Discover Your Eligibility for Health Insurance, Regardless of Immigration Status

Access to healthcare is a fundamental human right. In the United States, numerous programs and options ensure that documented and undocumented individuals can access essential medical services. However, navigating the U.S. healthcare system can be difficult due to the many choices, programs, and regulations. In this article, we will explain what health insurance is, outline the available healthcare options for documented and undocumented individuals, and provide guidance on the application process.

Next, we will answer the following questions:

1. What is health insurance?
2. What health insurance options are available to documented individuals?
3. What healthcare options exist for undocumented individuals?
4. What is Medi-Cal, and who qualifies for it?
5. Do other states besides California provide healthcare programs for undocumented individuals?
6. How can individuals apply for these healthcare programs?

What is health insurance?

Health insurance in the United States is like a financial safety net for your health. When you have healthcare insurance, you pay a regular amount of money, called a premium, to an insurance company. In return, the insurance company helps with your medical expenses when you need healthcare services, such as going to the doctor, staying in the hospital, getting prescriptions, or having surgeries. While you may still need to pay a smaller amount when you receive care, like a copayment or deductible, it’s much less than what you’d have to pay if you didn’t have insurance.

What health insurance options are available to documented individuals?

Documented individuals in the United States, such as citizens and legal residents, have several options for healthcare insurance, including:

• Many employers offer healthcare insurance benefits to their employees and their families. To apply, contact your employer’s HR department or benefits coordinator.
• Medicare is available to people aged 65 and older and some younger individuals with disabilities. To apply, visit the official Medicare website at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227). Assistance is available in English and Spanish.
• Medicaid is available to low-income individuals and families who meet specific eligibility criteria. To apply for Medicaid, contact your state’s Medicaid office. You can find contact information and application details by clicking HERE. 
• Through the Affordable Care Act (ACA), individuals can purchase private medical insurance plans on state or federal health insurance marketplaces. To apply, visit www.healthcare.gov or your state’s marketplace website. Assistance is available in English and Spanish.

What healthcare options exist for undocumented individuals?

Undocumented individuals in the U.S. have limited options for healthcare access. Some options include:

• The Emergency Medical Treatment and Labor Act (EMTALA) mandates that hospitals provide emergency medical care to anyone in need, regardless of immigration status. To access emergency care, go to the nearest hospital emergency room. EMTALA ensures that you will receive the necessary treatment. If you do not have health insurance and cannot pay for the treatment, the hospital may work with you to establish a payment plan or explore other financial assistance options. 
• Federally funded community health centers may provide primary care services on a sliding fee scale based on income. To find a nearby community health center and inquire about services, visit the Health Resources and Services Administration (HRSA) website at findahealthcenter.hrsa.gov or call 1-888-275-4772 (1-888-ASK-HRSA). Assistance is available in English and Spanish.
• Some private insurance companies may offer coverage to undocumented individuals, but it can be expensive. To explore private insurance options and obtain quotes, you can contact insurance brokers, agents, or companies directly.

What is Medi-Cal, and who qualifies for it?

Medi-Cal is California’s healthcare program for low-income individuals and families. It offers coverage for a wide range of healthcare services, including doctor visits, hospital care, prescription drugs, and more.

Starting in January 2024, eligibility for ‘Full-Scope’ Medi-Cal is solely based on income, with age and immigration status no longer being factors that determine eligibility. In California, if you have a low income (please refer to the income chart below), you can access free medical insurance through Medi-Cal, regardless of your immigration status, whether you’re documented or undocumented. For those between the ages of 26 and 49, you can enroll in restricted scope coverage immediately and will automatically transition to full coverage starting on January 1, 2024. Additionally, individuals aged 0-25 and those aged 50 and older can sign up now for full-scope coverage.

To see if you qualify based on income, look at the chart below:

You can also get Medi-Cal if you are:

• Blind
• Disabled
• Pregnant
• A parent or caretaker relative of an age-eligible child
• A person enrolled in CalFresh, SSI/SSP, CalWorks (AFDC), Refugee Assistance, Foster Care, or Adoption Assistance Program.

To apply for Medi-Cal in California, follow these steps:

1. Apply online through the California Department of Health Care Services (DHCS) website. English: www.coveredca.com or Spanish: www.coveredca.com/espanol
2. Call the Medi-Cal Service Center at 1-800-541-5555. Assistance is available in both English and Spanish.

If you need assistance with the application process or have questions about your eligibility for Medi-Cal, organizations like BAILA (Benevolent Association for Immigrant Legal Assistance) specialize in helping immigrants, including undocumented individuals, navigate the healthcare system in California. 

Do other states besides California provide healthcare programs for undocumented individuals?

Several states have implemented programs or initiatives similar to California’s Medi-Cal to provide healthcare coverage for low-income individuals and families, including documented and undocumented residents. Here are a few examples:

• New York’s Medicaid program provides comprehensive healthcare coverage to eligible low-income residents, including documented and undocumented individuals. For more information, Call 311, text CoveredNYC to 877877 (or SeguroNYC for help in Spanish), or visit https://nystateofhealth.ny.gov/ 
• Washington’s Medicaid program, Apple Health, offers health insurance to low-income individuals and families, including undocumented immigrants in certain categories, such as pregnant women and children. For more information, click here. 

• Oregon’s Medicaid program, the Oregon Health Plan (OHP), offers emergency care and prenatal services to undocumented individuals, guaranteeing access to essential healthcare. Eligibility for full OHP benefits, regardless of immigration status, began after July 1, 2023. For further details, click here.
• New Jersey’s FamilyCare program offers healthcare to low-income families and children, including certain undocumented immigrants like children under 19 and pregnant women with qualifying status. For more eligibility details, click here.
• Massachusetts has the Health Safety Net program, which covers emergency and essential services for individuals ineligible for Medicaid due to immigration status but still need medical care. For more information, call 1-877-910-2100 or click here. 

Additionally, in Colorado, Illinois, Vermont, Connecticut, Rhode Island, Maine, and Washington, DC, Medicaid has expanded to include low-income children up to 18 years of age and pregnant individuals, regardless of their immigration status.

Please remember that these benefits are not considered a public charge, and therefore, it does not affect your immigration status. For more information, click here.