Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Enrollment and Subscriber
Program Area: Enrollment and Eligibility (ENR)
Question: Can an illegal immigrant enroll in private health insurance?
Answer: Per 45 CFR 155.305, only citizens, nationals of the United States, (US) or non-citizens who are lawfully present in the US are eligible to enroll in a QHP through the Marketplace. Per 45 CFR 147.104 (Guaranteed availability of coverage), a health insurance issuer that offers health insurance coverage in the individual or group market in a state must offer to any individual or employer in the state all products that are approved for sale in the applicable market, and must accept any individual or employer that applies for any of those products. CMS has interpreted this rule to mean that health insurance issuers offering qualified health plans through the individual market Marketplace generally must accept individuals in the applicable market who apply for coverage under such plans both when the application is received through the Marketplace and when it is received outside the Marketplace. Additionally, while the law prohibits coverage through the Marketplace from being available to individuals who are not lawfully present in the US, the same plans offered inside the Marketplace must be offered outside the Marketplace to any individual seeking health insurance coverage regardless of whether the individual is lawfully present. Therefore, an individual who is not lawfully present in the US cannot obtain individual market health insurance coverage through the Marketplace, but generally can obtain such coverage outside the Marketplace.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 27, 2014
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