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ACA Marketplace Coverage for Immigrant Families

ACA Marketplace eligibility rules for immigrant families, including coverage for lawfully present individuals, Medicaid and CHIP eligibility, the 5-year waiting period, Special Enrollment Periods for newly lawfully present clients, and emergency Medicaid.

Written by Micaela Caruccio

Agents frequently work with clients who are immigrants or have mixed-status households. Understanding the eligibility rules for Marketplace coverage, Medicaid, and CHIP for immigrant families helps agents guide clients to the right coverage options.

For a list of accepted immigration documents and how to handle verification issues on a Marketplace application, see Verifying Immigration Status for ACA Marketplace Eligibility — Frequently Asked Questions.


Eligibility for ACA Marketplace Coverage

To be eligible for ACA Marketplace coverage, an individual must be a U.S. citizen, U.S. national, or be lawfully present in the United States. Individuals who are not U.S. citizens or lawfully present are not eligible for Marketplace coverage.


Medicaid and CHIP Eligibility for Immigrants

Individuals may be eligible for Medicaid or CHIP if they are a U.S. citizen or have a "qualified" immigration status. However, many qualified immigrants must wait 5 years after receiving qualified immigration status before they can enroll in Medicaid or CHIP. In some states, lawfully present children and pregnant women may be eligible even without a "qualified" immigration status. State rules vary.


Marketplace Financial Assistance During the 5-Year Medicaid Wait

Clients who are in the 5-year waiting period for Medicaid or CHIP may still qualify for financial assistance for Marketplace coverage. The Marketplace application will determine whether the client qualifies for APTC and CSR based on income and household size.


Special Enrollment Period for Newly Lawfully Present Individuals

Clients who recently became lawfully present in the United States may qualify for a Special Enrollment Period (SEP) to enroll in Marketplace coverage outside of Open Enrollment.


Emergency Medicaid for Non-Eligible Individuals

Individuals who are not U.S. citizens or lawfully present may still be able to receive Medicaid coverage for emergency medical conditions, including labor and delivery.


Document Verification for Citizenship and Immigration Status

Clients may need to submit documents to the Marketplace to verify their citizenship or immigration status as part of the application process. The Marketplace states that this information will not be used for immigration enforcement purposes.


Additional Resources

HealthCare.gov/immigrants — Detailed information about Marketplace coverage for immigrants

Marketplace Call Center: 1-800-318-2596 (TTY: 1-855-889-4325)

For additional help please contact Producer Support, which is available by chat directly from your account, by phone at (866) 568-9649, or by email at [email protected].

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