New Immigrant Health Insurance: Options From Day One

New immigrant health insurance usually comes in stages. A short term bridge plan can cover new illnesses and injuries from the day you land, an employer or ACA Marketplace plan becomes your lasting coverage within the first weeks or months, and Medicaid and Medicare generally stay out of reach for about five years. The right mix depends on your age, your visa category, and whether you have health conditions that need ongoing care.

This guide maps every option and the rule changes that took effect in 2026. It is general information, not legal advice.

Key facts at a glance

• Marketplace access: HealthCare.gov states that lawfully present immigrants can buy Marketplace coverage, and that moving to the US from a foreign country can open a Special Enrollment Period.
• Medicaid waits: HealthCare.gov explains that most people with qualified immigration status face a five year waiting period for Medicaid and CHIP.
• State exceptions: KFF reports that as of April 2026, 38 states including DC cover lawfully residing children without the wait and 32 cover pregnant individuals.
• Subsidy rules changed: according to KFF, the 2025 budget law ended Marketplace subsidies for lawfully present immigrants with income under 100 percent of the federal poverty level from January 1, 2026.
• Bridge plans have limits: the new immigrant plans in Ombrela's catalog are travel medical plans that do not cover pre-existing conditions, apart from limited acute onset benefits on some plans.

What health insurance can a new immigrant get right away?

On arrival day you typically have no US coverage at all. Employer benefits have not started, a Marketplace plan begins on the first of a later month, and public programs are not yet available. A single emergency room visit in that window can be costly.

A bridge plan fills that window. These are short term travel medical policies bought for a set number of days or months, and several can start on the day you arrive. They pay for new, unexpected illnesses and accidents, usually through a PPO network, and can be cancelled when lasting coverage begins. You can compare new immigrant plans on Ombrela by arrival date and age.

Know what they are not. According to the plan catalog, the IMG Patriot plans and Trawick Safe Travels USA plans exclude pre-existing conditions, with acute onset benefits that shrink or disappear at older ages. They are not ACA compliant, they do not cover routine care or maternity in the way a Marketplace plan does, and they are written for people whose home country is still outside the United States. Carriers decide eligibility, so confirm it on the quote form, and do not expect to qualify once you have lived in the US for years.

Can new immigrants buy an ACA Marketplace plan?

Yes. Lawful permanent residents and most other lawfully present immigrants may enroll through HealthCare.gov or their state exchange. Marketplace plans cannot exclude pre-existing conditions and have no annual dollar cap on essential benefits, which makes them the durable choice for most families. HealthCare.gov lists moving to the US from a foreign country as a qualifying change, and Special Enrollment Periods generally run for 60 days, so do not wait for open enrollment.

Help with premiums is where the rules have tightened. Premium tax credits are available for incomes between 100 and 400 percent of the federal poverty level, according to HealthCare.gov. KFF reports that since January 1, 2026, lawfully present immigrants with income below that 100 percent floor no longer receive subsidized Marketplace coverage, and that from January 1, 2027 subsidies are limited to green card holders, Cuban and Haitian entrants, and people living in the US under the Compacts of Free Association.

For green card holders with moderate income, little changes. For a sponsored parent with almost no income of their own, the plan may now be full price. Our guide to the ACA Marketplace for green card holders covers documents and timing, and new immigrant insurance versus ACA plans compares the two side by side.

Why can't most new immigrants use Medicaid or Medicare?

Federal law places a five year waiting period on Medicaid and CHIP for most people with qualified status, including most green card holders. Refugees, asylees and green card holders who were formerly refugees or asylees are not subject to that wait, HealthCare.gov notes. KFF adds that from October 1, 2026 federal Medicaid eligibility is limited mainly to lawful permanent residents, Cuban and Haitian entrants and COFA residents, plus lawfully residing children and pregnant people in states that cover them. Read Medicaid eligibility for new immigrants for state detail.

Medicare is similar. A permanent resident aged 65 or older who lacks enough US work history generally must live in the US continuously for five years before buying into Medicare. Until then, an older immigrant needs private cover. See health insurance for green card holders over 65 and how the Medicaid bar affects immigrant parents.

How does new immigrant health insurance cost change with age?

Age is the largest driver of price on both bridge plans and Marketplace plans, and it also changes what a bridge plan will pay.

