Medicaid rules for undocumented immigrants vary sharply by state
Federal Medicaid law bars most undocumented immigrants from coverage. However, a growing number of states have used their own funds to extend Medicaid to undocumented adults, and a few cover undocumented children. What you can receive depends entirely on which state you live in, not on your immigration status alone.
The federal government pays roughly half of all Medicaid costs; states pay the rest and set their own rules within federal limits. States that extend coverage to undocumented immigrants do so using state money only, which is why the programs exist in some places and not others.
As of 2024, California, New York, Illinois, Washington, Minnesota, and a handful of other states cover undocumented adults through Medicaid. Several more cover undocumented children or pregnant people. The list changes as states pass new laws, so the first step is to contact your state Medicaid office or a local health center to learn what your state currently covers.
Key Takeaways
- Federal Medicaid does not cover undocumented immigrants, but some states use their own money to extend coverage to undocumented adults, children, or pregnant people.
- Which groups are covered and under what income limits depends entirely on your state; you must contact your state Medicaid office or a local health center to find out what is available where you live.
- Even in states that do not cover undocumented immigrants through regular Medicaid, emergency services and pregnancy-related care are often covered under federal law.
- Your immigration status is not reported to immigration authorities when you seek Medicaid; health centers and Medicaid offices operate under confidentiality rules.
Which states cover undocumented immigrants and what they cover
California covers undocumented adults of all ages through Medicaid (called Medi-Cal in California). New York covers undocumented adults earning up to a certain income threshold. Illinois, Washington, Minnesota, and Massachusetts also cover undocumented adults, though income limits and exact coverage vary. New York, California, Illinois, and several other states cover undocumented children regardless of age.
Because state programs change when legislatures pass new laws, the coverage available in your state may have changed recently. The most reliable way to find out what your state covers is to call your state Medicaid office directly or visit a community health center in your area. You can also text your zip code to 211 to reach a local referral service that knows which programs are currently active in your region.
Some states that do not cover undocumented immigrants through regular Medicaid still cover emergency medical conditions and pregnancy-related services under federal law. This means you may be able to receive treatment for a heart attack, severe injury, or childbirth even if you do not otherwise may have access to for Medicaid in your state.
Income limits and what documents you need
Income limits for undocumented immigrants in states that do cover them are usually the same as for citizens — typically around 138% of the federal poverty line for adults, though this varies by state and by which group (children, pregnant people, or adults) you belong to. In 2024, 138% of the poverty line for a single adult is roughly $1,900 per month, but this number changes yearly and differs by state.
When you contact your state Medicaid office or a health center, ask them for the current income limit for your situation. They will tell you what counts as income (wages, self-employment, cash assistance) and what does not (some types of support from family or community organizations).
You will need to show proof of income, such as recent pay stubs, tax returns, or a letter from an employer. You will also need to prove you live in the state where you are applying. A utility bill, lease, or letter from a shelter or community organization can serve as proof of residence. You do not need a Social Security number in states that cover undocumented immigrants; these states use an Individual Taxpayer Identification Number (ITIN) or a state ID number instead.
How to apply in a state that covers undocumented immigrants
Contact your state Medicaid office or visit a community health center and ask whether your state covers undocumented immigrants. If it does, ask them to walk you through the application. Many states allow you to apply online, by mail, or in person at a local office.
Bring the documents listed above: proof of income, proof of residence, and identification (a passport, state ID, or driver's license). If you do not have a Social Security number, tell the staff member — they will use an ITIN or state ID number instead. The application process usually takes two to four weeks.
Some community health centers and nonprofit organizations help people apply for Medicaid for free. If you are unsure where to start, text 211 and your zip code, or call 211 from any phone, to reach a local referral service. They can tell you which health centers and nonprofits in your area help with Medicaid applications.
What happens if your state does not cover undocumented immigrants
If you live in a state that does not extend Medicaid to undocumented immigrants, you may still be able to receive emergency care and pregnancy-related services. Federal law requires states to cover emergency medical conditions for anyone, regardless of immigration status. This includes heart attacks, strokes, severe injuries, and other life-threatening situations.
Pregnancy-related care, including prenatal visits, delivery, and postpartum care, is also covered in most states even for undocumented immigrants. Some states cover family planning services as well. Ask a health center or your state Medicaid office which services are covered in your state.
If you need ongoing care for a chronic condition like diabetes or high blood pressure, you may be able to receive treatment at a community health center on a sliding fee scale. This means you pay based on your income — the lower your income, the less you pay. Community health centers exist in most areas and do not ask about immigration status.
Privacy and immigration concerns
Medicaid offices and health centers operate under strict confidentiality rules. Information you provide when you apply for Medicaid is not shared with immigration authorities. The Health Insurance Portability and Accountability Act (HIPAA) and state privacy laws protect your medical information and your application records.
However, if you are detained by immigration authorities for reasons unrelated to your Medicaid application, they may be able to obtain your records through a legal process. Medicaid itself does not report you or share your status with anyone. If you have concerns about your specific situation, you can speak with a legal aid attorney or an immigration lawyer before applying; many offer free consultations.
Frequently Asked Questions
Will applying for Medicaid hurt my immigration case?
Medicaid is not considered a "public charge" — meaning it does not count against you in most immigration proceedings. However, immigration law is complex and your situation may be unique. Before applying, consider speaking with an immigration attorney or calling a legal aid hotline in your state. Many offer free consultations and can tell you whether Medicaid is safe for your specific case.
Can I use Medicaid to see any doctor?
Medicaid in most states requires you to choose a primary care doctor or use a managed care plan. Not all doctors accept Medicaid, so when you receive your Medicaid card, you will get a list of doctors and clinics in your plan. Community health centers almost always accept Medicaid and are a reliable option if you have trouble finding a doctor.
What if I have a child born in the United States?
Children born in the United States are U.S. citizens and are covered by federal Medicaid regardless of their parents' immigration status. Your child can receive Medicaid coverage based on your household income. You do not need to worry about your own status affecting your child's coverage. Many states also cover undocumented children separately, so your child may have coverage even if you do not.
How long does it take to get Medicaid after I apply?
Most states make a decision within two to four weeks of receiving a complete application. Some states are faster; a few take longer if they need more information from you. Ask your state Medicaid office for an estimate when you apply. You can usually check the status of your application online or by calling the office.
What if I earn too much to may have access to?
If your income is above the limit, you may still be able to receive care at a community health center on a sliding fee scale. You may also be able to receive emergency services and pregnancy-related care. Ask a health center or your state Medicaid office what other options are available for people whose income is above the Medicaid limit.