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WashingtonLawHelp.orgWashington LawHelp

Health Care Reform: Immigrant Eligibility

Authored By: Northwest Justice Project LSC Funded
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The Affordable Care Act includes several provisions that may help you get coverage for your medical bills if you are an immigrant.


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What is the Affordable Care Act?

The Affordable Care Act (ACA) is a federal law that changed how health insurance companies operate, and how people can get medical coverage.

Read Health Care Reform: General Information. It explains, among other things, how to apply for coverage.

I am an immigrant. I need medical coverage. Can the ACA help?


The ACA expanded the Medicaid program for people with low incomes.  Medicaid is now available to people with higher incomes than before. It is also now available to adults who do not have children or disabilities. Read Health Care Reform – Medicaid Expansion.

The ACA also provided for the creation of health care exchanges where people can buy special insurance (Qualified Health Plans) and apply for financial help.  Washington State's health care exchange is called Healthplanfinder. Read Health Care Reform – Qualified Health Plans.

The ACA did not change which type of immigrants might be eligible for non-emergency Medicaid coverage. 

Am I eligible for Medicaid?


You may be eligible for non-emergency Medicaid if you are a U.S. citizen or a "qualified" immigrant.

These are "qualified" immigrants:

  • Lawful Permanent Residents (also called LPRs and "green card" holders)

  • Asylees

  • Refugees

  • Persons granted withholding of deportation or removal

  • Cuban and Haitian Entrants

  • Persons paroled into the U.S. for at least one year

  • Conditional Entrants

  • Certain battered immigrant spouses and children, and their children and/or parents

  • Certain victims of trafficking and some relatives

I immigrated recently. Do I qualify for Medicaid?

It depends.

Some qualified immigrants, including those who got their green card through a visa petition filed by a relative, cannot get non-emergency Medicaid until they have been in qualified status for five years. This does not apply to refugees, asylees, and other humanitarian entrants. There are also special exceptions for active duty military, veterans, and their families. 

I have not been in qualified status for five years yet. Can I get any medical help?

Yes. The five-year bar only applies to non-emergency Medicaid. You might still be eligible for

  • Emergency Medicaid

  • Health insurance bought on Healthplanfinder

  • Medical coverage for children and pregnant women with low incomes

  • The Medical Care Services (MCS) program for some lawfully present immigrants who are age 65 or older, blind, or have a disability

  • Testing and treatment of communicable diseases, including COVID-19

Can I buy insurance and apply for subsidies through Healthplanfinder?

Maybe, if you are in an immigration status considered "lawfully present" under the ACA.

The Appendix at the end of this publication lists who the ACA considers lawfully present. It includes

  • Many people with legal permission to be in the U.S. This includes "qualified" immigrants

  • Some people with immigration applications pending

I am undocumented. I do not have an immigration application pending. Am I eligible for any programs?

Not eligible: You are not eligible for non-emergency Medicaid. You cannot buy health insurance through Healthplanfinder.

Eligible: You may be eligible for programs available to all immigrants, regardless of status, including:

  • Emergency Medicaid

  • Dialysis, cancer treatment, and treatment for benign life-threatening tumors  

  • Medical coverage for children and pregnant women with low incomes

  • Testing and treatment of communicable diseases, including COVID-19

  • Treatment for a reduced fee at a community clinic

You can also buy health insurance on your own.  

I have DACA (Deferred Action for Childhood Arrivals) status. Am I eligible for any programs under the ACA?

No. Persons granted DACA are not eligible for benefits under the ACA. You cannot buy insurance through Healthplanfinder or get help paying the costs of insurance.  You are not eligible for non-emergency Medicaid. 

You may be eligible for programs available regardless of immigration status. These include emergency Medicaid, cancer treatment, dialysis, treatment of benign life-threatening tumors, and coverage for children and pregnant women with low incomes.

If you are over 65, blind, or have a disability, you may be eligible for the state Medical Care Services program. 

For more about how you may be able to get medical coverage, read Changes to DACA: Access to Health Care in Washington State from Northwest Health Law Advocates.

I do not have legal status. If I apply for medical coverage, will my information be shared with immigration officials?

No. The state can only use the information on your application to decide your eligibility for benefits. No one can use it for immigration enforcement.

You should always be truthful on your application and other eligibility forms.  If you lie or give fake documents or social security numbers, the government could accuse you of fraud. This could affect your immigration status or ability to get status in the future. You should also report right away any changes to your income or the income of anyone living with you.

I do not have legal status. Can I use Healthplanfinder?

Yes, even if it does not appear you are eligible for non-emergency Medicaid or eligible to buy insurance on the exchange. You may be eligible for other programs, such as emergency Medicaid and coverage for children and pregnant women with low incomes.

Will I have to provide a social security number?

Maybe not.

Both the on-line and paper application ask you for your social security number. If you do not have one, you can still fill out the application. Some programs do not require a social security number. You will have a chance to give other proof that you are eligible.

You may have to give other proof of income, like paystubs, for family members who do not have a valid social security number. The state may need this information to decide what benefits you or relatives may be eligible for.

*If you are eligible for a social security number and want one, you can get help applying for it.

I do not want medical coverage for myself. Can I use Healthplanfinder to apply for my children?

Yes.  You can apply for all your family members to see who is eligible.  All information you give on the application is confidential.

Do I have to get health insurance coverage?

The ACA requires most U.S. citizens and lawfully present immigrants to have a minimum level of medical coverage for themselves and their dependents. However, there is no longer a tax penalty if you do not have this coverage. 

If you are not lawfully present, you do not need health insurance for yourself. This includes people granted DACA. 

I am on Washington Apple Health. Will that affect my immigration status?

Probably not.

If you are in the process of becoming a lawful permanent resident (getting your Green Card) through a visa petition (I-130) submitted by a family member, you must show you will not need government benefits for your financial support. This is called the "public charge" test.

Immigration officials must consider many factors in the public charge test. They include your job skills, education, family support, and household income. Officials will also look at whether you have used certain benefits, including federally funded non-emergency Medicaid.   

Most people affected by the public charge test are not eligible for non-emergency Medicaid. Washington Apple Health includes some programs other than non-emergency Medicaid. 

Immigration officials will not consider many medical programs in the public charge test, including:

  • Emergency Medicaid

  • Medical benefits (including Medicaid) used by children under 21 and pregnant women

  • Medical benefits (including Medicaid) used by your family members

  • Qualified Health Plans purchased on the exchange (and subsidies or tax credit)

  • The Medical Care Services program for seniors and people with disabilities

  • Testing and treatment of communicable diseases, including COVID-19

I am applying to become a U.S. citizen. Will getting medical assistance hurt me?

There is no public charge test for persons applying for citizenship. Getting medical assistance or other public benefits will not keep you from becoming a U.S. citizen.

Get Legal Help

Visit Northwest Justice Project to find out how to get legal help.


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Last Review and Update: Apr 02, 2020