Let's face it, the U.S. medical system is tough to navigate. Even those of us who have lived our entire lives in this country can easily get confused by some of the terminologies used by medical service and health insurance providers. Adding to that is the maze of government agencies and legislation governing different social healthcare benefits.
Now think about how much more difficult it can be for someone who has just emigrated to the U.S.A. Take health insurance as an example. In many countries, basic medical services are provided by the public sector and the vast majority of population may never have had to deal with getting medical coverage by themselves. That explains why that to many new immigrants, terms like "pre existing condition" and "deductible options" are nothing but alien terms -- even if you try explain to them in their native languages.
If you like many other permanent residents, also known as green card holders, who are having trouble understand how medical insurance in the U.S. works and how to get them, we are here to help. In this blog post, we will run you through some key information for immigrants trying to get health insurance coverage for themselves and their families.
Can a Green Card Holder Get Medical Insurance?
The answer to this question is a simple "Yes". You don't need to be a U.S. citizen in order to buy medical insurance in the country. All you need is a social security number and a valid photo-ID.
The same goes for many government assistance, though there are some medical coverage benefits that are only available to citizens or permanent residents who have been residing in the U.S. for a period of time.
In fact, as long as you are legally residing in the U.S., whether you are a lawful permanent resident (green card holder) or are here on an employment or student visa, you will be eligible for some government benefits that can help lower medical insurance costs.
How can Green Card Holders Get Health Coverage?
Just like U.S. citizens, new immigrants can get medical insurance through a few different sources. The most common ones are
- Health insurance plans sponsored by employers;
- Private health insurance that they buy in the market;
- Medical insurance plans tailored specifically for immigrants
What is the Health Insurance Marketplace?
If this is your first time buying insurance, or if you do not have a preferred insurance provider and are unsure what health benefits are available to you, one good place to start is the federal Health Insurance Market.
Sometimes called the "Marketplace" or "Exchange," it is the website where you can browse and compare various health care plan available under the Affordable Care Act (ACA). After choosing the right plan, you can complete the enrolment procedure there.
The federal government runs the Marketplace for most states at HealthCare.gov, while some states run their own Marketplaces. The service is also available for small business owners who are providing coverage for their employees through the Small Business Health Options Program Marketplace.
When you apply for individual and family coverage through the Marketplace, you will be asked to provide income and household information. You’ll find out if you qualify for:
- Premium tax credits and other savings that make insurance more affordable
- Coverage through the Medicaid and Children’s Health Insurance Program (CHIP) in your state
What is the Affordable Care Act?
You might have noticed that we mentioned the term Affordable Care Act above (ACA) above So what exactly is it?
Enacted in 2010, the ACA is a law that seeks to extend access to health insurance to more uninsured people in the U.S., as long as they are lawfully residing in the country. It was introduced by then President Barack Obama with the aim of reforming the health insurance market.
With the ACA, also known as Obamacare, there are now more people who are eligible for subsidies when buying health insurance, provided that their income fall within the range set by the government and that their employers don't provide any sponsored plan.
Currently, the subsidies under the ACA are available to applicants whose income is at least 100% of the federal poverty line (FPL), as those who fall below this threshold are covered by Medicaid, which is a joint federal and state program that offers health coverage to people with limited income and resources.
Can New Immigrants Benefit from the ACA?
When it comes to the ACA, what's even better for new immigrants is that the income threshold that normally applies to U.S. citizens and long-term immigrants would not apply to them.
The reason behind this is because that in most states, Medicaid isn't available to new immigrants until they've been lawfully resided in the U.S. for five years. In order to ensure that immigrants have access to affordable medical insurance, the U.S. Congress has passed a law to allow recent immigrants to receive subsidies when they purchase health insurance in the Marketplace. regardless of how low their income-levels are.
Can Undocumented Immigrants Receive Benefits from ACA coverage?
While the ACA benefits are extended to lawfully-present immigrants, it does not provide any direct benefits for undocumented immigrants.
The ACA prevents those who are not lawful residents of the U.S. from enrolling in insurance plans through the Marketplace. Undocumented immigrants are also not eligible for Medicaid under federal guidelines.
Some states have implemented programs to cover undocumented immigrants, particularly low-income children or those who are pregnant. We will give more details on that later.
Medical Insurance for Green Card Holders Over 65
Besides Medicaid, another term that may require some explaining for new immigrants is Medicare, which is the federal health insurance for anyone age 65 and older, and some people under 65 with certain disabilities or conditions.
Most Americans become eligible for Medicare when they turn 65, and no longer require individual-market coverage. But for recent immigrants, the restrictions are higher -- they are not eligible to buy into the Medicare program unless they have been lawfully residing in the U.S. for five years.
In the past, this used to cause problems for some new immigrants as most insurance providers generally don't offer health plans to anyone over the age of 64 in the individual market. But as a result of the ACA, policies in the individual market are available on a guarantee-issued basis, regardless of age. And if they buy the plan in the Marketplace, they will be eligible for the subsidies that are available to younger applicants, though they are subjected to the same income threshold.
And even if their income is too high to qualify the subsidies, the ACA still offers them some form of protection by capping the premiums that providers can charge older applicants at three times the premiums they charge for younger applicants.
State-funded Health Insurance for Immigrants
Beside the Federal Government, medical insurance benefits is the U.S. may also come from other levels of the government. Some states have expanded fully state-funded coverage for either income-eligible children or pregnant women (or both) irrespective of their immigration status. These states are:
- New York
- Rhode Island
- New Jersey
Each state set up different agencies to run their state-funded program. You can refer to the websites of these agencies for more details.
Health Insurance for Immigrants Waiting for their Green Cards
While you may not be eligible for ACA benefits if you are still waiting to get your green card in the U.S., you can still get health insurance plans from private providers.
Many US insurance providers offer visitor health insurance. There are numerous visitor medical insurance plans in the market that can cover you during your stay or waiting period for your green card.
These plans typically cover medical-related benefits like eligible medical expenses, hospitalization charges, urgent care, doctor visits, prescriptions and drugs, emergency medical evacuation, repatriation, and more. Some of these plans also offer travel-related benefits similar to travel insurance, such as trip delay, trip interruption, baggage, personal loss, etc, at extra charges.
Are Pre-Existing Conditions Covered by Health Insurance for Immigrants?
Under ACA, health insurance companies can't refuse to cover you or charge you more just because of a health problem you had before the date that new health coverage starts. This provision also applies to new immigrants who are covered by the ACA.
Need Help Sorting Out Your Health Insurance Need?
While we hope that this article will serve as a good starting point in your journey to secure health insurance coverage in your new home, we understand that along the way, you will have many more more questions that needs to be answered.
The truth is, even if you already know the kind of benefits available to you under the ACA, chances are you will be able to pick the insurance provider and plans that best suit you -- namely your financial situation and medical conditions -- if you work with a reliable insurance agent.
At EASY Insurance Plans, we specialize in helping new immigrants like you with your health insurance needs. Our experts are here to answer any questions that you may have, and we will not rest until we find the right health plan for you and your family. And last but not least, our services are free of charge.