Health Insurance for Immigrants
Lawfully present immigrants can buy ACA Marketplace plans. Green card holders, visa holders, refugees and asylees can enroll; starting January 1, 2027, tax credits are limited to green card holders, Cuban/Haitian entrants and COFA migrants. Lawfully present people without an SSN can still apply. Emergency Medicaid may cover emergency care for people who meet their state’s Medicaid rules but don’t have an eligible immigration status. See the 2026 vs. 2027 eligibility table by immigration status below.
Get My Free Quote ↓Quick answer: Lawfully present immigrants, including green card holders, can enroll in ACA Marketplace plans. Under current law, starting January 1, 2027, only lawful permanent residents, Cuban/Haitian entrants and COFA migrants keep premium tax credit eligibility; refugees, asylees, parolees and TPS holders lose it but can still buy full-price plans. Since 2026, lawfully present immigrants with income under 100% of the poverty level don’t get tax credits. FreedInsure, a broker serving clients in 42 states, can check your options in English or Spanish.
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What You Need to Know
This is FreedInsure’s guide to health insurance for immigrants: the rules by immigration status, your coverage options, costs, enrollment timelines, ITIN and mixed-status questions, and common mistakes. Published by FreedInsure LLC, whose licensed agent is Constantino Lardi (NPN 20230457); it cites official sources.
FreedInsure LLC is an independent brokerage serving clients in 42 states, counting Washington, DC. We compare coverage from 14+ health insurance carriers to find your best option. Our service is 100% free — carriers compensate us, not you. Call (844) 788-3733 or use the form below for personalized guidance.
This page covers: the fundamentals of this topic, who qualifies and who doesn’t, a 2026 vs. 2027 eligibility table by immigration status, ITIN and mixed-status rules, every available option with costs, the most common mistakes people make, how to take action today, and answers to the most frequently asked questions.
Understanding Health Insurance For Immigrants
This comprehensive guide covers everything you need to know about health insurance for immigrants. Whether you’re researching for the first time or looking for specific details, this resource provides expert-level information from licensed insurance professionals.
Who This Guide Is For
Anyone researching health insurance for immigrants — whether you’re experiencing this situation right now, planning ahead, or helping a family member navigate their options. This guide covers eligibility requirements, available coverage types, enrollment timelines, costs with and without subsidies, and step-by-step instructions for taking action.
Key Concepts
Understanding health insurance for immigrants requires knowing: whether you qualify for a Special Enrollment Period (60-day window outside Open Enrollment), which plan types are available (ACA, PPO, short-term, supplemental), how subsidies affect your cost, and which carriers serve your area. Each of these factors is covered in detail below.
Immigration Status Rules to Know (as of fall 2026)
Tax credits from January 1, 2027: among lawfully present immigrants, only lawful permanent residents (green card holders), Cuban/Haitian entrants and COFA migrants keep premium tax credit eligibility. Refugees, asylees, parolees, TPS holders and similar statuses lose it but can still buy a Marketplace plan at full price. Separately, since 2026, lawfully present immigrants with income below 100% of the federal poverty level no longer get premium tax credits.
Medicaid and CHIP: qualified non-citizens are generally eligible after a 5-year waiting period. Federal Medicaid eligibility for some immigrants narrowed on October 1, 2026; in Kentucky, for example, refugees and asylees lose Medicaid while green card holders (after 5 years), Cuban/Haitian entrants and COFA migrants keep it. Rules vary by state. HealthCare.gov notes that Medicaid “may cover treatment of an emergency medical condition” for people who meet their state’s Medicaid rules but don’t have an eligible immigration status.
SSNs and mixed-status families: applicants who have a Social Security number must provide it, but lawfully present people without one can still apply and leave the field blank. Don’t enter an ITIN in the SSN field. Family members who aren’t applying for coverage don’t need to give their citizenship or immigration status.
2026 vs. 2027 Eligibility by Immigration Status
Three federal changes reach immigrant families between January 2026 and January 2027:
- January 1, 2026: lawfully present immigrants with income below 100% of the federal poverty level (FPL) stopped getting premium tax credits.
