State Health Coverage for Immigrants: What Programs May Be Available and How to Find Out If You're Eligible

Health coverage for immigrants in the United States depends heavily on which state you live in, your immigration status, how long you have resided in the country, your age, and your household income. Federal Medicaid and the Children's Health Insurance Program (CHIP) restrict eligibility based on immigration status — but a growing number of states have created their own programs, using state funds or federal Section 1115 waivers, that may extend coverage to people who are not eligible for federally funded benefits. Understanding which programs may be available to you — or to a family member — starts with knowing what each category of coverage actually covers and where the income thresholds fall.

Who Is Eligible for Federal Medicaid and CHIP?

Under federal law, most lawfully present immigrants must wait five years after receiving a qualifying immigration status before they can enroll in federally funded Medicaid or CHIP. This is commonly called the "five-year bar." Certain categories are exempt from this waiting period, including refugees, asylees, Cuban/Haitian entrants, and survivors of trafficking or domestic violence. Undocumented immigrants are generally not eligible for full Medicaid coverage under federal rules, though they may receive emergency Medicaid services.

For those who do meet immigration status requirements, federal Medicaid income eligibility is generally set at or below 138% of the Federal Poverty Level (FPL) for most adults in states that have adopted the ACA Medicaid expansion. CHIP covers children in families with incomes typically between 138% and 200% of FPL, though some states extend CHIP up to 300% or even 400% of FPL depending on the program design.

State-Funded Programs That May Fill the Gap

This is where the picture becomes more complex — and more hopeful for many families. According to research tracked by KFF (Kaiser Family Foundation), more than a dozen states have enacted programs that extend Medicaid-like or CHIP-equivalent coverage to immigrants who would otherwise be excluded by federal eligibility rules. These programs are funded entirely or partially with state dollars, which means they are not subject to the same federal immigration restrictions.

Coverage for Children

Children are the most widely covered group across state-funded immigrant health programs. States including California, Illinois, Massachusetts, New York, Oregon, Washington, and Colorado have extended comprehensive health coverage to children regardless of immigration status, often up to income thresholds of 200%–300% of FPL or higher. In California, for example, Medi-Cal (the state's Medicaid program) has been expanded to cover all income-eligible residents regardless of immigration status, including adults.

Coverage for Pregnant Individuals

Many states cover pregnancy-related care for immigrants who do not qualify for full Medicaid. Federally, "presumptive eligibility" for emergency Medicaid can cover labor and delivery, but several states go further by offering full prenatal, delivery, and postpartum care through state-funded programs. States such as New York, Illinois, and Washington have robust coverage for pregnant individuals regardless of documentation status, typically up to 200% of FPL.

Coverage for Adults

Adult coverage is the most variable. California's full Medi-Cal expansion to all income-eligible adults regardless of immigration status is the most comprehensive in the country. Other states offer more limited programs — covering specific age groups (such as adults 55 and older or young adults up to age 26) or restricting coverage to certain immigration categories. If you are an adult immigrant without documentation, your options depend almost entirely on your state of residence.

What About the ACA Marketplace?

Undocumented immigrants are not eligible to purchase coverage through the Affordable Care Act (ACA) Health Insurance Marketplace, even without subsidies. However, lawfully present immigrants — including those with Deferred Action for Childhood Arrivals (DACA) status in states that have chosen to extend eligibility — may be able to enroll in Marketplace plans and, depending on income, may qualify for Advanced Premium Tax Credits (APTCs) if their income falls between 100% and 400% of FPL (or higher under current enhanced subsidy rules). DACA recipients were made eligible for Marketplace coverage through a 2024 federal rule, though legal challenges have continued in some jurisdictions.

Federally Qualified Health Centers: A Safety Net Regardless of Status

If you are uninsured or uncertain about your eligibility for any program, Federally Qualified Health Centers (FQHCs) — also called Community Health Centers — are required to serve all patients regardless of immigration status, insurance coverage, or ability to pay. They operate on a sliding-fee scale based on income, meaning your out-of-pocket cost is adjusted to what you can afford. Services typically include primary care, preventive care, dental, mental health, and prescription assistance. You can find the nearest FQHC through the Health Resources and Services Administration (HRSA) at findahealthcenter.hrsa.gov.

Required Documents When Applying

Documentation requirements vary by program and state, but commonly requested items include:

• Proof of identity (passport, consular ID, or state-issued ID)
• Proof of state residency (utility bill, lease agreement, or bank statement)
• Proof of income (pay stubs, employer letter, or self-employment records)
• Immigration documents, if applicable (visa, I-94, Employment Authorization Document, or other status documentation)
• Social Security Number, if you have one (not always required for state-funded programs)
• Proof of household size (birth certificates for children, marriage certificate if applicable)

If you are applying for a state-funded program that does not require immigration documentation, the application may ask only for identity and residency proof. Ask your local Medicaid office or enrollment navigator what is specifically required for the program you are applying to.

Privacy Protections: What You Should Know

Many people in immigrant families hesitate to apply for health coverage due to concerns about immigration enforcement. It is worth knowing that most state Medicaid agencies have explicit data-sharing restrictions that limit what information can be disclosed and to whom. Applying for health coverage is generally not considered a "public charge" determination factor under current federal guidance for most immigration benefit applications, though this area of law has seen changes and legal challenges in recent years. Consulting with an immigration attorney or accredited representative before applying is advisable if you have specific concerns about your case.

How to Find Out What May Be Available in Your State

Because eligibility rules, program names, and income thresholds change frequently, the most reliable next step is to contact your state Medicaid agency directly or work with a certified application counselor or navigator in your area. Navigators are trained, federally funded assistants who can help you understand your options at no cost. You can also visit Benefits.gov to search for programs by state and household situation.

If you submit any inquiry form or request assistance online, note that by providing your contact information you may be consenting to be contacted about available programs — review any consent language carefully before submitting.

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Program eligibility and availability vary by state. Not affiliated with any government agency.

Last reviewed: May 2026