Your Options at a Glance
Many undocumented immigrants and ITIN holders assume health insurance is simply off the table. In reality, how much coverage you can access depends heavily on which state you live in — but every person in the U.S. has at least some options.
Emergency Medicaid
Covers emergency medical conditions — ER visits, emergency surgery, labor and delivery — for income-eligible people regardless of immigration status. Available in every state. Does not cover routine or preventive care.
Community Health Centers (FQHCs)
Federally Qualified Health Centers serve all patients regardless of ability to pay or immigration status. Sliding-scale fees based on income — often $20–$40 per visit. Offer primary care, dental, mental health, and pharmacy. Find one at findahealthcenter.hrsa.gov.
Full State Medicaid (income-eligible)
A growing number of states have expanded Medicaid to cover income-eligible residents regardless of immigration status. If you qualify by income, you receive full health coverage including doctor visits, prescriptions, dental, and preventive care.
Private Health Insurance
You can purchase private health insurance directly from an insurer without an SSN. Many insurers accept ITIN or no tax ID at all. Coverage is more expensive than subsidized plans but provides comprehensive protection. Short-term health plans are a lower-cost alternative with limited benefits.
ACA Marketplace (Healthcare.gov)
Undocumented immigrants are not eligible to purchase plans on the ACA marketplace or receive premium tax credits — even if you pay taxes with an ITIN. Immigration status, not tax filing status, is the determining factor.
Medicaid — What's Available and Where
Emergency Medicaid (every state)
Federal law requires every state to provide Emergency Medicaid to people who meet the income requirements for regular Medicaid but are excluded due to immigration status. Emergency Medicaid covers:
- Emergency room visits and hospitalization
- Emergency surgery
- Labor, delivery, and postpartum care
- Emergency dialysis (in some states)
It does not cover routine doctor visits, preventive care, prescriptions, dental, or mental health outside of emergencies. Income limits vary by state — generally up to 138% of the federal poverty level.
Full Medicaid — states that have expanded
The following states have extended full or near-full Medicaid coverage to income-eligible residents regardless of immigration status. Eligibility details and income limits vary — check with your state's Medicaid office or a local enrollment navigator.
This list changes as states update their programs. Check coverageforall.org for the most current state-by-state breakdown.
Children often have more options
Even in states that haven't expanded adult Medicaid, many cover children regardless of immigration status through state-funded programs. If you have children, check your state separately — the rules for kids are often more generous than for adults.
Community Health Centers — Care Without Insurance
Federally Qualified Health Centers (FQHCs) are the most universal option. They are funded by the federal government to serve underserved communities and are legally required to treat all patients regardless of ability to pay or immigration status.
What they offer:
- Primary care (checkups, sick visits, chronic disease management)
- Dental care
- Mental health and substance use services
- Prenatal and OB/GYN care
- Prescription assistance
- Translation services
Fees are on a sliding scale based on your household income — uninsured patients typically pay $20–$40 per visit. No one is turned away for inability to pay.
Find your nearest health center: findahealthcenter.hrsa.gov — enter your zip code. There are over 14,000 health center sites across the U.S.
Private Insurance Without an SSN
If you don't qualify for Medicaid and want more comprehensive coverage than an FQHC can provide, private health insurance is an option. Many insurers sell plans directly without requiring an SSN — you can use your ITIN or simply leave the field blank in some cases.
What to look for
- Individual or family plans sold directly by insurers (not through Healthcare.gov)
- Short-term health plans — lower premiums but limited coverage, high deductibles, and no coverage for pre-existing conditions. Best as a bridge, not long-term coverage.
- Health-sharing ministries — not technically insurance, and can deny claims; approach with caution
- Employer-sponsored plans — if your employer offers health insurance, you may enroll regardless of immigration status; SSN is not legally required to enroll
⚠️ Understand what you're buying
Short-term plans and health-sharing ministries are not required to cover essential health benefits like maternity care, mental health, or prescriptions. Read the coverage details carefully before purchasing. A plan with a $10,000 deductible provides emergency-only protection and may not be worth the premium.
The ACA Marketplace — Why It's Not Available
The Affordable Care Act marketplace (Healthcare.gov) is not available to undocumented immigrants. This applies even if you:
- Have lived in the U.S. for many years
- Pay federal taxes with an ITIN
- Have U.S.-born children who are citizens
Eligibility for marketplace plans is determined by immigration status, not tax filing status. Some lawfully present immigrants — including certain visa holders, asylees, and refugees — are eligible for marketplace plans and subsidies. If your status has changed or you are in a mixed-status household, a certified enrollment navigator can help you understand what each family member qualifies for without jeopardizing anyone's status.
To find a free, confidential navigator: localhelp.healthcare.gov