What You Need to Know About Health Insurance and Immigration Status

By The Legal Aid Society

There is a lot of information about what kind of health insurance (sometimes called “health coverage,” or “coverage”) you might be eligible for depending on your immigration status. This pamphlet is intended to provide basic information to you so that you can make an informed decision about your health coverage. Because this can be complicated, if you have questions or concerns you can contact The Legal Aid Society, another legal services organization, or a trained assistor to learn about your coverage options. Do not assume that just because you are not a citizen or a green card holder (lawful permanent resident) that you are not eligible for health coverage.

In New York, regardless of your immigration status and your ability to pay, you are entitled to hospital treatment in the case of a medical emergency. There are also many ways to access affordable health care in New York City.

What kinds of free or low-cost coverage are available in New York State?

Free or low-cost health insurance is available to individuals and families in New York State who meet income and other eligibility requirements. Coverage options include: Medicaid, Child Health Plus, Essential Plan and private insurance with financial help.

Will my immigration status be kept private when I apply for insurance?

Your immigration status will be kept private when you apply for public health insurance. Information about your immigration status is only used to determine your eligibility for public benefits, and is not used for immigration enforcement. That means that your immigration status is not reported to U.S. Immigration and Customs Enforcement (ICE) or to U.S. Citizenship and Immigration Services (USCIS).

How does my immigration status effect my eligibility for health insurance?

Determining whether your immigration status falls into one of the following categories can be difficult. You might hear a rumor or think that your immigration status makes you ineligible for health coverage even if you are eligible, so please speak with an attorney should you have any questions or concerns:

Lawfully Present

This is a general term to describe people who have valid non-immigrant status (like students or foreign workers), as well as people who have many other statuses. Those who have statuses listed below under “Qualified Immigrant,” and
“PRUCOL & Lawfully Present” are considered Lawfully Present. Those who have statuses listed below under “PRUCOL & Not Lawfully Present” and “Undocumented” are not considered lawfully present for purposes of health coverage.

Qualified Immigrant
• Green Card Holder (Legal Permanent Resident, “LPR”), Permanent Resident Alien
• Lawfully residing active duty service member & family
• Refugee
• Asylee
• Immigrant with withholding of removal or deportation
• Cuban or Haitian Entrant
• Amerasian
• T-visa holder (Trafficked immigrant)
• Parolee in United States for more than 1 year
• Battered immigrant spouse and child of U.S. citizen/LPR

PRUCOL & Lawfully Present
PRUCOL stands for “Permanently Residing Under Color of Law.” This is NOT a status granted by USCIS, but instead is a status that applies to the following groups of immigrants in order to determine their eligibility (along with income and other requirements) for Medicaid and some other public benefits.

• Holder of: U, K3/K4, V or S visas
• Approved applicant for Visa
• Approved applicant for adjustment of status
• Grantee of withholding of removal under CAT
• Parolee < 1 year
• TPS (Temporary Protected Status)
• Applicant for TPS
• Deferred Action (non-DACA)
• Order of Supervision
• Deferred Enforced Departure
• Grantee of stay of deportation or removal
• Temporary resident INA 210/245A
• Family Unity Beneficiary
• Applicant for SIJS (Special Immigrant Juvenile Status)
• Applicant for Asylum/Withholding under INA or CAT
• Applicant for Record of Admission under 249 (registry alien)
• Applicant for Adjustment under LIFE Act
• Applicant for Legalization Programs under SAW (Seasonal and Agricultural Workers) and IRCA (Immigration Reform and Control Act)

PRUCOL & Not Lawfully Present
• Noncitizen who can show continuous residence since on or before January 1, 1972
• Immediate relative with approved I-130
• DACA (Deferred Action for Childhood Arrival)
• Request for Deferred Action (non-DACA case) pending for 6 or more months and not denied
• DAPA (Deferred Action for Parent of U.S. Citizens and Permanent Residents)

Undocumented
• Visa overstay
• EWIS (entered country without inspection)

What if I’ve been ordered removed from the United States?

If you or someone you know has been ordered removed from the United States, but has been given a deferral, or an order from an immigration judge allowing you to remain in the country for a particular reason and/or under particular conditions, you are considered “PRUCOL,” and therefore eligible for certain kinds of health insurance.

To illustrate by example (please keep in mind this is just one example of many different possible situations):

One of The Legal Aid Society’s clients was ordered removed from the United States. Their removal was deferred, however, under an Order of Supervision based on the Convention Against Torture (C.A.T.) due to their mental illness and cognitive issues. The client’s Order of Supervision required the client to attend a behavioral health program in order to remain in this country, which Medicaid would cover. The client needed to apply for Medicaid and was told, incorrectly, that they needed a green card in order to get Medicaid. The client contacted The Legal Aid Society, which connected them with the right place to apply for Medicaid. The client was able to get Medicaid, enter a behavioral health program, and remain in the country.

Sometimes, behavioral health and rehabilitation programs will allow patients to enter treatment without coverage but will give patients a certain amount of time to get coverage. If you do not have health coverage and you need to enter a program, you should always ask if you can apply for coverage after entering the program. However, please be aware that you may be charged for your care if you do not then apply for insurance or if you apply for insurance but are not eligible.

What is Public Charge? 

Finally, you may have heard about something called “Public Charge.” Public charge is one of many grounds of inadmissibility, which means that it can be a basis for denying entry to a non-citizen into the United States, or for denying an application to adjust status to Lawful Permanent Resident (LPR or green card holder).

You might be worried about the impact that applying for, and continuing to receive, public benefits like Medicaid will have on your immigration status. As it stands currently, relatively few applications for admission and adjustment are denied on public charge grounds. Under current law, the only government benefits that count for public charge purposes are cash assistance/welfare, SSI, and government-funded long-term institutional care. In addition to receipt of these benefits, the government has to look at a range of factors, including your age, health, family status, assets, resources, financial status, education, and skills before it can find that you are a public charge.

In October 2018, the U.S. Department of Homeland Security (DHS) proposed changes to rules governing public charge. As of April 9, 2019, the current rules have not changed, and they will remain in effect until a final public charge rule is issued.

You can learn more about public charge by going to The Legal Aid Society’s Public Charge Notice that has advisories in English, Spanish, Chinese (simplified) and Chinese (traditional).

How do I contact The Legal Aid Soceity?

If you have any questions or concerns about Public Charge or need assistance, please call The Legal Aid Society’s Immigration Helpline at 844-955-3425, seven days a week from 9 a.m. – 5 p.m.

If you need assistance with a health coverage issue, please contact The Legal Aid Society’s Access to Benefits Helpline on the first and third Tuesdays of the month from 9:30 a.m. – 12:30 p.m. at 888-663-6880.

Disclaimer

The information in this document has been prepared by The Legal Aid Society for informational purposes only and is not legal advice. This information is not intended to create, and receipt of it does not constitute, an attorney-client relationship. You should not act upon any information without retaining professional legal counsel.