Immigrant Visa Health Insurance: IR-1, CR-1 and IR-5

Health coverage does not start when you are admitted on an immigrant visa, and most new permanent residents cannot use Medicaid or Medicare in their first years. The usual plan for IR-1, CR-1 and IR-5 immigrants is a bridge plan that starts on the port of entry date, followed by an employer or ACA Marketplace plan within your special enrollment window. You do not need to wait for your green card or Social Security number to enroll in the Marketplace.

Here is how to set up arrival day coverage, what to expect in your first 90 days, and how the timing differs for spouses and parents.

Key facts at a glance

• Your visa is proof of status: HealthCare.gov lists a machine readable immigrant visa with temporary I-551 language as a document you can use to apply, before the green card arrives.
• Green card by mail: USCIS states that you will not receive your green card until you pay the USCIS Immigrant Fee, and asks you to contact it if the card has not arrived within 90 days of paying the fee or entering the US.
• Arrival can open enrollment: moving to the US from a foreign country can qualify you for a Marketplace special enrollment period, generally 60 days, according to HealthCare.gov.
• Public programs wait: most green card holders face a five year wait for full Medicaid, and Medicare Part A can be bought only after five years of continuous residence under 42 CFR 406.20.
• Some nationals cannot enter: Proclamation 10998 of December 16, 2025 suspends immigrant visa entry for nationals of a list of countries, including Nigeria, Syria, Haiti and Iran, with narrow exceptions.

What coverage do IR-1 and CR-1 spouses need on arrival?

IR-1 and CR-1 visas are for spouses of US citizens; the CR-1 is issued when the marriage is less than two years old at admission and leads to a conditional green card. Health coverage works the same for both. If your US citizen spouse has employer coverage, the fastest long term option is often to join that plan, but the federal special enrollment right is tied to the date of the marriage, not your arrival, so a marriage that took place abroad months earlier may be outside the window.

That is why many couples buy a bridge plan for the arriving spouse and then choose between the employer plan, if it allows enrollment, and a Marketplace plan using the arrival special enrollment period. Our guide to health insurance for an immigrant spouse covers the employer rules and HR paperwork step by step.

What about IR-5 visa health insurance for parents?

IR-5 visas are for parents of US citizens who are at least 21. Parents are often over 65, so the gap is larger: they are too old for many low cost plans and cannot buy Medicare until they have lived in the US continuously for five years. The realistic plan is a bridge plan from arrival and an ACA Marketplace plan within 60 days, which can cover pre-existing conditions that a bridge plan excludes.

Age limits matter when choosing the bridge plan. The plan catalog lists IMG Patriot Platinum for ages up to 99 and Trawick Safe Travels USA Comprehensive for ages up to 89, and both reduce or remove acute onset benefits for older travelers. For a full budget, read our guide to health insurance cost for elderly immigrant parents.

When do the green card and SSN arrive, and why does it matter?

After admission, USCIS mails your green card to the US address you gave the State Department, once the Immigrant Fee is paid. Many immigrant visa applicants also ask for a Social Security number on their visa application, and the card is then mailed after arrival. Both can take weeks.

Neither is required to start coverage. A bridge plan is bought with your passport and US address. For the Marketplace, your stamped immigrant visa works as status evidence, and federal rules require an SSN only from applicants who already have one. Add the number when it arrives. Our guide to health insurance without an SSN explains the switch over.

How do you set up a bridge plan before you land?

Buy before you fly, and set the start date to your expected port of entry date. According to the plan catalog, IMG's Patriot plans begin once you have left your home country and are in transit to, or have entered, an eligible destination, and they can also be purchased after arrival. Trawick's Safe Travels USA plans must be purchased within 364 days of arrival, so they suit recent arrivals rather than long term residents.

• Check your eligibility first: Trawick's plans exclude residents of many European countries, Australia and the Dominican Republic, among others. IMG Patriot plans exclude citizens of Botswana, Gambia, Ghana, Kosovo, Niger, Nigeria and Sierra Leone and cannot be bought from New York.
• Choose the length: buy enough months to reach the first day of your Marketplace or employer plan, with a small buffer. Both carriers allow extensions within their limits.
• Choose the limits: a higher policy maximum and lower deductible raise the premium. Our guide to choosing a deductible and policy maximum helps you balance the two.

What medical records should you bring?

Your immigrant medical exam and vaccination records are part of your visa file, but keep your own copies. Also pack a summary of any ongoing conditions from your doctor, a list of current medications by generic name and dose, and a supply of medication to last until your US plan starts. Bridge plans do not cover pre-existing conditions, so a new US doctor will rely on these records, and you will pay for ongoing prescriptions yourself until a Marketplace or employer plan begins.

Nationals of countries listed in Proclamation 10998 should check travel.state.gov before planning coverage, as immigrant visa entry is currently suspended for them with narrow exceptions. This article is general information, not legal advice; confirm immigration questions with official sources or an attorney.

Download our free Immigrant Visa Arrival Coverage Checklist below. It lines up your port of entry date and coverage start, the SSN and green card timeline, bridge plan setup, the Marketplace window, the records to carry, and a first 90 days plan.

How to get covered

Pick your entry date, then compare plans that accept your age, citizenship and prior country of residence on our new immigrant insurance quote page. Premiums depend on age, length of coverage, policy maximum and deductible, so compare live quotes. After you land, apply for Marketplace coverage within your special enrollment window so the bridge plan only has to cover a few months.

Frequently Asked Questions

Do I need health insurance to enter the US on an immigrant visa?

Coverage does not come with the visa, and you are responsible for any medical bills from the day you arrive. Most new permanent residents cannot use Medicaid or Medicare in their early years, so a bridge plan from the port of entry date followed by an employer or Marketplace plan is the common approach. Check travel.state.gov for current requirements for your visa category.

Can IR-5 parents get Medicare or Medicaid when they arrive?

Generally not. Under 42 CFR 406.20, a green card holder aged 65 or older can buy Medicare Part A only after five years of continuous US residence, and most green card holders face a five year wait for full Medicaid. IR-5 parents usually rely on a bridge plan at arrival and an ACA Marketplace plan, which can cover pre-existing conditions.

Can I apply on HealthCare.gov before my green card arrives?

Yes. HealthCare.gov lists a machine readable immigrant visa with temporary I-551 language as an accepted document, so your stamped passport works before the card arrives. Apply within your special enrollment period, generally 60 days after moving to the US. If you do not have an SSN yet, you can apply without one and add it once it arrives.

When should my bridge plan start and end?

Start it on your expected port of entry date, so the flight and first days are covered. End it on or after the first day your Marketplace or employer coverage starts, with a short buffer. Marketplace coverage chosen during a special enrollment period usually starts on the first of a following month, so a bridge of two to three months is common.

Arriving is the start of a new chapter, not a coverage gap. Compare new immigrant plans on Ombrela for your port of entry date, then follow your checklist through the first 90 days.