Access to Coverage for Immigrants

Access to Coverage for Immigrants

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This article describes the categories of non-citizens who are eligible for health insurance coverage through Medicaid or HealthSource RI in Rhode Island.

Medicaid

Medicaid has different immigration eligibility rules for pregnant women, children, and non-pregnant adults.

Medicaid for Pregnant Women

Pregnant women in Rhode Island are eligible for Medicaid (from an immigration status perspective) regardless of their immigration status.  Even undocumented pregnant women can get Medicaid in Rhode Island.

Medicaid for Children

Children under age 19 are eligible for Medicaid if they are “lawfully present.”  There is never any 5-year waiting period (or any other waiting period) before non-citizen children can become eligible for Medicaid.

Lawfully present has a relatively broad meaning.  Roughly speaking, any person who is in the United States with the permission of immigration authorities will very likely be considered lawfully present.  Lawfully present statuses include, for example:

  • Lawful Permanent Resident (LPR / “green card” holder)
  • Asylee
  • Refugee
  • Cuban/Haitian Entrant
  • Paroled into the U.S.
  • Conditional Entrant Granted before 1980
  • Battered Spouse, Child and Parent
  • Victim of Trafficking and his/her Spouse, Child, Sibling or Parent
  • Granted Withholding of Deportation or Withholding of Removal, under the immigration laws or under the Convention against Torture (CAT)
  • Individual with Non-immigrant Status, includes worker visas (such as H1, H-2A, H-2B), student visas, U-visa, T-visa, and other visas, and citizens of Micronesia, the Marshall Islands, and Palau
  • Temporary Protected Status (TPS)
  • Deferred Enforced Departure (DED)
  • Deferred Action Status (Exception: Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for applying for health insurance)
  • Lawful Temporary Resident
  • Administrative order staying removal issued by the Department of Homeland Security
  • Member of a federally-recognized Indian tribe or American Indian Born in Canada
  • Resident of American Samoa

Applicants for the following statuses are also considered lawfully present, even if the status has not yet been granted:

  • Temporary Protected Status with Employment Authorization
  • Special Immigrant Juvenile Status
  • Victim of Trafficking Visa
  • Adjustment to LPR Status
  • Asylum **
  • Withholding of Deportation, or Withholding of Removal, under the immigration laws or under the Convention against Torture (CAT) **

** Applicants for these statuses are considered lawfully present only if they’ve been granted employment authorization or are under the age of 14 and have had an application pending for at least 180 days

Children with work permits are definitely lawfully present if their work permit shows any category code that begins with a “C.”  Children with work permits that show other category codes may (or may not) be lawfully present, depending on their underlying immigration status.

For more information with respect to the meaning of “lawfully present” for the purposes of children applying for Medicaid in Rhode Island, see:

Medicaid for (Non-Pregnant) Adults

Non-pregnant non-citizen adults are only eligible for Medicaid in Rhode Island if they have a “qualified” immigration status.  Even among those with “qualified” status, some non-citizen adults are eligible for Medicaid only after a five-year waiting period (the so called “five-year bar”).  Other “qualified” non-citizen adults are eligible for Medicaid right away, without waiting for five years.  And many non-citizen adults (those who do not have a “qualified” status) can never be eligible for Medicaid, even if they are lawfully present, and even if they wait for five years.

Adult Medicaid applicants subject to five-year bar

The following categories of non-citizen adults are eligible for Medicaid only after a five-year waiting period:

  • Most Lawful Permanent Residents (LPRs or “green card” holders)
    • As described below, some LPRs are not subject to the 5-year bar
  • Conditional entrant
  • Paroled in the U.S. for 1 year or more
  • Battered spouse, child, or parent who has a pending or approved petition with the Dept. of Homeland Security (DHS)

The five-year waiting period starts on the date the person enters the U.S. with the relevant status.

Adult Medicaid applicants exempt from the five-year bar

The following categories of non-citizens adults are eligible for Medicaid without being subject to a five-year waiting period:

  • Refugees
  • Asylees
  • Active duty military, veterans, and their spouses or unmarried dependents (who also have a qualified non-citizen status, whether ordinarily subject to the five-year bar or not)
  • LPRs who adjusted from a status that’s exempt from the 5-year bar (like a refugee who later became an LPR)
  • Cuban/Hatian entrants
  • Granted withholding of deportation or withholding of removal
  • Trafficking survivors and their spouses, children, siblings, or parents
  • Certain Amerasian immigrants

Other non-pregnant non-citizen adults

A non-pregnant adult applicant with an immigration status not listed above cannot receive Medicaid in Rhode Island.

Some, if they are “lawfully present,” will be eligible for commercial coverage and financial assistance through HealthSource RI as described below.

Others, who are not “lawfully present,” may be eligible for emergency Medicaid (which only covers emergency care and cannot be applied for until after the emergency) or hospital charity care.

HealthSource RI

Any individual who is “lawfully present” in the United States is eligible (from an immigration status perspective) to purchase a commercial qualified health plan through HealthSource RI (HSRI) and also to receive advance premium tax credits (APTCs) and cost sharing reductions (CSRs).

(For a summary of other eligibility criteria (like income), see this article on basic eligibility rules,  and this article on income eligibility for APTCs and CSRs, and this article on how access to other coverage impacts eligibility for APTCs and CSRs.)

“Lawfully present” has a relatively broad definition, almost identical to the definition as applied to children applying for Medicaid (described above).  Very roughly speaking, any person who is in the United States with the permission of immigration authorities will very likely be considered “lawfully present.”

One difference between the definition  of “lawfully present” with respect to HSRI is that you can only be certain of lawful presence based on applicant’s work permit if that work permit displays the following category codes: C9, C10, C16, C18, C20, C22, or C24.  Applicants with work permits that show other category codes may (or may not) be eligible for HSRI, depending on their underlying immigration status.

There is never a 5-year (or any other) waiting period before a lawfully present individual becomes eligible for coverage, APTCs, and CSRs through HSRI.

For more information on the meaning of “lawfully present” with respect to HSRI eligibility, see:

Resources

Overview

Medicaid for Children

Medicaid for Adults

  • 8 USC 1641 (defining “qualified” statuses)
  • 8 USC 1613 (creating five-year bar and outlining exemptions)
  • 210-RICR-10-00-3 (Rhode Island regulation delineating “qualified” statuses)

HealthSource RI