- October 1, 2026: full federally funded Medicaid and CHIP for non-citizens narrowed to lawful permanent residents, Cuban/Haitian entrants and COFA migrants.
- January 1, 2027: Marketplace savings (the premium tax credit and extra savings on out-of-pocket costs) go only to those same three groups among lawfully present immigrants.
Here is where each status stands as of October 2026, under current federal law. “Savings” still requires income in the eligible range, generally 100%–400% FPL (about $15,960–$63,840 for a single person for 2027 coverage).
| Immigration status | Can buy a Marketplace plan? | Savings in 2026 | Savings from Jan. 1, 2027 | Full Medicaid/CHIP from Oct. 1, 2026 (federal rule for adults) |
|---|---|---|---|---|
| Lawful permanent resident (green card) | Yes | Yes | Yes | Yes, generally after a 5-year wait (some are exempt) |
| Cuban/Haitian entrant | Yes | Yes | Yes | Yes |
| COFA migrant (Marshall Islands, Micronesia, Palau) | Yes | Yes | Yes | Yes |
| Refugee or asylee | Yes | Yes | No — full price only | No; see state notes |
| Paroled into the U.S. | Yes | Yes | No — full price only | No; see state notes |
| Temporary Protected Status (TPS) | Yes | Yes | No — full price only | Not on the federal list; see state notes |
| Valid non-immigrant visa (work, student and other visas) or work permit (EAD) | Yes | Yes | No — full price only | Not on the federal list; see state notes |
| Any lawfully present immigrant with income under 100% FPL | Yes | No (ended Jan. 1, 2026) | No | Depends on status (rows above) |
| DACA recipient | No | No | No | No; Emergency Medicaid may apply |
| Undocumented | No | No | No | No; Emergency Medicaid may apply |
State notes: the Medicaid column is the federal rule for adults, and states differ for children and pregnant people. Kentucky says lawfully present children and pregnant women can still qualify, and Texas says a lawfully residing child with a satisfactory immigration status still qualifies for Medicaid and CHIP under its CHIPRA 214 option. Texas HHSC says Emergency Medicaid isn’t affected by the October 2026 change, and Kentucky says time-limited Emergency Medicaid is still available regardless of immigration status if you meet its income and residency rules. In Illinois, Get Covered Illinois says lawfully present immigrants who lost Medicaid on October 1, 2026 stay eligible for help paying for Marketplace coverage through December 31, 2026. Some states run their own programs, so check with your state’s Medicaid agency. HealthCare.gov adds that people who aren’t eligible for Marketplace coverage may be able to get lower-cost care at a community health center.
ITINs, SSNs and Mixed-Status Households
An ITIN is a 9-digit number the IRS issues for federal tax purposes to people who aren’t eligible for a Social Security number. The IRS says an ITIN doesn’t authorize work and doesn’t provide or change immigration status, so it doesn’t decide your health coverage; your immigration status and income do. What to enter on a HealthCare.gov application:
- Applicant with an SSN: enter it. People who apply need to provide an SSN if they have one.
- Lawfully present applicant without an SSN: leave the SSN field blank; you can still apply.
- ITIN holder: don’t enter the ITIN in the SSN field. HealthCare.gov says not to enter ITINs or any other numbers there.
- Household member who isn’t applying: no SSN or immigration status needed, unless they’re a tax filer whose tax information is used to check the household’s savings; then give their SSN if they have one, and otherwise leave it blank.
Mixed-Status Families
HealthCare.gov says undocumented immigrants can’t get Marketplace coverage for themselves but may apply on behalf of eligible family members, and that “mixed status” families can apply for the premium tax credit and extra savings for the members who qualify. Family members who aren’t applying won’t be asked their immigration status, and Marketplaces and state Medicaid and CHIP agencies can’t require applicants to give the citizenship or immigration status of household members who aren’t applying. Starting January 1, 2027, those savings go only to members who are citizens or who hold one of the three qualifying statuses in the table above. For a step-by-step walkthrough, see our guide to health insurance without an SSN or ITIN.
