable, up-to-date health information on various topics. It provides resources on diseases, conditions, wellness issues, and health care services that are available to all residents, including immigrants.
• U.S. Citizenship and Immigration Services (USCIS): Provides information on immigration benefits and services. Its resources include guidance on health care access and benefits for various immigrant statuses, ensuring immigrants are informed about their rights and available services.