wife eligible for medicaid

Is Pregnant Wife Eligible For Medicaid With Green Card?

It’s no surprise that health insurance is ridiculously expensive in the United States, but you may be wondering “is my pregnant wife eligible for Medicaid?”. There are a few circumstances that affect an immigrants eligible for state benefits including Medicaid.

First, before we can figure out whether your pregnant wife is eligible for Medicaid, we need to know what it is.

Medicaid is state managed health program for eligible individuals and families with low incomes and resources. It is a means-tested benefit that is jointly funded by the states and the federal government.

Each state may have its own name for the program. Examples include “Medi-Cal” in California, “MassHealth” in Massachusetts, and “TennCare” in Tennessee.

Case Example:

Daniel has applied for his wife’s green card using I-485 adjustment of status. His wife Abigail arrived on a work visa from Ireland and got married after dating for a year. After she received her green card they found out they were expecting their first child.

But Daniel is concerned about the medical expenses since he is self-employed and his wife doesn’t have health insurance yet. He considers having her apply for medicaid but is unsure whether she would qualify.

You would be surprised how often this scenario plays out today. There are many immigrants who can’t afford health insurance but need medical assistance that can be very costly.

Since the U.S. citizen signed form I-864 affidavit of support, it may be difficult to then turn around and get the U.S. government (or the State) to fork over money to cover a health emergency.

Read this article if your wife is pregnant while the green card application is pending.

Are Green Card Holders Eligible For Medicaid?

If you arrived in the U.S. as a permanent resident (green card holder) or adjusted status, you likely qualify for Obamacare, but not Medicare.

I’m sure you’re wondering why this is so sit tight and I’ll explain further.

Qualifying for Medicaid isn’t black and white. It actually depends on where you live. Since Medicaid is a state-run program that is also funded by the Federal government it can vary across the country.

If you can’t afford the insurance premiums through Obamacare (Affordable Care Act), you will qualify for a federal subsidy. If you don’t have health insurance that year for your pregnant wife, you may face penalties.

So, what can you do if you can’t afford health insurance for your pregnant wife but you aren’t sure if she qualifies for Medicaid?

Well, as a green card holder, she would qualify for Medicare (a federal health insurance program) if:

  • Has worked in the United States for a total of 40 quarters — 10 years.
  • U.S. citizens and lawful permanent residents at least age 65, who have been here five years.
  • May buy-in to Medicare and can choose to participate in Medicare or buy Obamacare insurance.

As you can see, this leaves very little options to immigrants that are new to the U.S. and haven’t been permanent residents for 5 years yet.

Since Medicaid is a need-based health insurance program for people with little or no income. In some states, you can’t get full Medicaid until you have been a permanent resident for 5 years.

But, here’s the important thing to know: You can get Medicaid reimbursement for emergency services.

In some states, including New York, all permanent residents who meet the income qualifications can get Medicaid. You can get more information about Obamacare and eligibility at https://www.healthcare.gov/immigration-status-and-the-marketplace/.

Is Medicaid A Means-Tested Benefit To USCIS?

Okay, so before talk about what means-tested benefits are when it comes to USCIS, let’s find out who is considered a qualified alien:

  • Legal Permanent Residents
  • Asylees
  • Refugees
  • Aliens paroled into the U.S. for at least one year
  • Aliens whose deportations are being withheld
  • Aliens granted conditional entry (prior to April 1, 1980)
  • Battered alien spouses, battered alien children, the alien parents of battered children, and alien children of battered parents who fit certain criteria
  • Cuban/Haitian entrants
  • Victims of a severe form of trafficking

Eligibility of Qualified Aliens for Medicaid

States have the right to decide the eligibility for Medicaid of most qualified aliens who arrived in this country prior to August 22, 1996.

Most permanent residents who entered the U.S. on or after 8/22/96 are barred from receiving Medicaid for the first 5 years after their entry.

Exceptions To The 5 Year Ban on Medicaid:

  • Immigrants who are receiving SSI benefits if Medicaid is related to SSI receipt.
  • Refugees and Asylees, whose deportation is being withheld.
  • Amerasians, and Cuban/Haitian entrants, and victims of a severe form of trafficking.
  • Legal Permanent Residents who have worked 40 qualifying quarters of coverage (10 years).
    • After 12/31/96, no quarter can be considered a qualifying quarter if the individual is receiving a federal means-tested public benefit.
    • Quarters worked by parents (if you were a child), or by a spouse while married, can be counted towards the 40 quarter requirement.
  • Exception for certain Indians.
  • Veterans, members of the military on active duty, and their spouses and unmarried dependent children.


Does Form I-864 Affects Medicaid Eligibility

When you sign form I-864 as the U.S. citizen sponsoring your wife’s petition for permanent residence, you guarantee the U.S. government that you will financially support her.

Form I-864 is a legally enforceable document that can be used against you in court if your pregnant wife uses any means-tested benefits that she doesn’t qualify for.

This is why it’s important to know whether your pregnant wife is eligible for Medicaid before applying for it.

I’ve seen cases where someone didn’t qualify for Medicaid but applied and got approved. Years later, after an audit, the state found out that they never qualified in the first place and required them to reimburse the state for all benefits received.

Case Example:

Sebastian filed for the I-485 for his pregnant wife who was approved two months short of her due date. Sebastian is a student and is currently on his parent’s insurance plan. He makes very little money so therefore, can’t afford to buy her insurance in the marketplace.

Sebastian lives in New York where permanent residents do qualify for Medicaid so he decides to apply for her. She is approved and is able to give birth at a hospital without any medical bills.

Although not all states allow green card holders to get Medicaid without the 5 year residency requirement, you should always double check before applying for benefits.

Final Thoughts If Wife Eligible For Medicaid

So, now that we’ve reviewed the eligibility requirements for means-tested benefits, is your wife eligible for medicaid? If you’re unsure, check with your state’s Medicaid office to get a final answer.

If you do qualify, and you meet the income restrictions, consider applying as soon as possible to be sure the application is approved before the baby arrives.

Being pregnant is stressful enough, but add to that the thought of not being able to pay your medical bills can really send you over the edge.

If the U.S. spouse is employed and has insurance through their employer, you may want to add your pregnant wife due to a qualifying event (marriage).

Health insurance is mandatory in this country and it’s in your best interest to get some type of coverage before a medical emergency. There are countless stories of families going bankrupt because of medical bills and not being covered.

I’ll be honest with you though, having insurance or coverage doesn’t mean you pay nothing. Unless you are truly in need (for example extreme poverty), it’s likely you will need to pay something out of pocket.

As a new immigrant, there are many restrictions on green card holders using public benefits. By know what you are allowed and not allowed to use will protect your family financially in the future. The last thing you want is the U.S. government coming after you in court.

Wondering if your wife eligible for Medicaid? Have you check your states restrictions and exceptions? Let me know in the comments below.

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