Many others get coverage through an employer, a school, the Affordable Care Act (ACA) Marketplace, or a private plan—in the same way that most U.S. citizens do.
Everyone in the U.S., regardless of citizenship or immigration status, has the right, under federal law, to emergency medical treatment. That, however, is different from ongoing healthcare for preventative treatment or disease management.
Starting Oct. 1, 2026, some Medicaid and CHIP rules affecting noncitizens will change. CMS has outlined the main restrictions and exceptions, but it has also said more guidance is coming, so the impact may depend on your immigration status and the state where you live. These changes are tied to the 2025 federal law commonly called the One Big Beautiful Bill Act (OBBA).
Manifest Law breaks down who may qualify for public health programs, how immigration status affects eligibility, and what recent federal changes mean for noncitizens.
Key takeaways
The term “immigrants” can be used to refer to many different types of people living in the U.S. There are lawful permanent residents, nonimmigrants, asylees, refugees, undocumented immigrants, and others.
Some may be eligible for certain healthcare programs, but not all immigrants have access to the same health coverage options.
Although some people qualify for government programs or other lower-cost options, healthcare isn’t free for immigrants.
In many cases, a person must still meet eligibility rules for income and immigration status, and the coverage itself likely isn’t fully free. Some programs require copays or other out-of-pocket costs, while others only cover a limited amount of care, which is different from full, ongoing health insurance.
Eligibility can depend on an individual’s:
Medicaid is available to certain categories of immigrants, but they must also meet income requirements and other eligibility rules under federal and state law.
Medicaid is jointly funded by the federal government and states, but states run their own programs within federal rules. That means there are national baseline rules under federal law, but states have some flexibility to decide whether to cover additional groups or services.
According to the Congressional Research Service, qualified noncitizens who may be eligible for Medicaid include:
Even within these categories, not everyone can get Medicaid right away.
The five-year rule refers to the five years that many green card holders must wait before they can receive full federally funded Medicaid.
Certain individuals are exempt from the five-year rule, including, but not strictly limited to:
Whether someone is subject to the five-year rule differs significantly from one state to another, since federal law allows states to choose whether to cover some people.
In most cases, undocumented immigrants do not qualify for full federally funded Medicaid. They also are not generally eligible to enroll in marketplace coverage through Healthcare.gov. They may have access to limited emergency care and, in some places, limited state or local programs, but not the same broad coverage options available to many citizens or lawfully present immigrants.
This is despite the fact that a large portion of undocumented immigrants do file and pay taxes, using an ITIN number, even though they’re not eligible for a refund or many of the benefits funded by these taxes.
Federal Medicaid law does allow payment for limited emergency services for certain people who are otherwise ineligible for full Medicaid coverage, if they meet all the other Medicaid eligibility requirements in their state. This is commonly called Emergency Medicaid. It is not the same as full health insurance coverage, and it does not replace regular access to preventive or ongoing care.
Some undocumented immigrants may also be able to get emergency medical care through:
Nonimmigrants, including many people on work, student, or other temporary visas, don’t receive free public healthcare just because they’re in the United States.
Some may qualify as lawfully present for marketplace purposes, which can allow them to buy coverage through the ACA (also known as Obamacare) Marketplace if they meet the rules. But that is not the same thing as automatic free coverage.
Many nonimmigrants get health coverage through:
Many temporary workers, such as those on an O-1 visa or H-1B visa, and students purchase healthcare coverage through their employer or school.
For many immigrants and nonimmigrants who live and work in the United States, health insurance comes through a job, just as it does for American citizens.
Employer-sponsored plans are not free, but they may be subsidized because the employer often pays part of the premium. The employee may still have payroll deductions, copays, deductibles, and other out-of-pocket costs. That means this kind of coverage can be more affordable than buying a private plan through the marketplace, but it is not “free healthcare.”
State rules can make a major difference in what healthcare programs are available to immigrants living there.
Federal rules set the baseline, but states often have more generous options for certain groups or people. Some states also fund their own programs for residents who would not qualify for full federal coverage.
Immigrants seeking health coverage should always check the guidelines for programs run by the state where they live.
Here are a few examples of state or city programs:
The takeaway is that some areas offer broader state- or locally funded healthcare, while others mainly provide emergency-only coverage unless a person fits into a specific eligibility category.
Always check eligibility rules in your city and state. Medicaid and CHIP rules vary by state, but some states or cities offer more coverage than others. Some areas also offer local clinics that offer low-cost care if insurance isn’t available or programs for specific populations, such as children or refugees.
If you think you may qualify for Medicaid, CHIP, or another health coverage program, these are typically the first steps:
Health coverage rules often depend on a person’s immigration category. Whether someone is a green card holder, a nonimmigrant work visa holder, receiving asylum, an undocumented immigrant, or someone with a pending application can affect which benefits are available.
While immigration lawyers can’t serve as health insurance navigators, immigration status can shape what options exist in the first place.
Do green card holders get free healthcare?
Some green card holders qualify for Medicaid if they meet income and state eligibility rules, but many face a five-year waiting period unless they qualify for an exception.
Can undocumented immigrants get Medicaid?
Generally, undocumented immigrants are not eligible for full federally funded Medicaid, but they may qualify for emergency medical treatment.
Can immigrants get health insurance through work?
Yes. Many immigrants and nonimmigrants qualify for employer-sponsored health insurance.
Can visa holders buy health insurance in the U.S.?
Some lawfully present nonimmigrants may qualify for Marketplace coverage, and others may get employer, school, or private insurance.
This story was produced by Manifest Law and reviewed and distributed by Stacker.