Can Green Card Holders Get Medicaid? The Five-Year Bar in 2026

Green card holders can get full-scope Medicaid, but those who entered the United States on or after August 22, 1996 must first wait five years unless an exception applies. The five-year clock starts on the date of entry with a qualifying immigration status.1 Since October 1, 2026, green card holders have been one of the few noncitizen groups for which federal funding for full Medicaid is available, while refugees and asylees who have not become permanent residents have generally lost it.2 If your parent is inside the five-year wait, Emergency Medicaid still covers treatment of an emergency medical condition when she meets the state's other Medicaid rules.1

In This Guide

• Who Counts as a Qualified Immigrant for Medicaid
• How the Medicaid Five-Year Bar Works
• Who Skips the Five-Year Wait
• What Changed on October 1, 2026
• What Covers Your Parent During the Wait
• Medicare at 65 for a Green Card Holder
• Does Medicaid Affect a Green Card?
• After the Five Years: How a Green Card Holder Applies for Medicaid
• Frequently Asked Questions
• Learn More

Who Counts as a Qualified Immigrant for Medicaid

Every Medicaid rule for immigrants starts with one federal definition. The 1996 welfare-reform law (PRWORA) defines a "qualified alien" at 8 U.S.C. 1641, and an immigrant who is not on that list is barred from full federal Medicaid under 8 U.S.C. 1611, with an exception for Emergency Medicaid.3,1

Section 1641(b) lists eight categories of qualified immigrant:3

1. Lawful permanent residents (green card holders)
2. People granted asylum
3. Refugees admitted under the refugee program
4. People paroled into the United States for at least one year
5. People whose deportation is being withheld
6. People granted conditional entry under INA section 203(a)(7) as that section read before April 1, 1980
7. Cuban and Haitian entrants
8. People lawfully residing in the United States under a Compact of Free Association (migrants from the Marshall Islands, Micronesia and Palau)

Section 1641(c) adds a second route into the qualified-alien definition. Section 1641(c) covers certain immigrants subjected to battery or cruelty in the family who have an approved or prima facie pending petition, but only where the agency finds a substantial connection between the abuse and the need for benefits, and not while the abuser lives in the same household. Section 1641(c) also makes people granted T nonimmigrant status as trafficking victims, or with a pending T application that sets out a prima facie case, qualified aliens.3

Temporary Protected Status (TPS), Deferred Action for Childhood Arrivals (DACA), U nonimmigrant (crime-victim) status and having no lawful status are not listed anywhere in 8 U.S.C. 1641(b) or 1641(c).3 The section 1641 list settles only who is a "qualified alien" under that section. It does not by itself decide every benefit a person with one of those statuses can receive.

Being qualified is no longer the end of the question. Since October 1, 2026, whether a qualified immigrant can get full federal Medicaid also depends on a narrower list, covered in What Changed on October 1, 2026.2

How the Medicaid Five-Year Bar Works

The Medicaid five-year bar comes from 8 U.S.C. 1613(a). The statute says a qualified alien "who enters the United States on or after August 22, 1996, is not eligible for any Federal means-tested public benefit for a period of 5 years beginning on the date of the alien's entry into the United States with a status within the meaning of the term 'qualified alien'."1

A few points follow from that wording:

• The five-year bar reaches only qualified immigrants who entered on or after August 22, 1996.1
• The five-year clock is tied to entry with a qualified status. This guide doesn't compute that start date for a parent who adjusted to permanent residence from inside the United States. Ask the state Medicaid agency which date it counts from.
• The five-year bar still applies after October 1, 2026. The Centers for Medicare & Medicaid Services (CMS) told states in State Health Official letter SHO #26-001 that "on and after October 1, 2026, states must continue to apply the five-year waiting period to LPRs in accordance with 8 U.S.C. § 1613(a)," unless a 1613(b) or (d)(1) exception applies.1

For a green card holder with no exception, the practical answer to "do green card holders have to wait 5 years for Medicaid?" is yes. During those five years, full-scope federal Medicaid is closed to your parent, while Emergency Medicaid is not.1

Who Skips the Five-Year Wait

Section 1613(b) lists the people the five-year limit "shall not apply to." For families with an older parent, the military-connected group comes first.1

• Military families. A person lawfully residing in any state who is an honorably discharged veteran meeting the minimum active-duty service requirement, whose discharge was not on account of alienage, or who is on active duty other than for training. The exemption also covers that person's spouse, unmarried dependent child, and unremarried surviving spouse.1
• Humanitarian admissions. Refugees, people granted asylum, people whose deportation is withheld, Cuban and Haitian entrants, and Amerasian immigrants.1
• Citizens of the freely associated states, meaning COFA migrants.1

