For green card holder, understanding the healthcare system in the United States can be a complex and daunting task, especially when it comes to finding the right health insurance coverage.
With so many different types of insurance plans available, it can be challenging to determine which ones you are eligible for and which ones provide the best coverage for your needs as new immigrants to the U.S.
In this article, we’ll explore the different types of availalbe health insurance for green card holders. We will also provide information to help you make an informed decision about your healthcare coverage.
Can a Green Card Holder Get Medical Insurance?
Yes, green card holders, also known as lawful permanent residents, are generally eligible to purchase health insurance in the United States. You can choose to purchase insurance through your employer (Employer-Sponsored Health Insurance), through a government program (such as Medicare or Medicaid) if you meet the eligibility requirements, or you can purchase individual health insurance plans on the private market.
Let’s take a closer look at each type of health insurance plan for you as a green card holder.
Types of Health Insurance Options Available for Green Card Holders
Green card holders in the United States have various options for medical insurance. Depending on your medical needs, you will be able to find the right plan for you and your family. Here are three main types of medical insurance for your consideration:
Individual Health Insurance
You may purchase individual health insurance plans from private insurance companies. These plans can be purchased through the Health Insurance Marketplace or directly from insurance companies.
Employer-Sponsored Health Insurance
Many green card holders are eligible to participate in group health insurance plans offered by their employers. These plans may provide coverage for the employee and their families on medical, dental, vision care, as well as prescription drugs.
Government-Funded Health Insurance Program
There are federal and state programs, such as Medicaid and Medicare, that provide medical insurance coverage to low-income individuals and families, and for people with certain disabilities or end-stage renal disease. Green card holders who have worked in the U.S. for at least 10 years and paid Medicare taxes during that time may be eligible for Medicare. If you hold a green card and are under 65 with a disability, you may also be eligible for Medicare.
Are You Eligible for Medicaid or Medicare?
Eligibility for Medicaid and Medicare is based on certain factors, such as household income, family size, and disability status. Eligibility criteria and rules vary by state, and benefits can change over time. Some states have expanded their Medicaid programs to cover more low-income adults, including some green card holders who meet the income requirements.
If you are interested in Medicare or Medicaid coverage for you and your family, you should check the eligibility requirements for your specific situation and state of residence. You may contact your local Social Security Administration Office to learn more about Medicare eligibility and your state’s Medicaid Agency or Health Insurance Marketplace to learn more about Medicaid eligibility.
What is Marketplace Health Insurance?
If a green card holder is not eligible for employer-sponsored health insurance, Medicare, or Medicaid, they can purchase an individual health insurance plan on the Health Insurance Marketplace established by the Affordable Care Act (ACA).
The Marketplace offers a range of health insurance plans with different levels of coverage and costs. Green card holders may be eligible for premium subsidies or cost-sharing reductions based on their income and household size.
How to Choose a Health Insurance Plan That Fits You Best?
Choosing a health insurance plan for you and your family can be a difficult and overwhelming process for many people. The complexity of the domestic healthcare system, confusing terminology, high costs, provider networks, and your family’s medical needs can all contribute to the difficulty.
With so many options available, it can be challenging to determine which plan offers the best value. Knowing a few tips and pointers before comparing medical plans can make your life a lot easier.
Here, let us discuss the most important factors that are worth considering when comparing plans:
Health Coverage
First things first, you’ll want to understand the scope of coverage offered by each of the plans you are considering. This includes benefits such as doctor visits, hospitalization, prescription drug coverage, preventive care services, mental health services, etc.
For example, doctor visits should include routine check-ups, consultations with specialists, and visits to urgent care clinics. When it comes to hospitalization, make sure you understand the coverage of hospital stays, surgeries, and other medical procedures that require inpatient care.
If you need medication prescribed by doctors, make sure to check if the plan covers the specific drugs you need and if there are any restrictions or limitations.
Specialty care, such as vision and dental, rehabilitation services, mental health services, maternity care, etc., are also important items check and understand how they are covered by your plan and whether there is any limitation on pre-existing conditions coverage. You will be glad you did so when you are in need of such services.