Privacy and Public Charge
HealthCare.gov says it uses the immigration information you give it, and information it gets from other sources, only to determine eligibility, and that the Department of Homeland Security may verify an applicant’s status. Public charge is an immigration question, not an insurance one. Texas HHSC told its staff that, effective September 18, 2026, federal immigration officials may consider certain public benefits, including Medicaid, received on or after that date as a factor in a case-by-case public charge decision, and that this doesn’t change Medicaid eligibility rules. If you have concerns, talk with an immigration attorney or a legal aid group before you apply; we’re licensed insurance agents, not immigration advisors.
Your Coverage Options
ACA Marketplace Plans
The primary option for most situations. ACA plans from HealthCare.gov or your state’s exchange must cover pre-existing conditions, include the essential health benefits, and offer premium tax credits based on income to people whose immigration status qualifies (see the table above). In the 2026 Open Enrollment, 29% of HealthCare.gov enrollees picked a plan with a $0 monthly premium after the tax credit (CMS). Available during Open Enrollment (Nov 1–Jan 15 on HealthCare.gov) or with a qualifying life event (usually a 60-day Special Enrollment Period). Check your subsidy →
Private PPO and EPO Plans (Outside the Marketplace)
FreedInsure can also quote private PPO and EPO plans sold outside the ACA Marketplace. The ones we offer use the Cigna PPO network; they are not insured by Cigna. You can apply outside Open Enrollment, but approval depends on each plan’s eligibility and underwriting rules, and the start date depends on the plan. Benefits, limits and pre-existing-condition rules vary by plan, so get them in writing. PPO options →
Straight talk: A plan sold outside the Marketplace can cost less than a full-price ACA plan if you’re healthy, earn too much for a tax credit, or want a specific network. But if you qualify for a tax credit or Medicaid, have a pre-existing condition, are pregnant or planning to be, or take expensive medications, an ACA plan is usually the safer buy, and the only way to get the premium tax credit is through the Marketplace. We’ll price both side by side before you decide. Call (844) 788-3733.
Important: Plans sold outside the ACA Marketplace may be subject to underwriting, age limits, state availability and each plan’s own eligibility rules. Not all plans are available in all states. Rates are not guaranteed and can change. Benefits, limits and exclusions are set by the official plan document or policy, which controls if it differs from this page. This page is a general summary, not a contract or an offer of coverage.
These plans are not sold through the ACA Health Insurance Marketplace (HealthCare.gov or your state’s exchange) and are not individual-market ACA plans. You can’t use a premium tax credit or cost-sharing reduction to pay for them. As HealthCare.gov puts it, “the only way to get the premium tax credit is through the Marketplace.”
The Cigna PPO network is a provider network, not an insurance company, and it doesn’t pay claims. A plan that uses the Cigna PPO network sets its own benefits and pays claims through its own administrator. Before you get care, confirm your doctor or facility is in network using the directory and phone number on your plan ID card.
When a private plan can make sense: you won’t get a tax credit in 2027 (for example, because your immigration status no longer qualifies or your income is above 400% FPL, about $63,840 for a single person), you’re healthy with low, predictable care needs, you want a plan that uses the Cigna PPO network, and you accept higher stated deductibles and the plan’s limits and exclusions.
When an ACA plan is the better call: you qualify for a tax credit or Medicaid, have a pre-existing condition, are pregnant or planning to be, or take expensive medications. Marketplace plans must cover pre-existing conditions even when you pay full price.
Short-Term Medical
Bridge coverage for a gap between plans; approval is medically underwritten, and the start date depends on the plan and your application. Short-term plans are temporary coverage, and how long you can keep one depends on your state and the plan, from 3 months or less in some states to longer terms with renewals where state law allows; some states, including Illinois, don’t allow them. Does NOT cover pre-existing conditions, isn’t an ACA plan, and can’t be paid for with a premium tax credit. Each insurer sets its own application and identification requirements, so confirm them before you apply. Prices depend on age, state and plan, so we quote them individually. Best for healthy individuals between coverage periods.
Supplemental Coverage
Required notice for hospital indemnity (fixed-indemnity) coverage:
THIS IS A SUPPLEMENT TO HEALTH INSURANCE AND IS NOT A SUBSTITUTE FOR MAJOR MEDICAL COVERAGE. LACK OF MAJOR MEDICAL COVERAGE (OR OTHER MINIMUM ESSENTIAL COVERAGE) MAY RESULT IN AN ADDITIONAL PAYMENT WITH YOUR TAXES.