• Children and adults under 50: bridge plan premiums are at their lowest and plan choice is widest. Marketplace premiums are also lowest in this group.
• Ages 50 to 64: premiums rise steadily. A pre-existing condition becomes a stronger reason to move to a Marketplace plan quickly.
• Ages 65 to 79: bridge premiums are much higher and benefits narrow. The catalog shows that IMG's Patriot Plus offers acute onset cover only under age 70, and Trawick's Safe Travels USA Comprehensive reduces its acute onset benefit from age 70.
• Age 80 and over: options are thin. The catalog lists a $10,000 maximum for travelers over 80 on Patriot Plus and Patriot Lite, and the Safe Travels USA plans accept applicants only up to age 89.

Premiums change with age, months of cover, policy maximum and deductible, so use live quotes instead of fixed figures.

Which option fits your visa type?

• Spouses, parents and children arriving on immigrant visas: start a bridge plan on the entry date, then enroll in an employer or Marketplace plan inside the enrollment window. See immigrant visa health insurance.
• K-1 fiance visa holders: you arrive as a nonimmigrant and adjust status after marriage, so marriage itself can open a spouse's employer plan. See K-1 fiance visa insurance.
• Employment based immigrants: ask HR for the benefits start date. Federal rules cap employer waiting periods at 90 days, and a bridge plan can cover the interval.
• Parents aged 65 or older: price a Marketplace plan first if there is any chronic condition, and treat a bridge plan as temporary cover for new problems only.
• Anyone without a Social Security number yet: you can still apply for coverage. See health insurance without an SSN.

If you have lived in the US for a long time and lost coverage, for example after a layoff, a new immigrant bridge plan is not the right product. Look at COBRA, a Marketplace Special Enrollment Period, or a spouse's plan instead.

Who cannot buy a new immigrant bridge plan?

Eligibility is set by the carriers. According to the catalog, the IMG Patriot plans are not available to residents of Botswana, Cuba, Gambia, Ghana, Iran, Kosovo, Niger, Nigeria, North Korea, Sierra Leone, Syria or Venezuela, and cannot be purchased from New York. The Trawick Safe Travels USA plans exclude residents of a longer list that includes Australia, most European Union countries, the Dominican Republic, Haiti, Nigeria, Russia and Venezuela, and must be bought within 364 days of arrival.

If your home country appears on both lists, your bridge options through Ombrela are limited, and a Marketplace plan with the earliest possible start date is likely your main route. The plan finder shows what is open to you.

To keep the first months organized, download our free New Immigrant First 90 Days Coverage Plan below. It sets out what to arrange before the flight, the enrollment deadlines to track in weeks one to eight, and the checks to make for parents over 65.

How to get covered

Work in this order. Before you fly, get a new immigrant insurance quote with a start date that matches your arrival, and choose an end date a little beyond when you expect lasting coverage to begin. In your first week, ask any employer in the household about adding you to a plan. Within 60 days of arrival, apply at HealthCare.gov or your state exchange. Cancel the bridge plan only after the new plan is active.

On public charge, rules have been under review, so check the current USCIS guidance or speak with an immigration attorney before relying on any summary, including this one.

Frequently Asked Questions

Can a new green card holder get health insurance immediately?

Yes, through private options. A bridge plan can start on your arrival date and covers new illnesses and injuries. A Marketplace plan can be requested during the Special Enrollment Period that follows a move to the US, and usually begins on the first of a following month. Medicaid and Medicare generally involve a five year wait for most new permanent residents.

Do new immigrant plans cover pre-existing conditions?

No. The bridge plans in Ombrela's catalog exclude pre-existing conditions. Some include a limited acute onset benefit for a sudden, unexpected flare up, and that benefit is reduced or removed at older ages. If you need regular care or medication for an existing condition, an ACA Marketplace or employer plan is the appropriate coverage, since those cannot exclude pre-existing conditions.

How long can you stay on a new immigrant bridge plan?

These plans are sold for limited periods, generally up to 364 or 365 days at a time according to the catalog, with some allowing extensions. They are designed as temporary cover for recent arrivals. Plan to move to an employer or Marketplace plan within your first enrollment window, and keep the bridge plan only until that coverage is confirmed active.

Is health insurance required for new immigrants in the USA?

There is no federal penalty for being uninsured, though a few states apply their own coverage mandates to residents. The practical reason to insure is cost. US medical bills for an uninsured hospital stay can be very large, and public programs are generally unavailable for the first five years, so private coverage from day one protects your savings and your sponsor.

The first weeks set the pattern for everything after. Cover the arrival gap, enroll in lasting coverage before the window closes, and compare new immigrant plans on Ombrela to see what fits your age and dates.