Medicare for Green Card Holders: A Comprehensive Overview

You must meet specific requirements for federal health insurance in the United States. While most United States citizens naturally born in the country will automatically be eligible for many federal health insurance programs, those who immigrated have a few hurdles they may need to overcome. Medicare is one program requiring individuals with green cards to meet several conditions to obtain health insurance.

Medicare is a U.S. federal health insurance program offering medical service coverage for those 65 or older, younger people with disabilities, or individuals with End-Stage Renal Disease (ESRD). Medicare helps cover expenses for various medical services.

There may be additional requirements for green card holders to be eligible for Medicare because they aren’t natural United States citizens.

If you want health insurance as a non-citizen permanent resident, here’s what you need to know about Medicare for green card holders.

Are green card holders eligible for Medicare?

Yes, but it depends on how long they’ve resided in the United States. A non-citizen, such as a green card holder, must have continuously resided in the United States for at least five years to qualify for Medicare benefits.

If you’ve recently immigrated to the States, you likely won’t be eligible for benefits until you've met the time requirement.

What are the requirements for Medicare as a green card holder?

If you meet the five-year residency requirement, you can apply for Medicare if you are at least 65, have worked at a job for at least 40 quarters or 10 years, are paying Medicare taxes, or have a spouse who qualifies for Medicare in this same manner.

In addition, if you’re at least 65 but don’t have any work history paying Medicare taxes and have been in the United States for five consecutive years, you can purchase Medicare Part A but will have to pay its premium.

If you’re 65 or younger and have a documented disability, you may meet the eligibility requirements for Social Security Disability Insurance.

Ultimately, your Medicare costs will vary depending on if or how much taxes you’ve paid into Medicare.

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Is Medicare free for green card holders?

You won't get free Medicare benefits if you haven’t paid into Medicare for ten years. You’ll have to pay the Medicare Part A premium to get health insurance coverage.

Those who don’t qualify for premium-free Medicare Part A can expect to pay $278 or $506 monthly, depending on how long you or your spouse worked and paid Medicare taxes.

Medicare Part A covers the following medical services:

• Inpatient care in a hospital facility
• Skilled nursing facility care
• Nursing homecare
• Home healthcare

If you’re unsure whether Medicare Part A covers certain medical services, contact your healthcare provider or the Medicare office for assistance.

Also, even if you meet the 10-year requirements for premium-free Medicare coverage, you will have to pay for any additional benefits of Medicare, like Part B premium and coinsurance.

Medicare Part B covers medically necessary and preventive services such as:

• Ambulance services
• Durable medical equipment (DME)
• Mental health inpatient, outpatient, and partial hospitalization
• Limited outpatient prescription drugs

In 2023, most people paid $164.90 monthly for Medicare Part B. The Social Security Administration can tell you the exact amount you can expect to pay once you’re accepted.

There’s also Medicare Advantage or Part C, which includes Parts A and B coverage, and Part D, which covers prescription drug costs. The monthly costs of these plans will vary depending on eligibility.

Medicare Supplement, or Medigap, is another type of Medicare coverage green card holders may be eligible for. It covers the deductibles and coinsurance out-of-pocket costs not covered by Original Medicare Parts A and B.

How to enroll in Medicare as a green card holder

Applying for Medicare as a green card holder isn’t much different than the requirement for U.S. citizens. You must enroll during the initial enrollment period, which begins three months before you turn 65 and ends three months after, giving you seven months to sign up for coverage.

If you sign up for Medicare the month before you turn 65, coverage begins the month you turn 65. If you enroll the month you turn 65 or the three months after, it will start the following month.

You may be automatically enrolled into Medicare A and B if you receive Social Security Benefits four or more months before turning 65. If that doesn’t happen, you can visit the Social Security Administration’s website to sign up.

If you fail to enroll during the initial enrollment period, you must wait to sign up and pay a monthly late fee as long as you keep Part B coverage. The longer you wait to enroll, the higher your penalty will be. This penalty can also be applied for missing enrollment for the Part A premium.

What other benefits can Medicare green card holders receive?

Aside from Social Security benefits, in some instances, if you’re a green card holder who receives Medicare, you may be able to receive the following benefits:

• Medicaid health insurance for those with low incomes.
• Health insurance coverage through the Health Marketplace.
• Children's Health Insurance Plan (CHIP): Low-cost health coverage for children with families that earn too much for Medicaid.
• Temporary Assistance for Needy Families (TANP): Provides families with financial assistance and other support services.
• Supplemental Nutrition Assistance Program (SNAP): Provides food benefits for low-income families to purchase nutritious food.
• Section 8 housing assistance: Also known as the Housing Choice Voucher Program, provides tenant-based rent assistance.

Will having Medicare affect green card holders?

You may be concerned Medicare will affect your journey to citizenship in the United States. Fortunately, Medicare won’t affect your ability to get citizenship, as you’ll need to be in the States for five years to qualify for the federal insurance program. This also goes for other Medicare, like Medicare Supplement or Medicare Advantage.

Can non-residents get Medicare?

New immigrants are not eligible for Medicare regardless of whether they meet the age requirements. You’ll need to qualify for premium-free Medicare Part A or Medicare Part A premium by meeting the residency requirements or having a spouse who paid Medicare taxes or is at least 65.

If you don’t have the paperwork or proof of residency, you won’t be eligible for Medicare or other forms of health insurance in the United States. You may have to seek private or temporary health insurance.

Are there other health insurance options for green card holders?

If you’re a green card holder but cannot get Medicare, you can apply for other health insurance coverage through the Healthcare Marketplace.

When open enrollment starts, you must create an account and apply by November 1. From then until January 15, you can pick a health and dental insurance plan based on your income, preexisting conditions, and other factors that can alter your monthly premium. Coverage through the Healthcare Marketplace begins on February 1.

If you’re an immigrant with a green card and have been in the United States for at least five years, you’re likely eligible for Medicare. Medicare Parts A and B can cover essential medical services, but you may have to pay out-of-pocket if certain services aren’t covered.

Depending on whether you or your spouse has worked for 10 years or more and paid Medicare taxes, you may or may not have to pay for Medicare for green card holders. You’ll need to apply to better understand the costs for Medicare green card holders.