Hospital indemnity, critical illness, accident, dental and vision plans; prices depend on the plan, your age and where you live, so we quote them individually. Hospital indemnity pays a fixed dollar amount per covered event, not your actual bill: there’s no out-of-pocket maximum, and you pay charges above the scheduled amount. These cash benefits help with gaps but don’t replace major medical coverage. You can apply for them outside Open Enrollment; acceptance and start dates depend on the policy. Learn more →
Costs and Subsidies
ACA With Subsidies
Enhanced subsidies expired at the end of 2025 and, under current law, are not back for 2027 unless Congress acts. Starting January 1, 2027, only lawful permanent residents, Cuban/Haitian entrants and COFA migrants among lawfully present immigrants qualify for the credit; the examples below assume you do. For 2027 coverage, premium tax credits apply at 100%–400% FPL (about $15,960–$63,840 for a single person), and you’re expected to pay about 2.15%–10.22% of income for the benchmark Silver plan; above 400% FPL the credit is $0. 2027 examples for one adult (benchmark Silver, after the credit): $25,000 income (about 157% FPL) → about 4.63% of income, roughly $96/month; $40,000 (about 251% FPL) → about 8.68%, roughly $289/month; $60,000 (about 376% FPL) → 10.22%, about $511/month. These use the 2026 poverty guideline ($15,960) that applies to 2027 coverage and the percentages in IRS Rev. Proc. 2026-26; a Bronze plan can cost less, and your exact price depends on the benchmark plan where you live. Estimate yours with the 2027 subsidy calculator →
Without Subsidies
Without a tax credit, you pay the full premium. In the 2026 Open Enrollment, the average Marketplace premium before tax credits was $741/month across all enrollees nationally (CMS); your own price depends on your age, where you live and the plan you pick. This matters more from January 1, 2027, when refugees, asylees, parolees, TPS holders, visa holders and other lawfully present immigrants outside the three qualifying groups pay full price. Private PPO plans are priced by age, state, network, plan design and each plan’s underwriting rules, so we quote them individually.
Cost-Sharing Reductions
Income at 100–250% FPL? Silver plans get cost-sharing reductions (CSR): lower deductibles and copays and a lower out-of-pocket maximum. For 2027 the self-only out-of-pocket cap drops from up to $12,000 to $4,000 at or below 200% FPL and $9,600 at 200%–250% FPL. This is separate from the premium tax credit and only applies to Silver plans bought through the Marketplace. Starting January 1, 2027, HealthCare.gov says these cost-sharing savings, like the tax credit, go only to lawful permanent residents, Cuban/Haitian entrants and COFA migrants among lawfully present immigrants. A broker makes sure you don’t miss it.
How to Take Action
Step 1: Check Your Eligibility
Check where your immigration status lands in the 2026 vs. 2027 table, then determine if you have a qualifying life event for Special Enrollment, or if Open Enrollment is active. If neither, ask about short-term, private PPO or supplemental plans, which you can apply for outside Open Enrollment; approval depends on each plan’s eligibility rules, and the start date depends on the plan. Medicaid and CHIP accept applications all year. A FreedInsure advisor can help you check your options.
Step 2: Compare Plans With a Licensed Advisor
Call (844) 788-3733 or submit the form below. Your advisor presents 3–5 best options with real after-subsidy pricing from multiple carriers. Free consultation — no obligation.
Step 3: Enroll Same Day
Pick your plan and enroll over the phone. During Open Enrollment, pick a plan by December 15 for a January 1 start. After a loss of coverage, Marketplace coverage starts the first day of the month after you pick a plan (or after your old coverage ends, if you pick before it ends). Private plan start dates depend on the plan. All free.
