Sat, 07/09/2022 - 19:22

Health insurance for undocumented immigrants

Non-citizens are more likely to be uninsured than citizens. But by far, citizens without insurance represent the bulk of the uninsured in America not undocumented people.

♦ Currently 44 million Americans are uninsured and another 38 million have inadequate health insurance.

It is estimated that there are 10.5 million undocumented immigrants residing in the U.S. This number has been in decline since 2007.

About two-thirds of undocumented immigrants have been in the U.S. for more than 10 years.

♦ It is estimated that 45% of undocumented immigrants (4.7 million) are uninsured, while 23% of lawfully present immigrants are also uninsured.

These numbers are large but they do not justify the fear stories pushed by many people.

What can undocumented people do?

Undocumented immigrants have limited access to health insurance and medical care. The Affordable Care Act does not change this.

Undocumented immigrants can apply for private health insurance but they cannot receive any financial help. Premium tax credits are only available to legal immigrants.

♦ Undocumented individuals cannot purchase health insurance through the Marketplace or any of the state run exchanges.

Undocumented individuals may apply for coverage on behalf of documented individuals, such as their children who may have been born in the U.S.

Medicaid & Public Services

Some Individuals are eligible for Medicaid payment for services in situations defined as emergencies in the Medicaid law, including labor and delivery.

There are no immigration status requirements for some public health services including immunizations.

There are no immigration status requirements for services provided by:

• Federally Qualified Health Centers

These centers or clinics are usually limited to preventive and primary care not specialty care.

• Migrant and rural health centers

• Hospital charity care

Federal law requires hospitals to screen and stabilize every patient that seeks emergency care.

• Some states provide coverage of prenatal services to women regardless of immigration status.

A few states and local governments extend health coverage to undocumented children and / or some non-citizen adults using state funds.

• Undocumented individuals can sign up for employer-sponsored insurance if their employer offers it. Usually these are low-wage jobs with employers who cannot afford to subsidize health insurance policies for their workers.

Buy insurance directly

Undocumented individuals may purchase insurance from insurance companies directly.

♦ Undocumented immigrants are often employed in low-paying jobs, making it a challenge to afford coverage due to their limited incomes and lack of subsidies to offset premium costs.

► Every insurance company has its own rule for approving an application but generally immigration status is not a requirement.

• Proof of address and some form of identification will be requested.

• Most insurance companies will ask for a social security number but undocumented individuals will not have this.

• An alternative is an Individual Taxpayer Identification Number (ITIN).

An Individual Taxpayer Identification Number, is a tax processing number. It is for nonresident and resident aliens who cannot get a Social Security Number (SSN). It is a 9-digit number, beginning with the number "9", formatted like an SSN (NNN-NN-NNNN).

► To obtain an ITIN, you must complete an IRS Application for Individual Taxpayer Identification Number, Form W-7.

The Form W-7 requires documentation substantiating foreign /alien status and true identity for each individual.

Present the completed form at an IRS walk-in offices, or process your application through an Acceptance Agent authorized by the IRS.

• Acceptance Agents are authorized by the IRS to assist applicants in obtaining ITINs.

They review the applicant's documentation and forward the completed Form W-7 to IRS for processing.

• They charge a rather hefty fee to verify the application but using an agent that speaks the applicant's language may be worth the money.