Applying for Marketplace Insurance Without a SSN

Find out what you need for your application

There are a lot of things to know and do before applying for a Health Insurance Marketplace® plan if you don’t have a Social Security number. It is somewhat confusing but it can be done,  and you deserve access to quality health care.

Because accuracy is so important when filling out your Marketplace application, it is strongly advised that you gather the documents listed ahead of time. Having to submit supporting documents later is possible and it isn’t difficult. However, it can lead to a delay in the processing of your application, and that can lead to a delay in the date your policy goes into effect. Leaving things blank on the application (especially SSN) will automatically cause an error, but you can avoid this, if you plan ahead.

Links provided here will assist you in knowing what paperwork to have ready, and local Navigators, assisters, agents, and brokers can also help explain what you’ll need. The Marketplace Call Center is available around the clock (1-800-318-2596) and is available in over 200 languages. Getting help in a language other than English

The process may seem like a lot but there are many resources to help you through it, and I have links to quite a few of them here. Just take your time to make sure you do your best to supply what’s required.

Marketplace eligibility based on immigration status

To enroll in a plan through the Health Insurance Marketplace®, individuals must have a lawfully present immigration status. (see list below for immigration statuses that are considered lawfully present for the purpose of Marketplace eligibility.) In general, this means people permitted under the law to be in the U.S. if they meet all other requirements including state and/or Marketplace service area residency requirements.

For detailed information about Social Security numbers (SSN) and who needs to have them to apply, view the following guide:
Helping Families That Include Immigrants Apply for Health Coverage - Beyond the Basics

Deferred Action for Childhood Arrivals (DACA) Marketplace eligibility

I had a full section here for DACA updates that I have removed. This topic in particular is changing so much and so quickly that I'm going to step back from providing information about it at this time. I do not want to contribute to spreading misinformation about this or any other issue and will wait until I feel confident that the information I'm getting is true and complete.

In the meantime, these are the sources I'm relying on for updates and explanations about the decisions being made:

NATIONAL IMMIGRATION LAW CENTER
https://www.nilc.org/resources/latest-daca-developments/

RECENT COURT DECISIONS IMPACTING THE MARKETPLACE (DACA is the first issue on the page)
https://www.healthcare.gov/court-decisions/

Immigration Categories Eligible for Marketplace Coverage

“Lawfully Present” Statuses that Also Meet Federal Medicaid Standard

“Qualified” Immigrants

• People with lawful permanent resident status (LPR/ green card holder)
• People with refugee status
• People with asylee status
• Cuban/Haitian entrants
• People granted parole into the U.S. for at least one year
• People granted withholding of deportation or withholding of removal
• Certain domestic violence survivors and their children and/or parents
• Certain people who are survivors of trafficking and their spouse, child, sibling or parent
• Citizens of Compact of Free Association (COFA) nations residing in the U.S.
• Iraqi/Afghan special immigrant visa holders
• People who are Amerasian immigrants

Others

• Members of a federally recognized Indian tribe or American Indians born in Canada
• Certain people from Afghanistan or the Ukraine with parole status in the U.S.

Other Lawfully Present Statuses

• People granted relief under the Convention Against Torture (CAT)
• People with temporary protected status (TPS)
• People with deferred enforced departure (DED)
• People with deferred action (including DACA)
• People granted parole into the U.S. for less than one year
• People with nonimmigrant status (includes student visa; U visa; and many others)
• People with an administrative order staying removal issued by the Department of Homeland Security
• People with lawful temporary resident status
• People with family unity benefits
• People with special immigrant juvenile status
• Others granted employment authorization

Applicant For Any of These Statuses

• Lawful permanent resident status
• Special immigrant juvenile status
• Victim of trafficking visas (T visa)

Must Also Have Employment Authorization if 14 or Older

• Applicants for asylum
• Applicants for withholding of deportation or withholding of removal, under the immigration laws or under CAT
• Applicants for temporary protected status
• Registry applicants
• People with an order of supervision
• Applicants for cancellation of removal or suspension of deportation
• Applicants for legalization under IRCA
• Applicants under the LIFE Act

SOURCE: Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics

Marketplace subsidy eligibility (PTC, CSR) based on immigration status

People with a lawfully present immigration status are eligible to purchase ACA marketplace coverage and may also qualify for premium tax credits (PTC) and cost sharing reductions (CSR) if they meet all other requirements such as income, tax filing status, residence, etc.