CMS gives the example of "LPRs who are veterans or active-duty armed forces service members or certain family members of such an individual" as green card holders who still skip the wait after October 1, 2026, and says states must continue to exempt Cuban/Haitian entrants and COFA migrants.1

Being exempt from the wait is not the same as qualifying for full federal Medicaid. Since October 1, 2026, a refugee or asylee who has not become a permanent resident skips the wait but no longer has federal funding for full Medicaid unless another qualifying status applies, as the next section explains.2

What Changed on October 1, 2026

Section 71109 of the 2025 budget reconciliation law, Public Law 119-21, took effect on October 1, 2026 through new section 1903(v)(5) for Medicaid and amended section 2107(e)(1)(R) for the Children's Health Insurance Program (CHIP). CMS explains section 71109 in SHO #26-001, issued April 8, 2026.2

Beginning October 1, 2026, federal funding for full Medicaid and CHIP benefits is generally limited, with limited exceptions, to four groups:2

• U.S. citizens and U.S. nationals
• Lawful permanent residents (green card holders), who remain subject to the five-year bar unless an exception applies
• Cuban/Haitian entrants
• COFA migrants

Since October 1, 2026, refugees, asylees, parolees, victims of trafficking and people granted withholding of deportation have lost federal funding for full Medicaid and CHIP unless they have another immigration status or category that keeps federal funding available. The October 1, 2026 loss of federal funding for full Medicaid and CHIP reaches people already enrolled under those statuses, not only new applicants. CMS notes that a potentially affected beneficiary may already have adjusted to permanent residence or may count as a Cuban/Haitian entrant, in which case federal funding for full benefits remains available. If your parent is already on Medicaid under one of these statuses and has since received a green card, make sure the state agency has her current immigration documents.2

Sources for the table: the 1641 categories, the 1613(b) exceptions, and the four groups CMS lists in SHO #26-001.3,1,2 Every row in the last column is about full-scope Medicaid for an adult such as an older parent. Two routes sit outside the October 1, 2026 funding limit: a state that elects the CHIPRA 214 option keeps federal funding for full benefits for lawfully residing children and pregnant women, and Emergency Medicaid, covered below, is a separate track.2

Two things did not change. Section 1903(v)(5) made no changes to Emergency Medicaid, and none to the CHIPRA 214 option that lets a state cover lawfully residing children and pregnant women.2 CMS also says it will not require states to fund coverage for qualified immigrants who lost federal funding. A state may choose to keep covering qualified immigrants who lost federal funding with 100 percent state money, but CMS would not treat that state-only coverage as Medicaid.2 Your state Medicaid agency is the place to ask whether it offers any state-funded program.

What Covers Your Parent During the Wait

Full Medicaid may be closed for five years, but three federal rules still matter to a parent in the bar or in the middle of an application.

Emergency Medicaid

Emergency Medicaid is outside the five-year bar entirely. 8 U.S.C. 1613(c) says the five-year limit does not apply to medical assistance described in 8 U.S.C. 1611(b)(1)(A), which is Medicaid "for care and services that are necessary for the treatment of an emergency medical condition."1

The statute attaches two conditions in the same sentence. For Emergency Medicaid, the care must not be "related to an organ transplant procedure," and the person must otherwise meet the eligibility requirements of the state's Medicaid plan.1 CMS confirmed that section 1903(v)(5) did not change Emergency Medicaid.2

Emergency Medicaid is limited to care necessary to treat an emergency medical condition as section 1903(v)(3) defines it.1 Section 1903(v)(3) defines an emergency medical condition as one, including emergency labor and delivery, with acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably be expected to place the patient's health in serious jeopardy, seriously impair bodily functions, or cause serious dysfunction of any bodily organ or part.4 Routine prenatal and postpartum care fall outside the Emergency Medicaid pathway.4

If your parent has a hospital emergency during the five years:

1. Tell the hospital that your parent is a green card holder inside the five-year wait, and ask how to start an Emergency Medicaid application.
2. Apply through the state Medicaid agency, using the routes listed in how to apply for Medicaid by state. The agency decides whether your parent otherwise meets the eligibility requirements of the state's Medicaid plan, as Emergency Medicaid requires.1
3. Ask the agency which dates of care the application covers, and whether the emergency fits the section 1903(v)(3) definition. If the stay has already ended, the federal retroactive rule, covered in Retroactive coverage below, reaches back to the third month before the month of application for a person who would have been eligible then.5

Georgia families can see how one state runs it in our guide to Georgia Emergency Medicaid.

