US Immigration News

Why is Health Insurance So Important for Green Card Applicants?

5 minute read
"The changes introduced by the former Trump Administration to the “Public Charge rule” was mainly to reduce the number of people who were eligible for a Green Card, or officially called a Permanent Resident Card and other US visas, by redefining what made them dependent on government benefits or “likely” to be in the future. Meaning it will be difficult for immigrants to apply for permanent residence if they are receiving any social assistance provided by the US government. "
Written by My Visa Source Team
Published on:  Sep 8, 2021
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The changes introduced by the former Trump Administration to the “Public Charge rule” was mainly to reduce the number of people who were eligible for a Green Card, or officially called a Permanent Resident Card and other US visas, by redefining what made them dependent on government benefits or “likely” to be in the future. Meaning it will be difficult for immigrants to apply for permanent residence if they are receiving any social assistance provided by the US government. 

While the 2019 Public Charge Final Rule is no longer in effect, medical treatment in the US remains very expensive. Therefore to avoid receiving social benefits, it is always best to apply for health insurance. Your health insurance card will make or break your Green Card application. 

The US Department of State and the Department of Homeland Security have their versions of the public charge rule. Technically, the rules might be different, but there are many similarities. Public charge is considered as a grounds for inadmissibility to the United States. If you are likely to become a public charge, then the immigration official can deny your Green Card application. 

To avoid this, you must demonstrate that you have enough financial resources and adequate insurance to cover any medical expenses that may arise in the future to assure the immigration official that you will not become a public charge shortly. Health insurance cards are considered a good factor in demonstrating this. However, not having health insurance may work in a negative way for your application. 

What Is the Department of State Form DS-5540, Public Charge Questionnaire?

Due to the 2018 rule change, new immigrants were required to submit Form DS-5540, also known as the Public Charge Questionnaire. This questionnaire gathers information regarding your health and financial status to help the consular official determine the possibility of you becoming a public charge in the future. Applicants were required to prepare for this questionnaire before their interview and have any supporting documents and evidence ready to demonstrate their financial ability. 

Having a serious medical condition, especially anything that will cost a lot to treat, will require you to demonstrate that it is covered by your health insurance and your ability to pay for your medical expenses in the US. 

How to Apply for a Green Card from Inside the United States?

The US Citizenship and Immigration Service (USCIS) is responsible for processing Green Card applications from inside the US. Immigrants applying from inside the US are required to adjust their status. The USCIS has its guidelines regarding the public charge rule which is different from the State of Department’s guidelines. Though, it is still very similar. 

It is determined that you will not become a public charge in the future if:

  • You have private insurance for the expected period of admission
  • You are not receiving any subsidies under the Affordable Care Act (ACA) in the form of premium tax credits for this private health insurance

Not having private health insurance will be viewed as a negative factor if you have any serious medical conditions that will limit your ability to be self-sufficient. Instead of the DS-5540, you will be required to submit Form I-944, which is the USCIS’s version of the Public Charge Questionnaire. You will be required to disclose information regarding your financial status and health insurance coverage.

This will be reviewed by a USCIS officer who will determine if you have sufficient financial resources to not become a public charge. You may be required to demonstrate that you have resources to cover the following medical expenses:

  • A physical or mental condition that may require institutionalization
  • A medical condition that may hinder your ability to take care of yourself or attend school or work

Having the ability to pay for such medical expenses greatly improves your chances of your Green Card application being approved.

How to Apply for a Green Card from Abroad?

If you are applying for a Green Card from abroad, then your application will be processed by the US Department of State. They have strict guidelines for the consular officials to deny a Green Card application if it does not meet certain criteria.

In October 2019, former President Trump issued a “Presidential Proclamation on the Suspension of Entry of Immigrants Who Will Financially Burden the United States Healthcare System.” The consular officials require proof of the 1 of the following before approving your Green Card application:

  • You intend to buy health insurance within 30 days of entering the US
  • You have sufficient financial resources to pay for any anticipated medical expenses

Currently, this proclamation is halted by a federal court. President Biden intends to revert the rule to its previous guidelines. This means that adjustment of status applicants would no longer be required to submit Form I-944, Declaration of Self Sufficiency. However, most new immigrants will still be required to submit Form I-864, Affidavit of Support.

How to Make Health Insurance a Positive Factor for a Green Card Application

While health insurance is not a mandatory requirement when filing Form DS-5540 or USCIS Form I-944, it always affects your application positively. If you have anticipated higher medical expenses in the future, then having medical insurance may be crucial for your application.

You can get short-term medical insurance, however, if it is not possible to get coverage from an employer or family member’s employer coverage, then you may get a quote from another insurance provider in the US.

Once, you have received medical insurance, you will be required to submit the following information:

  • A copy of each policy page showing:
  • The terms and type of coverage and the people covered
  • The annual deductible or premium amount of health insurance and the documentation for the amount
  • Other evidence from the health insurance company that the noncitizen is currently enrolled in a health insurance plan including the terms and coverage
  • The most recent Form 1095-B, Health Coverage and Form 1095-C, Employer-Provided Health Insurance Offer and Coverage with evidence of renewal of coverage annually.

A health insurance card generally works fine as proof without the effective and expiration date. However, if you are 21 years of age or older and receiving Medicaid benefits, then it is considered negatively towards your Green Card application. 

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