This page will cover health care and mental health rights and resources for undocumented immigrants in the Greater Boston area.

Health Insurance

Without coverage, many will continue to turn to emergency departments and public hospitals, or defer care and experience adverse health outcomes. It is important—for both the uninsured and for a well-functioning health care system—to devise insurance options for the immigrants left behind.

BOX:
Note that MassHealth is just the name we use for Medicaid in Massachusetts—the programs are the same for Massachusetts residents.

“MassHealth offers various types of coverage with different benefits based on age, income, health status and other factors. Some immigrants are eligible for MassHealth benefits in the same way as US citizens are, while other immigrants are eligible for some benefits, but not the same benefits for which they would be eligible if they were US citizens.” If you do not have documentation of your immigration status, you may qualify for extra coverage if you are a pregnant woman, or if you have special PRUCOL status (read more below).

For questions about health insurance or how to navigate the health care system, call Health Care for All’s helpline for multilingual assistance in English, Spanish and Portuguese. The HelpLine is staffed by specially-trained Health Care For All counselors with up-to-date information about health care coverage, and is not part of a government agency.

(800) 274-4232
www.hcfama.org

Insurance for undocumented non-citizens:

Immigrants who do not have a Social Security Number or documentation of their immigration status may still qualify for certain types of limited coverage under MassHealth. Note that your total income and resources must fall below certain eligibility limits, which means that you may need to provide proof of income and identification in order to apply. Additionally, coverage is available for Massachusetts residents only. Pregnant women and infants are eligible for MassHealth Standard regardless of status, and those who are considered PRUCOL immigrants (read more below), who may qualify for additional coverage.

MassHealth Limited
MassHealth Limited provides emergency health services to people who have an immigration status that keeps them from getting more services.” For MassHealth Limited, you can get care only for medical emergencies (conditions that could cause serious harm if not treated). Note that MassHealth is just the name we use for Medicaid in Massachusetts—the programs are the same for Massachusetts residents.

Children’s Medical Security Plan
for children (age 18 or younger) whose family has a low income. Covers primary & preventive care only, for services at acute Hospitals or Community Health Centers.

MassHealth coverage for pregnant women
Pregnant women are eligible for MassHealth Standard regardless of status.

Emergency MedicAid
In emergent situations, i.e. a visit to the E.R, a medical team will determine if the patient qualifies for emergency Medicaid. Any procedure/maneuver/operation that would save a person’s life would be covered by emergency Medicaid as well as delivering babies regardless of immigration or insurance status. This applies to anyone without insurance.

Download MassHealth YEAR booklet here.

Insurance for PRUCOL and Special Status Immigrants

If you have had your status or lived in U.S. less than 5 years, and do not qualify for any of the conditions above, you may be entitled to certain healthcare benefits as a PRUCOL (Person Residing in the US Under Color of Law) or Special Status immigrants. In general terms, you may have PRUCOL status if the US government knows you are living in the country and does not plan to make you leave. PRUCOL is therefore not an immigration status granted by the Department of Homeland Security, but rather a public benefits eligibility category based on your immigration status.From MassHealth: “Nonqualified PRUCOLs are certain noncitizens who are not lawfully present. These individuals may be permanently residing in the United States under color of law as described in 130 CMR 504.000. People who are nonqualified PRUCOLs and meet one of the following statuses may be eligible for MassHealth Standard, CommonHealth, Family Assistance, Limited, or CMSP. They may also be eligible for benefits through the Health Safety Net.”

As a PRUCOL immigrant, you may under certain conditions be eligible for:

  • MassHealth Standard
  • MassHealth CommonHealth
  • MassHealth Family Assistance
  • MassHealth Limited
  • CMSP

Immigrants who are “Non-qualified PRUCOL” are not eligible for the Connector but may be eligible for MassHealth Family Assistance, or, for disabled children and young adults, CommonHealth.

You can find out if you have PRUCOL status by calling the Massachusetts Immigrant and Refugee Advocacy (MIRA) Coalition at 617-350-5480 x208.

Massachusetts residency

“Individuals who are not Massachusetts residents are not eligible for MassHealth or other health care benefits that are funded by the Commonwealth of Massachusetts. If you are visiting Massachusetts for personal pleasure, such as for vacation, or for the purposes of receiving medical care in a setting other than a nursing facility, you do not meet residency requirements for MassHealth.”

Alternatives for Uninsured or Undocumented

Even if you have no form of health insurance, you have the right to medical attention in cases of emergency. Below are programs that may help to pay health care related costs for uninsured Massachusetts residents.

