Medicaid rules for undocumented immigrants vary by state

Federal Medicaid law bars undocumented immigrants from most Medicaid coverage, with a few narrow exceptions. However, many states have used their own funds to extend Medicaid to undocumented residents anyway — so what you can get depends entirely on where you live.

The federal government pays for most Medicaid, but states can add their own money to cover people the federal program excludes. Some states have chosen to do this for undocumented immigrants. Others have not. This means two undocumented immigrants with identical health needs and income can have completely different coverage options depending on which state they live in.

The only Medicaid services available to undocumented immigrants in every state are emergency services — meaning care for a sudden, serious condition that requires when ready treatment to prevent death or serious harm. Emergency Medicaid covers the hospital visit and related care, but only for that emergency.

Key Takeaways

  • Federal Medicaid does not cover undocumented immigrants except in medical emergencies, but many states use their own money to extend coverage.
  • Emergency Medicaid is available in all states and covers sudden, serious conditions that need when ready care to prevent death or serious harm.
  • States that extend Medicaid to undocumented immigrants often cover pregnancy, childbirth, and children under a certain age, though the details differ by state.
  • You can find out what your state covers by contacting your state Medicaid office or a local health center that serves uninsured patients.
  • Some states also offer separate programs for undocumented immigrants that are not called Medicaid but work similarly.

Which states cover undocumented immigrants with state-funded Medicaid

As of now, California, Illinois, New York, and Washington have extended Medicaid to undocumented adults using state funds. Several other states cover undocumented children or pregnant women. The list changes as states pass new laws, so the coverage available in your state may have changed recently.

California covers undocumented adults of all ages through its state Medicaid program. New York covers undocumented adults age 65 and older, and also covers undocumented children and pregnant women. Illinois covers undocumented children and pregnant women. Washington covers undocumented children and pregnant women. Other states may cover one or more of these groups but not others.

Because these rules change, the best way to find out what your state covers is to call your state Medicaid office directly or visit your state's Medicaid website. You can also contact a community health center in your area — they work with uninsured and undocumented patients regularly and know the current rules.

Emergency Medicaid in all states

Emergency Medicaid covers the cost of emergency care when you have a sudden, serious medical condition. It is available to undocumented immigrants in every state, regardless of immigration status or income. The catch is that it only covers emergencies — not routine care, preventive care, or ongoing treatment for chronic conditions.

An emergency is defined as a condition serious enough that without when ready care, you would be in serious danger of death, loss of bodily function, or serious harm to your health. A broken bone, chest pain, severe bleeding, difficulty breathing, sudden loss of consciousness, and active labor are examples of emergencies. A cough that has lasted a week, a rash, or back pain that started yesterday are not emergencies under this definition, even if they are uncomfortable.

To use Emergency Medicaid, go to a hospital emergency room. Tell the staff you do not have insurance. The hospital will determine whether your condition is an emergency. If it is, Medicaid will cover the emergency care and related hospital stay. You do not need to have a Social Security number or proof of citizenship to receive Emergency Medicaid.

Pregnancy and childbirth coverage in some states

Many states cover pregnancy, childbirth, and postpartum care for undocumented women, even if they do not cover other services. This includes prenatal visits, delivery, and care for 60 days after birth. The states that offer this coverage vary, so you will need to check with your state Medicaid office to know whether you are covered.

If your state covers pregnancy care for undocumented women, you can usually get it by contacting your state Medicaid office, a community health center, or a hospital maternity department. You will likely need to provide proof of pregnancy (such as a positive pregnancy test or a letter from a doctor), proof of income, and proof of residence in the state. You will not need to provide a Social Security number or proof of citizenship.

Children's coverage in some states

Several states cover undocumented children under Medicaid, usually up to age 18 or 19. Coverage typically includes doctor visits, hospital care, prescription drugs, and preventive care like vaccinations and checkups. The income limits and exact services covered vary by state.

To find out whether your state covers undocumented children, contact your state Medicaid office or a school nurse — schools often have information about health coverage for students. If your state does cover undocumented children, you can usually explore through your state Medicaid office or a community health center. You will need to provide proof of the child's age, proof of residence in the state, and proof of household income. You will not need a Social Security number or proof of citizenship.

Alternative programs in some states

Some states offer health coverage programs for undocumented immigrants that are not technically Medicaid but work similarly. California's Medicaid program for undocumented adults is state-funded but uses the same rules and covers the same services as regular Medicaid. New York has a separate program called the Emergency Health Insurance Plan for undocumented immigrants age 65 and older.

These programs are often harder to find information about because they are not called Medicaid and are not part of the federal Medicaid system. If you live in a state known to cover undocumented immigrants and cannot find information through the state Medicaid office, try calling a community health center or a hospital social worker. They can tell you what programs exist in your area and how to get coverage.

How to find out what your state covers

The fastest way to find out what Medicaid coverage is available to you is to call your state Medicaid office directly. You can find the phone number by searching "[your state] Medicaid" online or by calling 211, which is a free helpline that connects you to local health and human services.

When you call, tell them you are asking about coverage for an undocumented immigrant and ask what services are available. Have ready your state of residence, your age or the age of the person you are asking about, and your approximate household income. You do not need to provide your name or any identifying information to get this information.

You can also visit a community health center in your area. These centers serve uninsured and undocumented patients and know the coverage rules in your state. Many offer free or low-cost care regardless of immigration status or ability to pay, so even if you do not may have access to for Medicaid, they may be able to help you.

Frequently Asked Questions

Will using Medicaid hurt my immigration case?

Using Emergency Medicaid will not hurt your immigration case. Using other Medicaid benefits may affect your case if you are in immigration proceedings, because immigration officials can consider whether you have used public benefits. However, many states have laws that protect Medicaid use and do not report it to immigration authorities. Contact a local immigration attorney or a legal aid organization before using non-emergency Medicaid if you are in active immigration proceedings.

Can I get Medicaid if I have a work permit or DACA?

If you have a work permit, DACA, or another form of legal status, you may be able to get regular Medicaid depending on your income and your state's rules. Contact your state Medicaid office to find out. The rules are different for people with legal status than for undocumented immigrants.

What if I need ongoing care for a chronic condition?

If you have diabetes, high blood pressure, or another chronic condition and your state does not cover undocumented immigrants, a community health center can often provide ongoing care at a reduced cost based on your income. Call 211 to find a health center near you, or search online for "federally may have access to health center" in your area.

Do I need a Social Security number to use Emergency Medicaid?

No. You do not need a Social Security number, proof of citizenship, or any immigration documents to use Emergency Medicaid. Tell the hospital staff you do not have a Social Security number, and they will help you explore for Emergency Medicaid using other information.

What counts as an emergency under Medicaid?

An emergency is a sudden, serious condition that requires when ready care to prevent death, loss of bodily function, or serious harm. Examples include chest pain, difficulty breathing, severe bleeding, broken bones, active labor, and sudden loss of consciousness. Conditions that developed slowly, like a cough lasting a week or chronic back pain, are not emergencies even if they are painful.