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Healthcare for the Immigrant

Heiddy Chipollini

Keiser University

Abstract
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Most of the resident aliens and refugees that relocated to a developed country like the

United States come from places where the health care services are limited and infectious

illnesses such as malaria, tuberculosis, hepatitis, and parasitic diseases are rather

common. In order for them to be healthy in this country, they should make full use of the

extensive health care services that are available. The United States has many

organizations that offer refugee health care programs, and they provide the necessary

medical services as well as valuable advice on nutrition to ensure that refugees and

resident aliens will be able to lead a healthy and happy life. Many of these newcomers are

from countries are from countries where the natural culture is dramatically different from

that of the United States. It is important for healthcare providers to understand the special

challenges some of these patients have due to the stresses they have gone through coming

to this country. Awareness of common immigrant and refugee health considerations,

including acculturation stress, can help eliminate disparities among certain immigrants

and refugee populations.

A refugee is someone who has been forced to flee his or her country because of

persecution, war, or violence. A refugee has a good reason to have fear of persecution for
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reasons of race, religion, nationality, political opinion or membership in a particular

social group. Most likely, they cannot return home or is afraid to do so. War and ethnic,

tribal and religious violence are the leading causes refugees flee their countries. The

Department of Homeland Security determines refugee status before a person is eligible

for resettlement in the United States. According to the Annual Flow Report on Refugees

and Asylees, the annual report for refugees admitted to the United States through the

resettlement program increased from 70,000 to 80,000 in 2008. Nationals of Burma, Iraq,

and Bhutan accounted for nearly two-thirds of all refuge arrivals in 2008. California and

Texas received the largest numbers of resettled refugees in 2008.

Refugees receive permission to immigrate to the United States while they are still abroad.

Once approved, the principal applicant, alone or with his or her close family (spouse or

unmarried children under the age of 21), is eligible to come to the United States.

Refugees resettled in the United States are automatically eligible to work and to receive

public aid cash assistance and medical assistance for up to eight months as an individual

and up to five years as a family. A permanent resident is someone who has been granted

authorization to live and work in the United States on a permanent basis. As proof of that

status, a person is granted a permanent resident card, called a "green card." You can

become a permanent resident several different ways. Most individuals are sponsored by a

family member or employer in the United States. Other individuals may become

permanent residents through refugee or asylee status. Refugees or asylees are granted

permanent residency after one year. Refugees must undergo medical screening overseas

that specifically focuses on medical eligibility for the U.S. Refugee Program. Upon

arrival in the U.S. or soon after, however, refugees are advised to undergo a medical
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screening. The US-based medical screenings are managed by State and local health

departments focus on a wider range of medical conditions and on the general health of

new refugees.

Refugees are lawful immigrants, and they are eligible to receive the same protections and

benefits under the Affordable Care Act as any other U.S citizen. Refugees remain exempt

from the five-year waiting period to receive Medicaid and Children’s Health Insurance

Program (CHIP), which is a state and federal partnership that provides low-cost health

insurance for children in families who earn too much income to qualify for Medicaid but

cannot afford to purchase private health insurance coverage. The benefits that the

Affordable Care Act provides are quite important for the refugee, because they often

arrive to the United States without having access to proper medical care for years and

many of these refugees work for an employer who does not provide health insurance.

These benefits also protect individuals with pre-existing conditions from being denied of

affordable health coverage.

With the Affordable Care Act, refugees have the same protections and benefits in the

insurance market, such as prohibiting lifetime benefit limits. Beginning in 2014,

Medicaid will be available to anyone under the age of 65 with incomes up to 133 percent

of the federal poverty level, including refugees. Many adult refugees become uninsured

after their eight months of Refugee medical assistance is exhausted. Starting in 2014,

Medicaid will be available to anyone, including parents and childless adults who meet the

income criteria. Starting in 2014, all states must extend Medicaid coverage up to age 26

for young adults who have grown up in the foster care system, including those grown up

in the Unaccompanied Refugee Minors program.

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Permanent resident aliens get almost the same rights as any U.S citizen gets, they have

the right to have private health insurance, or obtain health insurance from his/her

employer if it is offered. For a resident alien in order to get Medicare he or she must

work at least 10 years to get the benefit or be able to draw it from the spouse, but the

spouse also had to work for more than 10 years. In order to be eligible for Medicaid, any

legal resident may quualify for Medicaid after the five year period. However, at this

moment, Medicaid is only available to children, families with minor children, disabled

(by the Social Security Administration), or seniors over the age of 65. Also, they must

meet income and asset limitation.

There is always Emergency Medicaid for immigrants available. However, this is

situational and only pays a limited benefit for care provided on a retro basis, for example,

someone goes to the ER, and says he/she is an immigrant, the hospital will aplly for

Medicaid for your trip to the ER only.

The Emergency Medical Treatment and Active Labor Act requires hospitals to evaluate

patients regardless of their legal status and ability to pay, so absolutely no one can be

turned away from being seen.

Many hospitals in Florida offer financial assistance counseling, but the application

process is difficult to navigate. The state has an extensive although overburdened free

clinic system including community health centers and free clinics.

All immigrants including refugees and resident aliens have the right to be treated if they

have a medical emergency. All hospital emergency rooms in Florida provide medical

screening to patients, regardless of their immigration status and regardless of their ability

to pay. Uninsured individuals, undocumented immigrants, as well as people who have

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non-immigrant visas have the same rights to emergency care as all other Floridians.

Anyone with an emergency medical condition has the right to an ambulance (emergency

medical transportation), regardless of immigration status or ability to pay. In the place I

work, All uninsured Floridians, including people who are undocumented, can receive

health care from federally funded community health centers, and from the public

hospitals, diagnostic and treatment centers, long-term care facilities, and clinics

maintained by the state . These medical providers are not permitted to turn away patients

who cannot pay for care, even if a patient’s medical condition is not an emergency. Many

immigrants are allowed to use public (government) health insurance programs to pay for

the cost of their medical care.

All hospitals, public and private alike, have the ability to reduce the fee for healthcare, as

do federally funded clinics and health centers. In what is referred to as sliding fee scale,

fee reductions, and fee settlement, a lower charge is offered based on a patient’s income,

which makes the health care more affordable.

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