Health Safety Net
“Health Safety Net (HSN) pays acute care hospitals and community health centers for certain essential health care services provided to qualified uninsured and underinsured Massachusetts residents.” This means that you can only use the HSN at acute care hospitals and community health centers. For a list of HSN providers, look here.

Federally Qualified Health Centers (FQHC)
“FQHC is a community-based organization that provides comprehensive primary care and preventive care, including healthoral, and mental health/substance abuse services to persons of all ages, regardless of their ability to pay or health insurance status. Thus, they are a critical component of the health care safety net.[1] FQHCs are called Community/Migrant Health Centers (C/MHC), Community Health Centers (CHC), and 330 Funded Clinics.” “Federally Qualified Health Centers are community-based health care providers that receive funds from the HRSA Health Center Program to provide primary care services in underserved areas. They must meet a stringent set of requirements, including providing care on a sliding fee scale based on ability to pay and operating under a governing board that includes patients.”

FQHCs are critical in being the safety net for Health care amongst uninsured and undocumented. To receive care, you just need an address and proof of income as well as pay a modest clinic fee.

You can find a Federally Qualified Health Center by using the following databases: https://findahealthcenter.hrsa.gov/help/
http://www.massleague.org/findahealthcenter/
NPI
Boston Health Net – Boston Medical Center also lists Community Health Centers here.

Visit the National Association of Community Health Centers here.

Health Insurance: step by step

Health Insurance – step by step | How to: a step-by-step guide to health insurance

1) Determine how long it is since the person submitted their application. If less than 8 months, they should be covered by the Refugee Medical Assistance. If more than 8 months have passed, they may need to purchase insurance through an employer or in the marketplace.

2) Determine whether the person has a job that offers health insurance, or whether they prefer to buy through the state/market. Note that the individual needs to show proof of MA residency in order to qualify for MASS health insurance

3) To purchase health insurance during open enrollment, and for more information on the type of health insurance that best fits you, visit Massachusetts Health Connector at www-

Health Care

Preventive Care

List of providers that specifically serve immigrant populations or people with or without insurance:

Family Van
Family Van provides free health screenings and checkups, they will see anyone, insurance or no insurance, legal citizen or non legal citizen. Find the weekly schedule of the Family Van here.

Boston Center for Refugee Health and Human Rights (BCRHHR)
BCRHHR provides holistic health care coordinated with social services and legal aid for asylum seekers, refugees, survivors of torture, and their families. They will see indivuduals with or without health insurance.

Boston Medical Center’s Immigrant and Refugee Health Program
“The Immigrant & Refugee Health Program provides comprehensive primary care services to immigrant and refugee health patients through our practice at the Shapiro Center at Boston Medical Center. Our team of clinicians takes care of general healthcare needs through regular check-ups, immunizations and screenings, as well as providing care for illnesses and injuries. Also, we will coordinate patient care if a patient needs to see a specialist for a more serious health issue. Our practice provides on-site interpreters and over the phone interpreters for more than 30 languages. We also offer access to psychiatric and case management support to provide support and care for the wide range of needs of our patients.

People who are new to Boston Medical Center should call at 617.414.5612 to schedule a first appointment.”

Women’s Health

Women may have special health care needs related to contraception, pregnancy, etc. As the refugee population may need different types of assistance, due for example to past trauma or language barriers, or help with particular issues such as female genital cutting, there are several clinics in the Greater Boston are that cater specifically to the refugee women.

Boston Medical Center’s Refugee Women’s Health Clinic.
Provides comprehensive and culturally sensitive women’s health services to refugee, asylum seeking, and recent immigrant communities in the Greater Boston area.
Services include:

  • Pregnancy and postpartum care
  • Annual check-ups
  • Gynecologic care
  • Contraception counseling
  • Surgical consultation
  • Medical affidavit writing for patients seeking asylum
  • Consultation regarding Female Genital Cutting.

No one is turned away because of lack of funds. We welcome people who may need support with health insurance and addressing transportation, food, and housing needs. Providers speak Spanish, French, and Haitian Creole.

Women, Infants, & Children (WIC) Nutrition Program
WIC is a nutrition program that provides free healthy foods, nutrition education, breastfeeding support, and referrals to healthcare and other services, free of charge, to eligible Massachusetts families.

You can participate in WIC if you:

  • Live in Massachusetts
  • Have a nutritional need (WIC staff can help you determine this)
  • Are a child under 5, a new mom, or a pregnant or breastfeeding woman
  • Have a family income less than WIC guidelines

Contact them at: (800) 942-1007.

Mental Health and Survivors of Abuse

Further exceptions are made for applicants awaiting decisions on their legal status, including applicants claiming asylum, but only those “granted employment authorization” or “under the age of 14 and have had an application pending for at least 180 days”, those awaiting a victim of trafficking visa, Withholding of Deportation, or withholding of removal under immigration laws. or under the Convention against Torture, amongst others (healthcare.gov 2017a).