The reasonable opportunity period

When a person declares a satisfactory immigration status and the state can't verify it promptly through electronic data, federal rules at 42 CFR 435.956 require a reasonable opportunity period to submit proof. The Medicaid reasonable opportunity period ends when the state verifies the status or determines the person did not verify it, or 90 days after it begins, whichever comes first. The state agency may extend the reasonable opportunity period past 90 days for an immigration-status declarant who is making a good faith effort to get documents.6

During the reasonable opportunity period, the state may not delay, deny, reduce or terminate benefits for someone it has found otherwise eligible for Medicaid.6 The reasonable opportunity period helps when paperwork lags behind a status your parent already holds, but it is not one of the exceptions to the five-year bar listed in 8 U.S.C. 1613(b).1 Our guide to the Medicaid reasonable opportunity period covers the notice dates and what happens when it ends.

Retroactive coverage

Once a person is found eligible, federal law requires Medicaid to cover services from as early as the third month before the month of application, if the person would have been eligible when the care was given.5 For a Medicaid application filed on or after January 1, 2027, the federal retroactive coverage window shortens to two months before the application month, or one month for the ACA expansion adult group.5 Each state plan sets the exact effective date of retroactive coverage, and a Section 1115 waiver can shorten the window, so confirm your state's rule.5 Retroactive coverage reaches back only to months in which your parent would have been eligible, so months still inside the five-year bar do not qualify for full Medicaid.5,1 See Medicaid retroactive eligibility and the 2027 Medicaid changes for details.

Medicare at 65 for a Green Card Holder

Medicare runs on its own immigrant rule. Section 1899C limits Medicare entitlement and enrollment to citizens and nationals, lawful permanent residents, Cuban or Haitian entrants, and COFA residents.7

A green card holder aged 65 or older gets premium-free Part A on the same basis as a citizen if she or a spouse paid Medicare taxes long enough while working, generally at least 10 years.7 Without that work history, a green card holder 65 or older must have lived in the United States continuously for the 5 years immediately before the month of application to enroll in Medicare Part B or buy premium Part A, and buying Part A requires enrolling in Part B.7 The Social Security Administration handles Medicare enrollment.7

Medicare's five-year continuous-residence test sits in the Medicare statute, and Medicaid's five-year bar sits in 8 U.S.C. 1613, so meeting one does not answer the other.7,1 Our guide to Medicare for immigrants covers premiums, penalties and enrollment periods.

Does Medicaid Affect a Green Card?

Public charge is the immigration test of whether a person "is likely at any time to become a public charge."8 The Department of Homeland Security (DHS) rescinded its 2022 public charge rule effective September 18, 2026, in a final rule published July 20, 2026 at 91 FR 45324. The rescission applies to applications for admission made on or after that date and to adjustment-of-status applications postmarked or submitted electronically on or after it.8

Medicaid your parent received before September 18, 2026 will be judged under the 2022 rule. In DHS's words, "Receipt of means-tested public benefits before September 18, 2026 will be considered consistently with the 2022 Final Rule."8 Under the 2022 rule, the only Medicaid that counted was long-term institutionalization at government expense. Even receipt of Medicaid for long-term institutionalization could not, under the 2022 rule, "alone be a sufficient basis" for a public charge finding.8 Benefits received while a person was in an exempt category, such as a refugee at admission or an asylee at grant, were not considered at all.8

How DHS will weigh Medicaid received on or after September 18, 2026 is not settled by any source this guide relies on. DHS says the rescission "restores broader discretion for DHS officers to evaluate all pertinent facts."8 If your parent has a pending or upcoming immigration application, or you are unsure, talk with a qualified immigration attorney or a nonprofit legal service before deciding to skip coverage your parent may need.

After the Five Years: How a Green Card Holder Applies for Medicaid

Once the five years have run, the federal waiting period no longer stands in the way, and a green card holder remains in a group for which federal Medicaid funding is available.2 Your parent still has to meet every other eligibility rule of her state's Medicaid program. Clearing the five-year bar does not make anyone automatically eligible for Medicaid.

Income is one of those rules. HHS says Medicaid uses the federal poverty guidelines as a criterion for some or all eligibility determinations. For 2026, the guideline is $15,960 a year for one person and $21,640 for two in the 48 contiguous states and the District of Columbia.9 Medicaid counts income under its own rules, so compare your parent's situation with the limit for her state and pathway in Medicaid income limits by state, not with a raw paycheck figure.9

Next steps:

1. Find your parent's state agency. Medicaid by state links each state's program.
2. Gather immigration documents that show the status and entry date, and apply through the state agency. How to apply for Medicaid by state lists where and how.
3. Ask about sponsor rules if you signed an affidavit of support. Sponsor income rules for Medicaid are outside this guide, so ask the state agency how it treats a sponsor before you apply. For SSI, see whether a sponsor's income counts against SSI.
4. If your parent is 65 or older, check Medicare enrollment with the Social Security Administration at the same time.

Georgia families can read the state-level version of this guide, Georgia Medicaid for immigrants and the five-year bar.

Learn More

Find personalized help working out when your green-card-holder parent can get Medicaid at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.