Six Ways to Get Health Coverage or Lower-Cost Care: A Guide for Newcomers

In the United States, health insurance helps pay for medical care. Coverage may come from a government program, your job, or a private insurance plan. Some health clinics may also offer free or lower-cost care to people without insurance.

If you do not qualify for Medicaid or the Children’s Health Insurance Program (CHIP), or if your coverage ends, you may have other ways to get health insurance or lower-cost care. Your options depend on your immigration status, income, age, household size, job, and the state where you live.

If you currently have Medicaid or CHIP, your state Medicaid or CHIP agency must review your eligibility and send you a notice before changing or ending your coverage. Make sure the agency has your current contact information, and respond to any notices by the deadline. For more information, read Changes to Medicaid and CHIP: A Guide for Newcomers. 

This guide describes six options for finding health coverage or lowering the cost of care. Rules vary by state and may affect each person differently. Ask a trusted health insurance navigator or resettlement provider what options may be available to you. Health insurance navigators are trained to explain your coverage options and help you apply at no cost.

1. Refugee Medical Assistance

Refugee Medical Assistance, often called RMA, provides short-term health coverage to some newcomers. You may qualify if you are eligible for services through the Office of Refugee Resettlement (ORR), do not qualify for Medicaid, and are still within the period when you may receive RMA.

RMA coverage may be available for up to 12 months after the date you become eligible for ORR benefits, depending on your eligibility date and whether you meet the program’s other requirements.

Ask your resettlement provider or state refugee health program:

• Do I qualify for RMA?
• When does my eligibility period begin and end?
• What doctors, medicines, and services are covered?

2. Medicaid or CHIP for children and pregnant people

Even if an adult in your family loses Medicaid, a child or pregnant family member may still qualify for Medicaid or CHIP. Eligibility rules and program names vary by state.

Contact your state Medicaid or CHIP agency to ask whether your state covers lawfully residing children or pregnant people through an option called CHIPRA 214 and how to apply. See which states offer this coverage on Medicaid.gov.

3. Health insurance through a job

Your employer or the employer of your spouse or parent may offer health insurance. Ask the employer or its human resources (HR) office:

• How much will be taken from each paycheck to pay for the health insurance plan?
• What is the deductible, or how much will I have to pay before the plan starts paying for many services?
• Can I continue seeing my current doctors, and are my medicines covered?
• When can I enroll if I lose Medicaid or CHIP?
• When will the new coverage begin?

Losing Medicaid or CHIP may give you a limited time to join an employer plan, so contact the employer as soon as you receive a notice saying your coverage will end.

4. Health Insurance Marketplace plans

The Health Insurance Marketplace is a place to compare and buy private health insurance plans online. Most states use HealthCare.gov; some states have their own Marketplace websites.

Your immigration status may allow you to buy a Marketplace plan. Beginning January 1, 2027, eligibility rules for federal help paying for a Marketplace plan will change for some non-U.S. citizens. Whether you qualify for this help depends on your immigration status, household income, and other circumstances.

Complete an application or speak with a health insurance navigator to find out what applies to you. Find assistance near you using the HealthCare.gov Find Local Help tool.

If you lose Medicaid or CHIP, you may be able to enroll in a Marketplace plan outside the regular enrollment period. This is called a Special Enrollment Period. Apply as soon as possible to help you stay covered.

For help, visit HealthCare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325). Free language assistance is available.

5. Community health centers and other low-cost clinics

You may be able to receive free or lower-cost care even if you do not have health insurance. Community health centers offer services such as checkups, treatment for common health problems, and care that helps prevent illness. They may lower their fees based on your income and family size.

Find a nearby community health center using the HRSA Find a Health Center tool. You can also search for a free or charitable clinic using the National Association of Free & Charitable Clinics’ Find a Clinic tool.

Your community may also have:

• County or city public health clinics
• Faith-based clinics
• Mobile clinics
• Hospital programs that may lower or cover the cost of care
• Programs for dental, vision, pregnancy, mental health, or prescription care

You can also call 211 or find your local 211 online to ask about community clinics and other health care resources near you. 

Before an appointment, ask whether the clinic can lower the cost of your care or offer other financial help, and what documents you should bring.

6. Help paying for prescriptions

If a medicine costs too much, tell your doctor or pharmacist. Ask whether:

• A lower-cost version of the medicine, called a generic, is available
• The clinic or pharmacy has a program that can help pay for the medicine
• The company that makes the medicine may offer a program to help pay for it
• A prescription discount card could lower the price if you pay without insurance

What if I need emergency care?

Call 911 or go to an emergency room if you have a life-threatening emergency. Do not delay emergency care to apply for Emergency Medicaid.

Some people who cannot receive full Medicaid because of their immigration status may qualify for Emergency Medicaid. To qualify, you must meet your state’s other requirements, such as income and residency rules. Emergency Medicaid pays only for certain emergency care. Ask the hospital or your state Medicaid agency how and when to apply and what care may be covered.

You still have options

If your Medicaid or CHIP coverage ends, you may qualify for another type of health insurance or lower-cost care. Start looking at your options as soon as you receive a notice saying your coverage will end. A health insurance navigator, resettlement provider, or state agency can help you understand your choices and apply.

This article provides general information and is not legal or medical advice. Health coverage rules can change and vary by state. For advice about your own case, contact your state Medicaid or CHIP agency, a health insurance navigator, or your resettlement provider.