The intricacy of these legal exceptions can have life-altering implications for immigrants, particularly those who claim asylum. It is more difficult to provide resources to asylum seekers than refugees, and asylum seekers are often not afforded the same rights or support as refugees (NCTTP 2016). In 2016, there were more than “620,000 pending removal and asylum cases resulting in combined wait times of up to six years for asylum seekers” (AIC 2016). These long waits can have negative effects on the mental health of asylum-seekers and their families, perpetuating fear and uncertainty and impeding opportunities for recovery (AIC 2016).

Domestic Violence, Sexual Assault, Child Abuse, Elder Abuse

All people have the right to safety and autonomy over their own body. Across Massachusetts, there are multiple organizations who provide free and confidential assistance to survivors of domestic violence or sexual assault, regardless of immigration status. Immigrants may be a particularly vulnerable group, as their immigration status is sometimes tied to that of a spouse, or because they may have experienced sexual violence during the /flight/ from their country. Several organization provide support and information specifically to refugee victims of domestic violence.

“In Massachusetts, local domestic and sexual violence programs provide free and confidential services to any victim or survivor regardless of your immigration status. Advocates are there to listen to your concerns and work with you to help you and your family live in safety and with dignity. Many of these programs are part of a network called RISE (Refugee and Immigrant Safety and Empowerment). The advocates in these programs provide education and outreach to particular ethnic communities on violence against women, sexual violence, and domestic violence. Additionally, these programs provide direct services to victims, from cultural and linguistic minority backgrounds, who have experienced domestic violence and/or sexual assault.”

UC Hastings Center for Gender and Refugee Studies have created a Pro Se Guide for Survivors of Domestic Violence, which can be downloaded in EnglishSpanish, and Haitian Creole.

Jane Doe
Jane Doe is a statewide organization advocating for survivors of sexual and domestic violence, and have several resources for immigrants.

Read more about rights and available resources for immigrants and refugees

Find free and confidential support and services via their interactive service locator tool

List of organizations catering to immigrant victims of sexual assault 

Casa Myrna
Casa Myrna is a Boston organization providing domestic violence awareness, as well as shelter and supportive services to survivors. Their services are available in both Spanish and English. Trained advocates offer confidential support, assistance with safety planning, direct connections to shelters and referrals to community services.

For support, assistance with safety planning, and information on appropriate resources, Call their toll-free SafeLink hotline at (877) 785-2020

Call SafeLink for:

  • Safety planning resources for survivors to learn how they and their families can stay safe.
  • A safe and confidential space in which to talk about your relationship or someone else’s.
  • A direct connection to domestic violence programs across Massachusetts
  • Referrals to local domestic violence and other community resources
  • Support and resources for anyone who is concerned about a victim of domestic violence
  • Information about domestic and dating violence

Services for survivors of Torture

Refugees may have experienced torture or other inhumane treatment, either as the reason for fleeing, or during the flight. Below is information on health care providers ad resources specifically for survivors of torture. Note that many of these organizations also can assist with an affidavit to support an asylum or immigration case in court.

The Services for Survivors of Torture program (SOT) – Office of Refugee Resettlement is committed to assisting persons who have experienced torture abroad and who are residing in the United States, to restore their dignity and health and rebuild their lives as they integrate into their communities. Services for Survivors of Torture Programs focus on physical, psychological, social and legal services for torture survivors as well as education and training of service providers.

Healtorture.org has created a new online resource center for programs serving torture survivors, individuals wishing to learn more about serving this population, and for survivors looking for information and services.  Healtorture.org has also created an easy-to-use resource site for ORR related materials, forms and guidanceVisit disclaimer page.

Visit HealTorture for an interactive map where you can find a Healing Center near you, and for an informational page for refugees.

The Boston Center for Refugee Health & Human Rights
Specializes in the care of people who have experienced persecution in their homeland. They accept people with and without insurance, and can help with medical and mental health services, as well as legal referrals and support groups.

Download their guide on health, legal, and social services, as well as life in Boston, and in the United States in general, here.

Language

All hospitals are required to provide translating services to patients that cannot speak English, regardless of status and free of charge. Hospitals in the city of Boston like Mass general or Boston Medical Center have at least 20+ different languages spoken in staff at all times, and if a certain language or translator is not available then the hospital will call the designated translator for the particular language. Smaller health care facilities like clinics will employ staff that resembles the population being served. For example, where there is a dense population of Haitians it is typical for the clinic in such area to be equipped with staff members to translate creole, and French.

 

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