Health Insurance for U.S. Immigrants

This article highlights some of the important considerations of immigrants to the U.S. when it comes to making health insurance choices and lists a few of the more popular low cost health insurance options available throughout most of the United States.  

Immigrants are more likely to be uninsured

Immigrants to the U.S. are twice as likely to be uninsured as other Americans. While 1 in 6 of all Americans lack health insurance, the ratio of uninsured immigrants is 1 in 3 according to the 2009 report by the Center for Immigration Studies. Stated another way, immigrants and their dependent children make up 17% of the total U.S. population but represent 32% of the total of those without health insurance. Illegal immigrants are even more likely to be uninsured. We estimate that as many as 2 out of 3 illegal immigrants have no health insurance.

Collectively, these indications suggest that immigrants are more likely to: 1) work in jobs that do not provide employer-provided health benefits, 2) have a low income, and 3) face language barriers, lack education and resources necessary to access affordable health insurance. It is important to realize that these three factors act in combination, rather than individually, to contribute to the high rate of uninsured immigrants. For example, college-educate middle income immigrants who could afford health insurance are almost as likely to be uninsured as other immigrants. In this respect, the situation is the same as with other uninsured Americans, where research indicate the lack of health insurance cannot be attributed solely to income or affordability of insurance (Note 1).

The most significant difference between uninsured immigrants and other uninsured Americans is the length of time without insurance. The majority of Americans without insurance remain uninsured for less than a year. In contrast, the Center for Immigration Studies found that 29% of immigrants who entered the US in the late 1980s are still uninsured almost two decades later. Chronically uninsured are less likely to access routine medical care and early screenings and this is suspected to contribute to greater (an more expensive) medical problems over the long term.

Despite these challenges, some type of affordable health insurance is available the the majority of immigrants, regardless of other factors.

Citizenship and social security number requirements

Despite popular notion to the contrary, citizenship is not a significant issue in qualifying for health insurance. Very few of our health insurance plans require U.S. citizenship (Note 2). In fact, most insurance applications do not ask about citizenship. Most domestic insurance plans do require applicants to have a social security number or tax identification number (TIN). A TIN is available to any person who does not qualify for a social security number, regardless of legal status, so this requirement should not be a deterrent to anyone who needs health insurance.

Legal and political considerations

State law - Health insurance in the United States is primarily controlled by state law. That means that their are 50+ variations on every topic associated with health insurance. For an incoming immigrant, the most important immediate consideration is that the location at the time of purchase affects the insurance choices available. Once a health insurance is issued it is equally valid in all states so the only  concern is the availability of the best insurance at the location of purchase. Whenever possible, an immigrant should consider the options of purchasing insurance before entering the U.S. Migratory immigrants like farm workers, for example, will find that health coverage to be more liberal and affordable in one state than another. Some states like New York limit the availability of the most attractive immigrant policies. In this case it is possible to obtain a better insurance value by purchasing insurance before relocating to New York state.
 
Medicaid - Currently about 4 million immigrant adults and about 5 million immigrant children are covered under the state Medicaid plans. These health benefits are increasingly at risk by state governments facing budget deficits. Most recently the Commonwealth of Massachusetts announced plans to drop Medicaid coverage for more than 400,000 immigrants. Budgetary problems are likely to persist  for the foreseeable future in many states so we expect this trend of cutting Medicaid eligibility for immigrants to continue.

Health insurance and immigration reform - President Obama vows that any health insurance reform eventually enacted will not apply to illegal immigrants. Meanwhile, the separate political debate continues on the best way to integrate those undocumented residents already living and working in our communities. Many believe that denying health coverage to any specific group is not only ethically wrong and impractical to enforce, it would ultimately be damaging to the rest of us as well. A recent New York Times editorial summed up this position stating "There is a line beyond which antipathy to the undocumented can be damaging to those voters' health, not to mention the federal budget".
 
Coverage for children - State Children's Health Insurance Plans (SCHIP) are available to the children of all low and middle income families regardless of legal status. While the number of uninsured children has decreased as a result of these programs, the children of low income illegal immigrants are least likely to access the subsidized coverage available through these programs. It is suspected that the fear of being "discovered" prevents parents from enrolling their children in SCHIP. Additional education an promotion of the programs, including the national "Cover Kids Now" campaign, appears to have had minimal impact in recruiting the children of illegal immigrants.
 

Popular health insurance plans for U.S. immigrants

The six most popular health insurance choices among immigrants using Freedom Benefits online enrollment service are listed below with a brief description of each option. Not all of these policies are available in all states. For full details on each option, follow the link to the online rate quoting pages that include full descriptions of coverage, definitions, exclusions and eligibility details.

1) Inbound Immigrant - a health insurance specifically designed for this purpose; provides up to 5 years of liberal coverage at an affordable price. This plan has a low annual deductible and includes maternity coverage. Maximum benefits are lower than most other types of domestic health plans. This combination of features makes this insurance the most popular choice among working class immigrants who buy their own health insurance.


2) HCC Life short term medical insurance is a domestic major medical insurance coverage. Enrollment support and policy contracts are available in both English and Spanish language. Coverage can be issued for up to six months on a month-to-month payment basis.

3) Patriot Exchange Program is ideal for exchange students attending a U.S. college or university. Coverage meets United States J1 travel visa requirements and can be extended for up to 4 years after entering the U.S.

4) Global Medical Insurance is a superior renewable major medical insurance that provides up to $8 million coverage worldwide that is suitable for individuals who expect to travel often or spend significant time in more than one country. Although this is the most expensive option listed on this Web page, it is less expensive than most U.S. domestic health insurance plans.

5) Value Med is a versatile mini-med plan paying up to $1,000 per day hospitalization and $75 for a doctor's visit, priced at about $75 per month for adult coverage.

6) Value ER is a simple supplemental policy that provides emergency coverage for accidents and injuries of $1,000 per person (or $2,000 per family) for a premium of $30 per month. This policy is unique in that the price for individual coverage is the same as the price for a whole family. We have noticed this policy being used by migrant farm workers who otherwise might not have any health coverage at all.

This article is meant to highlight just a few of the available insurance choices for immigrants. Browse the listings on this Web site for more options. Enrollment assistance with all of these affordable insurance plans is offered through OnlineAdviser service. Just send an e-mail to Onlineadviser@freedombenefits.net for personal assistance with any coverage questions.


Footnotes
Note 1- National Institute for Health Care Management (NIHCM) report titled "Understanding the Uninsured: Tailoring Policy Solutions for Different Subpopulations", April 2009.
Note 2 - One exception is American Health Shield insurance, a popular low cost short term medical insurance plan that is only available to U.S. citizens.

by Tony Novak, revised 11/10/2009