OBJECTIVES:  Effective use of healthcare is a relevant measure in healthcare research for universal health coverage. The objective of this study was to compare differences in effective use of long-term healthcare (any self-reported health problem 12 months prior to survey) between international migrants and the local Chilean-born population. METHODS: Exploratory secondary analysis of nationally representative, anonymous Chilean survey CASEN 2013 (n=218 491 participants belonging to 66 725 households). We divided the sample into self-reported immigrants (n=3555) and Chilean-born (n=212 346). We did not include in the analysis those who preferred not to report their migration status (missing values n=2590). We estimated self-reported long-term (i) healthcare need, and (ii) use of universal coverage guarantees available in Chile; for both populations. Analysis was conducted in STATA 13. RESULTS:  8.5% of immigrants report not having any health insurance in Chile (versus 2.5% of the Chilean-born). Of these, most are male or between 0-14 years-old. Regarding long-term healthcare, 13.3% of immigrants reported having any health problem in past 12 months (versus 24.4% in Chilean-born). Of these, 72.1% used universal coverage guarantees available in the country (versus 83.4% in Chilean-born). Most immigrants who did not request healthcare are not entitled to any healthcare provision in the country. CONCLUSIONS:  Our analysis suggest that international migrants are at disadvantage of using available healthcare treatments, under the universal health coverage scheme, compared to the Chilean-born. This is particularly relevant for immigrants without any healthcare provision. Future research should explore reasons behind these differences. This unique evidence supports of the need promoting social protection of health for all population in Chile, including foreigners in need for long-term healthcare.