In general, only individuals with incomes above the federal poverty line are eligible for premium tax credits. However, individuals with lawfully present immigration statuses who are not eligible for Medicaid because of their immigration status, including people with DACA, can qualify for premium tax credits even if their income is below the poverty line, regardless of whether their state has expanded Medicaid for adults with income up to 138 percent of federal poverty level.

For more key facts regarding immigrant eligibility, this guide is excellent. It presents a lot of information clearly, and in a way that is easy to understand.
Key Facts - Beyond the Basics

Information provided in the application WILL NOT be used for immigration civil enforcement purposes

Medicaid, CHIP, and the ACA marketplaces use the U.S. Citizenship and Immigration Services’ (USCIS) Systematic Alien Verification for Entitlements (SAVE) program to verify the citizenship or immigration status of people applying for coverage. However, this data match is only for the purpose of confirming that applicants meet the immigration or citizenship status requirement to enroll in an insurance affordability program. USCIS has issued guidance that information about applicants or households obtained for health insurance eligibility will not be used for civil immigration enforcement purposes.

Remote identity proofing (i.e., ID proofing) to submit a Marketplace application

The person designated as the household contact in an application (who must be an adult) is required by HealthCare.gov to successfully complete ID proofing to ensure that they are who they say they are before they can use the online process to apply for coverage, select health insurance plans, report changes, or renew coverage.

In the event that ID proofing online cannot be completed, HealthCare.gov gives household contacts a unique reference code and instructs them to call the Experian Help Desk to complete ID proofing over the phone. This step is skipped sometimes and people are immediately provided the opportunity on screen to upload documents that can be used to verify the identity of the person completing the application.

For much more detailed information about ID proofing, visit Helping Families That Include Immigrants Apply for Health Coverage - Beyond the Basics

If none of the documents listed for the HealthCare.gov ID proofing process are available

Household contacts who do not have any of the documents needed to complete the ID proofing process will not be able to submit an application online on HealthCare.gov. Instead, they may complete the application by mailing a completed paper application form or may apply over the phone by contacting the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). They should ask to receive notices about their application by mail.

How HealthCare.gov verifies citizenship

In the FFM (federally facilitated Marketplace), when applicants attest to being U.S. citizens and provide an SSN, their information is checked against information in SSA’s records to verify citizenship.

How HealthCare.gov verifies immigration status

In the FFM, all non-citizens applying for coverage for themselves must attest to having an “eligible immigration status.” They then must select a document type to use to prove their immigration status. They will be asked to provide one or two numbers from their document. HealthCare.gov will use this information to attempt to immediately verify their immigration status through the SAVE program.

For detailed information on the verification process and the SAVE program:
Helping Families That Include Immigrants Apply for Health Coverage - Beyond the Basics

Documents to Satisfy the Identity Proofing Requirement

ONE of the following

• Driver’s license (issued by state or territory)
• Voter registration card
• U.S. passport or U.S passport card
• School identification card
• Certificate of Naturalization (Form N-550 or N-570) or Certificate of U.S. Citizenship (Form N-560 or N-561)
• Permanent Resident Card or Alien Registration Receipt Card (Form I-551)
• Employment Authorization Document containing a photograph (Form I-766)
• Identification card issued by the federal, state, or local government
• Foreign passport, or identification card issued by a foreign embassy or consulate containing a photograph
• Military dependent identification card
• Native American tribal document
• U.S. Coast Guard Merchant Mariner document

or, TWO of the following

• U.S. public birth record
• Marriage certificate
• Employer identification card
• Property deed or title
• Social Security card
• Divorce decree
• High school or college diploma (including high school equivalency diplomas)

Source: www.healthcare.gov/help/how-to-verify-identity

Documents to Verify Citizenship

• U.S. passport (expired U.S. passports can be used to verify U.S. citizenship)
• Certificate of Citizenship
• Certificate of Naturalization
• State-issued enhanced driver’s license (currently available from Michigan, Vermont, New York, and Washington)
• Document from a federally recognized Indian tribe that includes the individual’s name, the name of the tribe, and membership, enrollment, or affiliation with the tribe

Individuals who do not have one of the above documents can provide one document from each of the lists below (totaling two documents)