Step 4: Add Supplemental (Optional)
After major medical is in place, consider gap protection: hospital indemnity + critical illness + accident + dental/vision, priced for your age and state. Supplemental options →
Mistakes to Avoid
Mistake 1: Not Checking Subsidy
In the 2026 Open Enrollment, 87% of Marketplace enrollees nationwide chose a plan with a premium tax credit (CMS). Many people who assume they earn too much, or too little, never check, and from 2027 your immigration status matters too. A 60-second check costs nothing. Check now →
Mistake 2: Choosing by Premium Alone
Cheapest premium ≠ cheapest total cost. Calculate premiums + expected out-of-pocket for true cost.
Mistake 3: Missing Deadlines
60-day SEP windows are firm. Missing one can mean waiting until the next Open Enrollment. Start enrollment within the first week of your qualifying event.
Mistake 4: Not Using a Broker
Brokers are free to you (insurance carriers pay us). Same Marketplace plans and prices + expert guidance. Zero downside.
Mistake 5: Assuming 2026 Savings Carry Into 2027
If you’re a refugee, asylee, parolee, TPS holder or visa holder with a tax credit in 2026, it ends January 1, 2027 under current law. Review your 2027 options during Open Enrollment (November 1, 2026 to January 15, 2027 on HealthCare.gov) and compare full-price ACA plans with other options before your first 2027 bill.
Mistake 6: Entering an ITIN in the SSN Field
HealthCare.gov says to leave the SSN field blank if a person doesn’t have an SSN and not to enter an ITIN or any other number there. Household members who aren’t applying generally don’t need to give an SSN or their immigration status.
How FreedInsure Helps
FreedInsure compares 14+ health insurance carriers simultaneously to find you the best rate and coverage for your specific situation. FreedInsure LLC is an independent insurance broker; its licensed agent, Constantino Lardi (NPN 20230457), is licensed in 42 states, and two of our licensed team members speak Spanish (página en español). Our help is free to you, and we’ll show you your ACA Marketplace options, including any tax credit you qualify for, next to any private plan.
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Where we can help: we don’t sell ACA Marketplace plans in Washington, DC, Maine, Maryland, Nevada, Pennsylvania or Virginia. In Maine, Maryland, Nevada, Pennsylvania and Virginia we can quote private PPO and EPO plans, short-term plans where state law allows, supplemental coverage and life insurance. DC residents use DC Health Link for Marketplace plans, and we can help them with life insurance and supplemental coverage. We aren’t licensed in Colorado, Connecticut, Idaho, Massachusetts, Minnesota, New Mexico, Rhode Island, Vermont or Washington State.
Ready to get started? Call (844) 788-3733 or complete the form below. A licensed advisor will call within 15 minutes with personalized options. No pressure, no spam, no data selling. Just expert guidance that’s 100% free.
Sources
- HealthCare.gov — Coverage for lawfully present immigrants
- HealthCare.gov — Immigration status to qualify for the Marketplace (including DACA and the 2027 savings rule)
- HealthCare.gov — Health coverage for immigrants
- HealthCare.gov — More information for immigrant households (mixed-status families)
- Kentucky Health Benefit Exchange (kynect) — Changes coming to Medicaid and Marketplace coverage
- Get Covered Illinois — Health insurance changes for 2026 and 2027
- KFF — Health provisions in the 2025 federal budget reconciliation law
- HealthCare.gov — Do I need to enter my Social Security number?
- HealthCare.gov — How we use your data (SSN and immigration status of non-applicants)
- IRS — Individual Taxpayer Identification Number (ITIN)
- Texas HHSC — MEPD and Texas Works Bulletin 26-15: October 1, 2026 non-citizen Medicaid and CHIP changes (PDF)
- Texas HHSC — MEPD and Texas Works Bulletin 26-17: public charge notice (PDF)
- IRS — Rev. Proc. 2026-26: 2027 premium tax credit percentages (PDF)
- CMS — 2027 out-of-pocket and cost-sharing reduction limits (PDF)
- CMS — Health Insurance Exchanges 2026 Open Enrollment Report (PDF)
Frequently Asked Questions
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Important: Plans sold outside the ACA Marketplace may be subject to underwriting, age limits, state availability and each plan’s own eligibility rules. Not all plans are available in all states. Rates are not guaranteed and can change. Benefits, limits and exclusions are set by the official plan document or policy, which controls if it differs from this page. This page is a general summary, not a contract or an offer of coverage.
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