Health Insurance for Green Card Applicants

More than a million people immigrate to the United States every year. Getting a permanent residence card (Green Card) is a multi-step process. The person gets the green card after completing the last step, which can be different depending upon whether the person is physically in the U.S. or outside the U.S.

Those already in the U.S. (such as non-immigrant visa holders, for example) would file for an Adjustment of Status (Form I-485) with the USCIS, which is part of the U.S. Department of Homeland Security. Those outside the U.S. would go through Immigrant Visa (also called Consular Processing) at the U.S. Consulate or Embassy abroad, which is part of the U.S. Department of State.

The processes of adjustment of status and obtaining an immigrant visa are considerably different but still have many similarities.

Either way, the government would like to make sure that the persons immigrating to the U.S. will not be a burden to the government in various ways. For example, they like to make sure that the person has adequate resources or adequate health insurance during adjustment of status, in case they were to get sick or injured while in the U.S., as healthcare in the U.S. is very expensive. In other words, they would like to make sure that the person immigrating to the U.S. would not become a public charge, which is one of the grounds of inadmissibility under which the green card (permanent residence) can be denied. Therefore, it is very important for applicants to demonstrate they are not likely to become public charges.

Immigrant Visa (Consular Process) - Outside the U.S.

If the person is outside the U.S., they would need to get an immigrant visa at the U.S. Embassy or Consulate to immigrate to the U.S.

In October 2019, President Donald Trump issued an executive order that required all immigrant visa applicants to get health insurance valid for up to 364 days even before they are in the U.S. or have sufficient resources to pay for the reasonably anticipated medical expenses.

Even though the presidential proclamation was halted by federal court and is no longer mandatory, it is highly advisable to procure such health insurance. It can be considered a positive factor as the U.S. consular officer tries to determine whether the intending immigrant would become a public charge or not.

They may ask the applicant to submit Form DS-5540, the Public Charge Questionnaire. The form asks for information about your health, financial status, and other factors that can help the consular officers determine whether you are likely to become public charge. It is best to complete Form DS-5540 and keep it ready to bring to the immigrant visa interview to avoid any last-minute hassles. As part of completing DS-5540, you should procure appropriate health insurance.

This is even more important for older applicants, such as parents of U.S. citizens or anyone likely to face serious medical conditions later while in the U.S.

Adjustment of Status - Inside the U.S.

When applying for the adjustment of status (I-485) with the USCIS, applicants are subject to a public charge rule. They are required to submit Form I-944, Declaration of Self-Sufficiency, which is a Public Charge Questionnaire in which the applicant must provide details about their financial resources such as household incomes, assets, health insurance coverage, and their overall ability to pay for medical expenses after becoming an immigrant in the U.S.

Therefore, if the immigrant already has existing health insurance—such as through their employer or from the Affordable Care Act (ACA)—they should show that proof. If not, they can purchase insurance from this website as a proof.

Not having sufficient financial resources and not having health insurance can be viewed as major negative factors that can affect the outcome of the I-485 application.

Therefore, having health insurance is very important, and most immigration attorneys recommend that applicants get such insurance and enclose the proof.

Proof of Insurance

As proof of health insurance for non U.S. citizens, simply submitting a copy of your insurance card is not sufficient. The applicant should submit a letter on the insurance company’s letterhead, also called the confirmation of coverage letter or visa letter.

For most insurance plans purchased through website, you can download this letter instantly after the purchase from MyAccount.