Answer Source: Healthcare.gov

Lawfully present immigrants are eligible for coverage through the Health Insurance Marketplace®.

The term “lawfully present” includes immigrants who have:

“Qualified non-citizen” immigration status without a waiting period (see details below) Humanitarian statuses or circumstances (including Temporary Protected Status, Special Juvenile Status, asylum applicants, Convention Against Torture, victims of trafficking) Valid non-immigrant visas.

Legal status conferred by other laws (temporary resident status, LIFE Act, Family Unity individuals) See a full list of immigration statuses eligible for Marketplace coverage.

Lawfully present immigrants and Marketplace savings

If you’re a lawfully present immigrant, you can buy private health insurance on the Marketplace. You may be eligible for lower costs on monthly premiums and lower out-of-pocket costs based on your income.

If your annual income is 400% of the federal poverty level or below: You may be eligible for premium tax credits and other savings on Marketplace insurance.
If your annual household income is below 100% federal poverty level: If you’re not otherwise eligible for Medicaid you’ll be eligible for premium tax credits and other savings on Marketplace insurance, if you meet all other eligibility requirements.

Immigrants and Medicaid & CHIP

Immigrants who are “qualified non-citizens” are generally eligible for coverage through Medicaid and the Children’s Health Insurance Program (CHIP), if they meet their state’s income and residency rules.

In order to get Medicaid and CHIP coverage, many qualified non-citizens (such as many LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after receiving "qualified" immigration status before they can get Medicaid and CHIP coverage. There are exceptions. For example, refugees, asylees, or LPRs who used to be refugees or asylees don’t have to wait 5 years.

The term “qualified non-citizen” includes:

• Lawful Permanent Residents (LPR/Green Card Holder)
• Asylees
• Refugees
• Cuban/Haitian entrants
• Paroled into the U.S. for at least one year
• Conditional entrant granted before 1980
• Battered non-citizens, spouses, children, or parents
• Victims of trafficking and his or her spouse, child, sibling, or parent or individuals with a pending application for a victim of trafficking visa
• Granted withholding of deportation
• Member of a federally recognized Indian tribe or American Indian born in Canada

Medicaid & CHIP Coverage for Lawfully Residing Children and Pregnant Women

States have the option to remove the 5-year waiting period and cover lawfully residing children and/or pregnant women in Medicaid or CHIP. A child or pregnant woman is "lawfully residing" if they’re "lawfully present" and otherwise eligible for Medicaid or CHIP in the state. Learn how someone is defined as lawfully present.

Twenty-nine states, plus the District of Columbia and the Commonwealth of the Northern Mariana Islands, have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant women without a 5-year waiting period. Twenty-one of these states also cover lawfully residing children or pregnant women in CHIP. Find out if your state has this option in place.

Getting emergency care

Medicaid provides payment for treatment of an emergency medical condition for people who meet all Medicaid eligibility criteria in the state (such as income and state residency), but don’t have an eligible immigration status.

Medicaid, CHIP, and “public charge” status

On February 24, 2020, new U.S. Citizenship and Immigration Services (USCIS) regulations apply to the definition and factors for “public charge” status. These regulations outline how USCIS will determine whether applications for admission to the United States or applications for adjustment to immigration status will be denied because the applicant is likely at any time to become a public charge.

Use of public benefits could be considered a negative factor in a public charge inadmissibility determination. This means it could affect your chances of admission or adjustment of status.

Enrollment in a Marketplace plan (with or without premium tax credits) is not a public benefit under the public charge final rule.
For children under age 21 and pregnant women, enrollment in Medicaid or the Children’s Health Insurance Program (CHIP) won’t be considered to be a public benefit under the public charge rule.
But for some foreign national adults, enrollment in Medicaid may be considered a negative factor in a public charge inadmissibility determination.

If you think this might impact you, contact USCIS directly before continuing your Marketplace application. It’s important to understand how these changes might affect you. For more information on what it means to be a public charge, visit USCIS’s website or call U.S. Citizenship and Immigration Services at 1-800-375-5283. If you would like to, read USCIS’s public charge final rule (PDF, 1.5 MB).

