Losing Medicare or Medicaid coverage can occur due to various factors, including non-payment of premiums, providing false information, or changes
in income or family circumstances. Likely, the optional Medicare and Medicaid benefits will get cut.
The Kaiser Family Foundation (KFF) offers Medicaid State Fact Sheets, which provide a snapshot of the most significant Medicaid data for every state. Click here to access KFF’s Medicaid State Fact Sheets.
The official website Medicaid.gov also contains a State Resource Center with tools, data, and resources that can help states manage their Medicaid programs. This website also contains a list of mandatory and optional benefits for Medicaid. Please use this resource to help differentiate the optional Medicaid services offered by each state.
Eligibility for Medicare and Medicaid as an immigrant is subject to certain conditions, typically their immigration status and time of stay in America. Undocumented immigrants are not eligible for federally subsidized coverage like Medicaid, CHIP, or Medicare. Depending on the state, undocumented non-pregnant adults younger than 65 years may still become eligible for Medicaid for emergency services if they meet other requirements.
For Medicare, lawfully present non-citizens are eligible if they receive or are eligible for Railroad Retirement or Social Security benefits. Green Card holders (lawful permanent residents) are ordinarily eligible for Medicare benefits if they have been a legal permanent residents in the United States for at least five consecutive years and are 65 years old or older, or meet disability criteria. New immigrants are not covered under Medicare directly, regardless of age, and must meet residency requirements prior to eligibility and enrollment being conducted like other residents.
For Medicaid, most immigrants must possess a “qualified” immigration status to be eligible. Some states pay for newly arrived immigrant children using “state-only” funds. Qualified immigrants usually must have legal permanent resident status for at least five years to qualify for Medicaid in the majority of states, though exceptions exist. Rules for health coverage vary among states for immigrant groups like lawfully residing children and pregnant women.
Starting January 1st, 2027, OBBBA directs Medicaid recipients aged 18 to 64 to prove that they work, volunteer, or attend school at least 80 hours a month to be eligible for coverage. This translates to a 20-hour weekly work or volunteering requirement for Medicaid enrollees starting January 1st, 2026. Unless an individual qualifies for exemption in Medicaid work requirements, they must be participating in "community engagement" activities to meet the 80-hour requisite.
Common exemptions from these work requirements include:
→ Alaska Native and American Indian individuals
→ Parents/guardians/caretakers of dependent children under 13 or disabled individuals
→ Pregnant individuals
→ Individuals under age 19
→ Individuals entitled to Medicare Part A/enrolled in Medicare Part B
→ Individuals with disabilities
→ Disabled veterans
→ Full-time caregivers
→ Individuals enrolled in a drug or alcohol rehabilitation program
→ Individuals incarcerated or released from incarceration within 90 days