In the United States, healthcare costs an arm and a leg. A visit to the doctor’s office may cost several hundred dollars, and a minimum three-day hospital stay may cost thousands of dollars. Also, the healthcare system is overwhelming and serpentine, especially for those new to the country. Health insurance is the only way to reduce healthcare costs to reasonable amounts.
The problem with health insurance in the US is that there isn’t a single form, which quickly becomes confusing for immigrants. The US healthcare system is a combination of privately and publicly funded programs with different rules and requirements for eligibility based on factors like immigration status, location, and income. Fortunately, there are resources to help you navigate the nuances of the US healthcare system, and this article is one of them.
But if you are a Spanish-speaking citizen and resident of the US and want specific information, then click here. This website focuses on helping Spanish speakers live a better life in the United States of America, and you’ll find answers to your most burning questions and doubts.
Why Should Immigrants Care About Healthcare?
Nobody wants to and knows when they might become injured or sick. It can happen anytime and to anyone. When this happens, you will thank your lucky stars you are insured.
Health insurance is a contract between the insurance company and you. Buying a plan means the company agrees to pay part of the medical expenses. Most plans cover care costs like medicine, emergency room visits, and regular check-ups, ensuring you and your family stay healthy.
Thanks to the Affordable Care Act, standardization is introduced to insurance plan benefits. This means that the benefits offered by insurance companies don’t vary drastically from plan to plan. Also, this Act requires most lawfully present immigrants and US citizens to have a minimum level of coverage. However, there’s no penalty if you are not insured.
Eligibility For Health Insurance
All lawfully present immigrants are eligible for coverage via the Health Insurance Marketplace.
The term ‘lawfully present’ means:
- Valid non-immigrant visa
- Qualified non-citizen immigration status without a waiting period, such as refugee, green card holder, or asylee
- The legal status is conferred by other laws like temporary resident status, family united individuals, LIFE Act, etc.
- Humanitarian circumstances or statuses like victims of trafficking, temporary protected status, convention against torture, special juvenile status, and asylum applications
Health Insurance Terms You Must Know
|Health insurance term||Meaning|
|Annual deductible||The amount paid by you out of pocket for covered services before the insurance company pays its share of the cost. For instance, if the deductible is $1,000, you are responsible for paying the first $1,000 in healthcare received each year and then the company will pay its share.|
|Out-of-pocket expense||It refers to the portion of the medical costs you will pay for the healthcare received. Once you have maxed out, the insurance company will pay 100% of the covered services.|
|Copayment or copay||A copay is an upfront, fixed amount you pay whenever you receive care covered by your insurance.|
|Premium||The amount paid each month for the health insurance plan.|
|Coinsurance||It refers to the percentage of the cost of the covered service that you must pay after meeting your deductible. For instance, if an MRI costs $1,000, you may have to pay 20% of the cost.|
Insurance Programs In The US
Primarily, there are two types of health insurance programs in the US:
- Public – Provided by the government and includes plans like Medicaid and CHIP (children’s health insurance program). Explained in the table below.
- Private – Purchased on the individual market or offered through an employer. If you are not employed, you can buy health insurance on the individual market via the ACA (Affordable Care Act) marketplace.
|Public Insurance Plans||What It Offers|
|Medicaid (called Apple Health in Washington and Medi-Cal in California)||
|CHIP (children’s health insurance program)||
You can apply for and enroll in CHIP or Medicaid at any time of the year. The coverage starts immediately if you qualify. But it is important to note that some states need a five-year waiting period, and you can enroll in programs after that.
1. If I receive public benefits, will it prevent me from becoming a citizen of the US?
Using Medicaid and other public programs will not affect your chances of becoming a US citizen.
2. Is the information on the health insurance application shared with the immigration officer?
No, the information you provide will only determine your eligibility.
3. What documents are required?
It is dependent on your immigration status. To enroll in Marketplace coverage, you may need to produce documents like employment authorization, green card, and foreign passport.