Health Insurance Eligibility and Health Insurance Enrollment

Health insurance enrollment depends upon marketplace eligibility. In turn, marketplace eligibility requires individuals to:

  • Live in its service area;
  • Be a U.S. citizen or national, or
  • Be a non-citizen who is lawfully present in the U.S. for the entire period for which health insurance enrollment is sought;
  • Not be incarcerated.*

* You’re not considered incarcerated if you’re in jail or prison pending disposition of charges-in other words, being held but not convicted of a crime. If an individual meets the eligibility requirements he or she is considered a “qualified individual.”

Health Insurance eligibility status will be determined through electronic data checks with the IRS, SSA, the Department of Homeland Security, and other electronic data sources approved for insurance eligibility verification.

Individuals with a student visa may be eligible for the Marketplace, but are not eligible for Medicaid or the Children’s Health Insurance Program.