Eligibility and Immigration

Most Immigrants Are Required to Have Health Coverage

Under the Affordable Care Act, most individuals who are U.S. citizens, U.S. nationals or lawfully present immigrants are required to have health coverage. There is a tax penalty — known as the “shared responsibility payment” — for those who do not have health coverage and do not qualify for an exemption.

Lawfully present individuals in the United States generally include:

  • U.S. citizens and U.S. nationals.
  • Lawful permanent residents or (“green card holders”).
  • Lawful temporary residents.
  • Persons fleeing persecution, including refugees and asylees.
  • Other humanitarian immigrants, including those granted temporary protected status.
  • Non-immigrant Status holders (including worker visas and student visas).

See www.healthcare.gov/immigrants/immigration-status for more information and for a full list of the groups that are considered lawfully present.

Individuals who are not lawfully present are exempt from the requirement to have health insurance. They must apply for an exemption directly with the Internal Revenue Service (IRS) on their federal income tax return.

Immigrants Can Apply for Health Care Coverage Through Covered California

Both lawfully present and not lawfully present individuals can apply through Covered California to see if they are eligible for health plan options through Covered California or Medi-Cal. Immigrants who are notlawfully present are not eligible to purchase a health plan through Covered California; however, they may be eligible for coverage through Medi-Cal.

For lawful permanent residents who are seeking health insurance coverage through Covered California or Medi-Cal, there is no “waiting period” or “five-year bar.”

Immigrants who are not lawfully present can apply through Covered California to see if they are eligible for health plan options through Medi-Cal, although the benefits may be limited. Immigrants who are not lawfully present can also buy private health insurance coverage on their own outside of Covered California. Additionally, some counties offer other health care options for which immigrants who are not lawfully present might qualify.

Individuals who are under Deferred Action for Childhood Arrivals (DACA) are not considered lawfully present. They are not eligible to purchase a Covered California health plan or receive financial assistance. However, they are not required to pay a tax penalty if they lack health insurance. These individuals may also be eligible for Medi-Cal and can apply for Medi-Cal through Covered California or at a county Medi-Cal office.

Immigrants Can Receive Financial Assistance to Help Pay for Their Health Care Coverage

U.S. citizens, U.S. nationals and lawfully present individuals who meet all other eligibility requirements, such as California state residency, may be eligible to purchase a health insurance plan through Covered California and may be eligible for financial assistance.

Annual household income is calculated by the income of the taxpayer, the taxpayer’s spouse (if any) and any child or dependent of the taxpayer who is required to file a tax return. Individuals who have not filed federal taxes in the past may still be eligible for financial assistance, but they must agree to file taxes for the upcoming tax year (under a Social Security number or an Individual Taxpayer Identification Number [ITIN]).

Immigrants Not Lawfully Present Can Apply on Behalf of Their Lawfully Present Family Members

Individuals who are not lawfully present may apply for coverage through Covered California for their lawfully present family members (such as a dependent child), who may be eligible for coverage through a Covered California plan or through Medi-Cal.

Additionally, Covered California encourages any U.S. citizen or person who is lawfully present to apply for health care coverage through Covered California even if they have family members in their household who are undocumented or not lawfully present. Families with mixed immigration status can still apply for health coverage through Covered California.

Immigrants Seeking to Enroll in Health Insurance Coverage Through Covered California Will Be Asked for Information to Verify Their Immigration Status

The law requires lawfully present individuals who enroll in a Covered California health plan to show proof of lawful presence.

Covered California only requires the immigration status of the person who is seeking the health coverage. Family members who are not applying for health coverage for themselves will not be asked for their immigration status.

All information provided by individuals who are applying for coverage through Covered California — and other health care exchanges — will not be used for any purpose other than to confirm eligibility and ensure the efficient operation of the health care exchange. For more information, see the letter from U.S. Immigration and Customs Enforcement at www.ice.gov/doclib/ero-outreach/pdf/ice-aca-memo.pdf.

Documents Used to Verify Enrollment Into Covered California

If a consumer wants to enroll in health coverage through Covered California but does not want to apply for financial assistance, either because they do not want help paying for their health coverage or because they do not think they qualify for financial help, all they need to provide is:

  • Their Social Security number, if they are a U.S. citizen; or, if they do not have a Social Security number or are a lawfully present individual, their corresponding documentation information (for example, a copy of a U.S. passport, a certificate of naturalization, a certificate of citizenship, a U.S. birth certificate and a photographed identification card, or proof of lawful presence). View the list of acceptable immigration documents for proof of lawful presence.

If a consumer is seeking financial assistance to help them pay their monthly health insurance premium costs, they will be asked to provide additional information during the enrollment process, to verify their income, as well as their citizenship and residency. This information includes:

  • Social Security numbers or proof of citizenship, or document information for lawfully present individuals, as described above.
  • Employer and income information for everyone in the consumer’s household.
  • Federal tax information.

Commonly Used Immigration Documents

For a list of examples of commonly used immigration documents, please click here.

Immigration VISAS Immigration VISAS

Getting Help With Enrollment

If an individual needs in-language assistance applying for health insurance coverage through Covered California, or help submitting documents to verify their lawful presence status, they may call (800) 300-1506 (TTY: [888] 889-4500) to get help from Covered California’s Service Center or visit Find Local Help to find free, confidential, in-person assistance from a Covered California Certified Enrollment Counselor or Certified Insurance Agent near them.

Immigration Status and Eligibility fact sheet