Immigrants: How the Insurance Mandate Affects You

How does health reform affect you if you're an immigrant? Must you buy health insurance? Can you get financial help from the U.S. government to help pay for insurance? Could you benefit from expanded Medicaid? It depends on your situation.

If you already have a health plan from your employer, another source, or use Medicaid or Medicare, you don't have to change it.

For Legally Present Immigrants

If you are a naturalized citizen or legally immigrated to the U.S., the health reform law applies to you. This means you may need to buy health insurance to avoid paying a penalty, unless you are exempt.

If your employer offers health insurance that meets the law’s requirements, you won’t qualify for a tax credit to help lower the cost of insurance.  In most cases, your work-based coverage is likely to be your best choice.

If your employer doesn't offer insurance or if you are self-employed, you can buy insurance through your state's online Marketplace, also called an exchange. You can also contact your state’s marketplace by phone or in person.

In the online Marketplace, when you enter your income, age, and family size, you will learn if you are eligible for a tax credit. That's a type of financial help from the U.S. government that lowers your premiums or your monthly insurance costs. You may also find that you are eligible for help paying out-of-pocket costs when you go to the doctor. Some people with very low incomes may also qualify for Medicaid.

In addition to your state's Marketplace, you can also enroll in a health plan from an insurance broker certified to sell health plans both on and outside of the government-run Marketplaces. That person may be able to help you find a plan that qualifies for a subsidy.  

If you didn't buy insurance for 2018, you may have to pay a penalty when you file taxes in 2019. The penalty is $695 or 2.5% of your income, whichever is more. There’s also a penalty for each child in your family who goes uninsured. Starting in 2019, there will be no penalty.

You may be eligible to apply for Medicaid or the Children’s Health Insurance Program (CHIP) if your annual income is low. These are health insurance programs for low-income people and their families. There is a waiting period of five years for most immigrants who are in the U.S. legally to qualify for these programs. However, about half of states waive this waiting period for children and pregnant women. Other groups exempt from the 5-year waiting period include refugees, those seeking asylum, human trafficking victims, and families of veterans.  

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For Immigrants Illegally Present in the U.S.

If you are not legally present in the U.S., the part of the law that requires people to either buy insurance or pay a tax penalty does not apply to you. You can't buy insurance through your state's Marketplace. But you can buy it through an insurance broker or directly through an insurance company. You won't be fined if you do not buy insurance.

If you are not legally present in the U.S., you can get low-cost health care at a community health center. These centers provide primary health care services to all residents, including immigrant families. In addition, you are eligible for emergency care.

 

WebMD Medical Reference Reviewed by Sarah Goodell on October 22, 2018

Sources

SOURCES:

Community Catalyst & Georgetown University Health Policy Institute: "Health Insurance 101."

Consumer Reports: "Health Reform: Seven Things You Need to Know Now."

Henry J. Kaiser Family Foundation: "The Requirement to Buy Coverage Under the Affordable Care Act" and "Explaining Health Reform: How will the Affordable Care Act affect Small Businesses and their Employees?"

Kaiser Permanente: "Your Guide to Reform."

National Immigration Law Center: "Immigrants and the Affordable Care Act (ACA)."

The Daily Beast: "Obamacare: It's Cheaper!"

Obamacarefacts.com.

Families USA: "Help Is at Hand: New Health Insurance Tax Credits for Americans."

IRS: "Part III Administrative, Procedural, and Miscellaneous."

Medicaid.gov: "Medicaid and CHIP Coverage of Lawfully Residing Children and Pregnant Women."

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