Health insurance plays a crucial role in helping immigrants, including undocumented immigrants, access healthcare in NYC. Free and affordable health care can cover essential services such as preventive care, prescriptions and doctor’s visits. Additionally, it helps to lower the burden of paying out-of-pocket costs for medical services.
To assist immigrants in navigating the U.S. health insurance system and obtaining essential healthcare, Documented engaged with two insurance experts: Vivian Feng, Health Insurance Specialist within the Social Worker Department at Charles B. Wang Community Health Center and Luis Estevez, Linkage to Insurance Benefits Coordinator at Alliance for Positive Change. Their insights have been distilled into this article and presented in a Q&A format.
What types of health insurance coverage are available to immigrants in NYC?
While various forms of health insurance are available to immigrants in NYC, it’s important to note that there are limitations applicable to undocumented immigrants.
According to Feng and Estevez, documented immigrants lacking access to employer-provided health insurance might be eligible for specific programs based on household size, income, immigration status, and age. These programs include:
- Medicaid: Offering free health insurance to low-income adults and children, Medicaid can also provide retroactive coverage for unpaid medical bills within 90 days of eligibility request. New York residents of more than five years can enroll in Medicaid, qualifying for essential plans contingent on income.
- Essential Plan: For low-income adults who don’t meet Medicaid criteria, the Essential Plan delivers free or low cost insurance. Immigrants can qualify shortly after relocating to New York with a valid visa or deferred action status, but it doesn’t include DACA individuals.
- Child Health Plus: This plan provides free or low-cost health insurance for children under 19 without Medicaid or alternative coverage.
- Qualified Health Plan: Certified by the Health Insurance Marketplace and available directly from insurance companies, this option permits most immigrants to purchase private plans on the NY State of Health Marketplace, often with financial assistance. Any individual can buy private health insurance via insurers’ direct contact methods.
Estevez underscores that these coverages can be accessed via the state’s official health insurance marketplace at nystateofhealth.ny.gov. When individuals are employed and offered employer-sponsored health insurance, they should go through this option, particularly if the coverage is affordable.
Feng also highlighted that individuals aged over 65, who aren’t a parent or caretaker of minor children, as well as people who are covered by Medicare and people who are seeking Medicaid eligibility based on a disability, should pursue coverage application through New York City’s Human Resources Administration (HRA). For free enrollment assistance, individuals can contact 347-396-4705. Trained enrollers can aid in Medicaid application or renewal and help access programs to reduce Medicare costs. Alternatively, they can visit any of HRA’s Medical Assistance Program Offices.
Is it possible for undocumented immigrants to purchase health insurance through the New York State of Health marketplace?
Unfortunately, undocumented immigrants are ineligible to buy Marketplace health coverage. However, there are still options for them to access crucial healthcare.
- Undocumented immigrants aged 19 or older: they are qualified for Emergency Medicaid, which is based on income rather than immigration status. This program covers emergency scenarios such as severe cases or life-or-death situations, particularly through the ER.
- Pregnant women: they can access full Medicaid coverage.
- Children under 19: they are eligible for Child Health Plus coverage.
According to Estevez, undocumented immigrants might share Medicaid eligibility under specific circumstances, particularly if they’ve received parole or legal permission to reside in the U.S. For instance, approved asylum or refugee cases allow the involved immigrants to get insurance through the marketplace.
According to Feng, undocumented immigrants facing financial constraints in obtaining insurance can access healthcare through NYC Care. Although not a health insurance plan, NYC Care is a healthcare access program introduced by the city of New York. Its objective is to provide low-cost or free healthcare services to individuals who do not qualify for or cannot afford health insurance, including undocumented individuals. Estevez pointed out that to qualify for this program, individuals must be screened first by the marketplace to ensure they are not eligible for health insurance. Those who have Emergency Medicaid can also enroll in the program.
NYC Care provides primary and preventive care, women’s health, medications 24/7, eye care and glasses, specialty care, mental health, alcohol, tobacco, and substance use, support services for housing, food, and nutrition help. All NYC Care services are provided through NYC Health + Hospitals. Click here to check all the locations. Call its hotline at 646-NYC-CARE or visit its website for more information.
What is the process for applying for these health insurances and what documents are required?
Applying for health insurance entails two approaches: individuals can either apply independently through the New York State of Health Marketplace’s website or seek assistance from in-person advisors (navigators, certified application counselors, certified Marketplace facilitated enrollers). You can visit this navigator directory page to find a navigator that speaks your language in your area by entering your ZIP code and preferred language.
Regardless of the chosen method, it’s essential to have the following documents prepared:
- Social Security numbers. Feng noted that if applicants lack one, they need to undergo a proof of identity process with a navigator. Otherwise, obtaining health insurance from the Marketplace could be hindered.
- Birth dates
- Current employment and income details include pay stubs, tax statements, or W-2 forms. Feng recommended preparing pay stubs from the past year.
- Insurance cards for household members with existing health insurance
- A list of insurance plans accepted by your regular healthcare provider, if applicable
- Proof of address, which could include a utility bill or lease, etc.
- Contact information: phone number, email address
Documents demonstrating legal immigration status in the United States may include:
- Permanent Resident Card (Green Card/I-551)
- Employment Authorization Card (I-766)
- Naturalization Certificate
- Arrival/Departure Record (I-94 or I-94A)
- ORR Verification of Release Form (ORR UAC/R-1)
- US Visa with 1-94 Stamp
- I-797 USCIS Notice of Action
- I-549 USCIS Acknowledgment of Receipt (those seeking asylum)
Estevez noted that, for undocumented immigrants, particularly regarding ID proofing, an official government ID such as a foreign driver’s license, IDNYC, or foreign passport is typically required. When individuals lack appropriate documentation, there is an alternative route involving working with a navigator and potentially filling out a specific form. The form DOH-5090 from the Marketplace can help individuals complete the process without any ID.
Completing the application usually takes about 20 minutes, and upon completion, applicants receive eligibility results based on their unique circumstances. The service provided by navigators is entirely free of charge.
What resources are available for immigrants who need help navigating the health insurance system in NYC?
According to Estevez, the Linkage to Insurance navigators at the nonprofit Alliance for Positive Change assists immigrants with enrollment, renewals, and inquiries about their health insurance. They collaborate closely with NYC Care to streamline direct referrals and simplify enrollment. People can also search for navigators based on specific languages and ZIP codes on the New York State of Health Marketplace’s website. Alliance for Positive Change aims to ensure that anyone in New York can access health coverage through the marketplace or programs like NYC Care. They provide services in English and Spanish. Consumers looking for assistance in other languages can call the NYS of health marketplace 855-355-5777 and an agent will be able to utilize language services and translators to assist consumers.
Feng highlighted that undocumented immigrants without income can utilize NYC Care for common medical conditions. Federally qualified health centers/community clinics, like the Charles B. Wang Community Health Center, provide comprehensive primary care services regardless of an individual’s ability to pay, language proficiency, or immigration history. These centers may charge fees based on a sliding fee scale.
Charles B. Wang Community Health Center offers a range of services, including Internal Medicine, Pediatrics, OB/GYN, dental care, and mental health, across three locations in Flushing and Manhattan. They offer language options including Mandarin, Cantonese, Fukienese, and Taishanese to accommodate new immigrants who are not proficient in English. Charges are determined based on income without requiring immigration status information.