ONE of the following

• U.S. public birth certificate
• Consular Report of Birth Abroad (FS-240, CRBA)
• Certification of Report of Birth (DS-1350)
• Certification of Birth Abroad (FS-545)
• U.S. Citizen Identification Card (I-197 or the prior version, I-179)
• Northern Mariana Card (I-873)
• Final adoption decree showing the person’s name and U.S. place of birth
• U.S. Civil Service Employment Record showing employment before June 1, 1976
• Military record showing U.S. place of birth
• U.S. medical record from a clinic, hospital, physician, midwife, or institution showing a U.S. place of birth
• U.S. life, health, or other insurance record showing U.S. place of birth
• Religious record showing U.S. place of birth recorded in the U.S.
• School record showing the child’s name and U.S. place of birth
• Federal or state census record showing U.S. citizenship or U.S. place of birth
• Documentation of a foreign-born adopted child who received automatic U.S. citizenship (IR3 or IH3)

AND ONE of the following (that has a photograph or other information, like your name, age, race, height, weight, eye color, or address)

• Driver’s license issued by a state or territory or ID card issued by the federal, state, or local government
• School identification card
• U.S. military card or draft record or military dependent’s identification card
• U.S. Coast Guard Merchant Mariner document
• Voter registration card
• A clinic, doctor, hospital, or school record, including preschool or day care records (for children under 19 years old)
• Two documents containing consistent information that proves your identity, like employer IDs, high school or college diplomas, marriage certificates, divorce decrees, property deeds, or titles

Source: www.healthcare.gov/help/how-do-i-resolve-an-inconsistency

Documents to Verify Immigration Status

• Permanent Resident Card, “Green Card” (I-551)
• Refugee travel document (I-571)
• Temporary I-551 stamp (on Passport or I-94/I-94A)
• Arrival/Departure Record (I-94/I-94A)
• Certificate of Eligibility for Nonimmigrant Student Status (I-20)
• Employment Authorization Card (I-766)
• Certification from U.S. Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR)
• Administrative order staying removal issued by Department of Homeland Security
• Office of Refugee Resettlement eligibility letter (if under 18)
• Reentry Permit (I-327)
• Machine-readable immigrant visa (with temporary I-551 language)
• Foreign passport (must not be expired)
• Arrival/Departure Record in foreign passport (I-94)
• Certificate of Eligibility for Exchange Visitor Status (DS-2019)
• Notice of Action (I-797)
• Document indicating withholding of removal (or withholding of deportation)
• Document indicating a member of a federally recognized Indian tribe or American Indian born in Canada
• Resident of American Samoa card
• Other documents

Source: www.healthcare.gov/help/immigration-document-types

For more information, please see Reference Guide to Documents Used to Verify Immigration Status

Options if you don't qualify for subsidies due to immigration status

• Even if they’re not eligible to purchase health insurance through the Marketplaces, people without a documented immigration status may enroll in private coverage outside the Marketplace.
• People who do not meet the immigration-related eligibility requirements for Medicaid but meet all other eligibility standards may be eligible for having limited treatment for life-threatening medical conditions paid for by Medicaid (including labor and delivery).
• There are no immigration-related eligibility requirements for certain public health services including immunizations as well as services provided by Federally Qualified Health Centers, migrant and rural health centers, and hospital charity care.

To learn more about these options and others, visit Health Insurance Affordability Programs’ Eligibility Based on Immigration Status - Beyond the Basics

Reference Guide to Immigration Documents

Many non-citizens in the United States are eligible for health coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or subsidized plans in the Affordable Care Act (ACA) Marketplaces.

This excellent reference guide (from Health Reform Beyond the Basics) walks through examples of the different immigration document types that can be used in HealthCare.gov and notes where different document numbers are located.

https://www.healthreformbeyondthebasics.org/wp-content/uploads/2023/09/REFERENCEGUIDE_Immigration-Documents.pdf

NOTE: This list is not a comprehensive list of all documents eligible immigrants may have and does not address what should be done if someone does not have one of the documents on the Healthcare.gov list. For more information on statuses that are considered an “eligible immigration status” for ACA Marketplaces, Medicaid and CHIP, see Immigrant-Related Resources - Beyond the Basics

In conclusion

I hope that this condensed version of the incredibly thorough guide provided by Beyond the Basics is helpful in gathering what you’ll need to apply for Marketplace coverage. Any further questions can be addressed to HealthCare.gov or the Marketplace Call Center (1-800-318-2596).

Thank you for learning with me!

• To keep up-to-date on news and information regarding the ACA & the Marketplace, you can check out my blog!
• Go take a look at my Resources page for helpful links from the entire website, my upcoming e-book, and social media series PLUS a glossary of key terms and gallery of infographics!
• Return to the Jensurance home page

Health Insurance Marketplace® is a registered service mark of the U.S. Department of Health & Human Services.