Answer Source: Healthcare.gov

All plans offered in the Marketplace cover these 10 essential health benefits:

• Ambulatory patient services (outpatient care you get without being admitted to a hospital)
• Emergency services
• Hospitalization (like surgery and overnight stays)
• Pregnancy, maternity, and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)

Additional benefits

Plans must also include the following benefits:

• Birth control coverage
• Breastfeeding coverage

Essential health benefits are minimum requirements for all Marketplace plans. Specific services covered in each broad benefit category can vary based on your state’s requirements. Plans may offer additional benefits, including:

• Dental coverage
• Vision coverage
• Medical management programs (for specific needs like weight management, back pain, and diabetes)

When comparing plans, you’ll see exactly what each plan offers.

Answer Source: Healthcare.gov

• Information about your household size. Figure out who in your household will apply together before you start your application. Visit HealthCare.gov/income-and-household-information/household-size for help figuring out
  who needs coverage.
• Home and/or mailing addresses for everyone applying for coverage.
• Information about everyone applying for coverage, like Social Security Numbers and birth dates.
• Information about the professional helping you apply, if you’re getting help completing your application.
• Information on how you plan to file your taxes in 2021.
• Employer and income information for every member of your household (for example, from pay stubs or W-2s).
• Visit HealthCare.gov/income-and-household-information/income to learn more about what types of income to include and not include.
• Your best estimate of what your household income will be in 2021. Visit HealthCare.gov/income-and-household-information/how-to-report for help estimating your income.
• Policy numbers for any current health plans covering members of your household.
• A completed “Employer Coverage Tool” for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.) Visit HealthCare.gov/downloads/employer-coverage-tool.pdf to view or print the tool.
• Notices from your current plan that include your plan ID, if you have or had 2020 Marketplace coverage.
• Document information for legal immigrants and naturalized citizens.

Answer Source: Healthcare.gov

For plan years through 2018, if you have insurance from a job (or a family member’s job), you're considered covered under the health care law and may not have to pay the penalty that uninsured people must pay.

Starting with the 2019 plan year (for which you’ll file taxes in April 2020), the fee no longer applies.

Changing to a Marketplace plan

If you have job-based coverage, you might be able to change to a Marketplace plan. But you probably won’t qualify for a premium tax credit or other savings. As long as the job-based plan is considered affordable and meets minimum standards, you won’t qualify for savings. Most job-based plans meet these standards.

Learn about changing to a Marketplace plan.

Canceling a Marketplace plan when you get a job-based insurance offer

If you have a Marketplace plan and then get an offer of health insurance through a job, you’re probably no longer eligible for any savings on your Marketplace plan. This is true even if you don’t accept the job-based coverage offer.

You may want to cancel your Marketplace plan for yourself and anyone else in your household eligible for the new job-based coverage.

Learn how to end a Marketplace plan when you get a job-based plan.

More information about job-based insurance

• Options if you lose your job-based insurance
• COBRA coverage and the Marketplace

Your rights, protections, and benefits for job-based coverage

The health care law provides important new rights, consumer protections, and benefits that apply to most job-based insurance plans.

Learn about your rights and protections.

Learn about free preventive benefits.

Learn the rules that apply to Flexible Savings Accounts (FSAs) for job-based health insurance.

Answer Source: Healthcare.gov

For plan years through 2018, if you can afford health insurance but choose not to buy it, you may pay a fee called the individual Shared Responsibility Payment when you file your federal taxes. (The fee is sometimes called the "penalty," "fine," or "individual mandate.")

Starting with the 2019 plan year (for which you’ll file taxes by July 15, 2020), the Shared Responsibility Payment no longer applies.

Note: Some states have their own individual health insurance mandate, requiring you to have qualifying health coverage or pay a fee with your state taxes for the 2019 plan year. If you live in a state that requires you to have health coverage and you don’t have coverage (or an exemption):

• You’ll be charged a fee when you file your 2019 state taxes.
• You won’t owe a fee on your federal tax return.

Check with your state or tax preparer to find out if there is a fee for not having health coverage.

The fee for 2018 plans and earlier

• You may owe the fee for any month you, your spouse, or your tax dependents don't have qualifying health coverage (sometimes called "minimum essential coverage"). See all insurance types that qualify.
• You pay the fee when you file your federal tax return for the year you don’t have coverage.
• In some cases, you may qualify for a health coverage exemption from the requirement to have insurance. If you qualify, you won't have to pay the fee. Learn about health coverage exemptions.

The fee for 2019 plans and beyond

• If you don’t have coverage during 2019, the fee no longer applies. You don’t need an exemption in order to avoid the penalty.
• If you’re 30 or older and want a “Catastrophic” health plan, you may want to apply for an exemption. See details about exemptions and catastrophic coverage.