Medical Cost
Apart from medical coverage, how to evaluate your budget and determine which plan offers the best value for your needs? The cost-sharing features of each plan can be complicated and confusing to many of us. Here you may find below an explanation of the most common insurance costs terminology helpful:
Monthly Premium –
The amount you pay each month to maintain your health insurance coverage
Deductible –
The amount you must pay out of pocket for covered medical expenses before your insurance starts paying.
Copayments –
A fixed amount you pay for certain medical services, such as a doctor’s visit or prescription drug.
Coinsurance –
The percentage of the cost of a covered medical service that you are responsible for paying after you meet your deductible.
Out-of-pocket maximums –
The most you will have to pay out of pocket for covered medical expenses during a plan year, after which the insurance company pays all covered expenses.
Provider Network
Always check the provider network to ensure that you have access to the medical providers you need.
For in-network providers, it is important to learn which doctors, hospitals, and specialists are included in the plans. Make sure they are in the areas where you live, work, and travel. They generally have negotiated rates with the insurance company, which can result in lower costs for you. When there is a need to visit out-of-network providers that are not included in the plan’s network, you may be responsible for paying more out-of-pocket costs.
If you or any of your family members need special health care, please remember to check whether the plan requires you to select a primary care physician and whether your preferred physician is in the plan’s network. You’d also like to understand if there are any restrictions on which pharmacies you can use.
Customer Service & Flexibility
Do not underestimate the quality of health insurance customer service. You’d appreciate their assistance with plan selection and policies, explanation of claims and billing issues, helping you find a specialist or scheduling appointments, etc. their guidance.
The policies of each insurance provider can change, as can the medical needs of you and your family. While making a plan selection, be sure to consider how flexible the plan is in terms of changing providers or modifying coverage throughout the year.
Can You Add Your Immigrant Spouse and Children to Your Health Coverage?
Yes, in most cases, you can add your immigrant dependents to your health coverage.
Many employers and insurance providers offer family coverage, which allows you to include your spouse and children on your health insurance plan. You can typically include them on your plan during your company’s open enrollment period if you have an employer-sponsored plan or during the annual open enrollment for your private insurance plan.
Are There Any Options for Children's Health Insurance Programs?
If you are looking for health insurance programs for your children, there are several children’s specific health insurance programs available for lawful permanent residents including green card holders. Note that eligibility requirements and benefits for these programs may vary by state and by individual circumstances. Green card holder families who are uninsured or underinsured should explore these programs to see if they qualify for coverage.
Medicaid, as discussed above, provides health coverage to low-income individuals and families including children. If you are eligible for Medicaid coverage, generally your children can be included as well.
Children’s Health Insurance Program (CHIP) is a federal and state program that provides health insurance coverage to children from low-income families who do not qualify for Medicaid. Eligibility for CHIP is also based on income and other factors such as family size and state residence. That is pretty much similar to Medicaid but at a lower entry level.
TRICARE is also another health insurance program specifically designed for military families, including children of active-duty service members, retired service members and their dependents.
Can I Get Health Insurance While Waiting For a Green Card in the United States?
People residing in the U.S. waiting for their green card can also get health insurance to ensure they have access to the medical coverage they need.
If you are not already covered by the health insurance offered by your employer, you may purchase your own on the Health Insurance Marketplace platform that we mentioned earlier.
Short-term health insurance plans provide temporary coverage for a limited period of time, typically up to 12 months. These plans may be a good option if you are waiting for your green card and need coverage for a short period of time.
If you recently lost your job and had employer-sponsored health insurance, you may be eligible for COBRA continuation coverage. COBRA allows you to continue your employer-sponsored health insurance plan for a limited period of time after you leave your job.
Best Health Insurance For Green Card Holders
Now that you may have the most relevant information required to choose the right health insurance plan that has the best value for your medical needs and green card holder status.
Remember, healthcare policies, rules, and costs can change over time. It is very important to stay informed so that you can adjust your plan according to your needs as time goes by. It is a good idea to consult with a healthcare professional or insurance agent who would be able to help determine the best coverage options for your specific needs.
Disclaimer: This article provides general information and should not replace professional medical advice. Consult a healthcare professional for personalized recommendations for your specific healthcare needs.
