10 things immigrant families need to know about the Marketplace

Published on June 26, 2014

Affordable coverage options are available in the Health Insurance Marketplace® for immigrant families. If you’ve recently moved to the United States and had a change in your immigration status, here are some things you should know about Marketplace coverage:

In order to buy private health insurance through the Marketplace, you must be a U.S. citizen or be lawfully present in the United States. See a list of immigration statuses that qualify for Marketplace coverage.

If you recently gained U.S. citizenship or had a change in your immigration status, you may qualify for a Special Enrollment Period. See if you can enroll in a Marketplace health plan outside Open Enrollment.

If you’re a lawfully present immigrant, you can buy private health insurance in the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income. If you make less than $11,490 ($23,550 for a family of 4) and you aren’t eligible for Medicaid, you may still qualify for lower costs on coverage.

If you’re a “qualified non-citizen” and meet your state’s income eligibility rules, you’re generally eligible for Medicaid and Children’s Health Insurance Program (CHIP) coverage. See a list of “qualified non-citizen” statuses.

In order to get Medicaid and CHIP coverage, you may have a 5-year waiting period. This means you must wait 5 years after receiving “qualified” immigration status before being eligible for Medicaid and CHIP. See a list of exceptions to the 5-year waiting period and other important details.

Many immigrant families are of “mixed status,” with members having different immigration and citizenship statuses. Mixed status families can apply for a tax credit or lower out-of-pocket costs for private insurance for their dependent family members who are eligible for coverage in the Marketplace or for Medicaid and CHIP coverage. Family members who aren’t applying for health coverage for themselves won’t be asked if they have eligible immigration status.

Federal and state Marketplaces, and state Medicaid and CHIP agencies can’t require you to provide information about the citizenship or immigration status of any family or household members who aren’t applying for coverage.

States can’t deny you benefits because a family or household member who isn’t applying hasn’t provided his or her citizenship or immigration status.

Information that you provide to the Marketplace won’t be used for immigration enforcement purposes.

If you’re not eligible for Marketplace coverage or you can’t afford a health plan, you can get low-cost health care at a nearby community health center. Community health centers provide primary health care services to all residents, including immigrant families, in the health center’s service area.