What Immigrants Must Know About Medicare Eligibility

Medicare eligibility rules are very clear for U.S. citizens. But what about green card holders? How about lawful immigrants that just moved here, or haven’t yet turned 65? We’ll explain how eligibility works for non-citizen Medicare applicants below.

Basic Medicare Eligibility Requirements for Older Immigrants

Immigrants with a permanent resident card (i.e., a “green card”) can enroll in Medicare once they:

1. Lawfully reside in the U.S. for at least five continuous years OR qualify for premium-free Medicare Part A coverage. Immigrants who are not permanent legal residents (i.e., undocumented) cannot enroll in Medicare. (We’ll explain who may qualify for premium-free Part A coverage without the five-year residency requirement in the next section.)
2. Are at least 65 years old. The only way younger immigrants may qualify for Medicare is after receiving Social Security disability benefits for 24 months.

Who Qualifies for Premium-free Part A Coverage?

In general, both U.S. citizens and lawful permanent residents qualify for premium-free Medicare Part A coverage once they:

• Work in jobs where they pay Medicare payroll taxes for at least 10 years, or
• Are married for at least one year to a spouse aged 65+ who qualifies for premium-free Part A coverage.

Immigrants who cannot qualify for premium-free Part A but meet the age and residency requirements may purchase Medicare coverage.

How Much Does Medicare Cost Each Month?

Those who qualify for premium-free Medicare Part A have hospital coverage only with no monthly fees. However, immigrants who don’t qualify for this policy must pay $471/month for Medicare Part A coverage. These monthly premiums do not include all out-of-pocket expenses, such as an annual deductible or coinsurance charges.

It isn’t possible for anyone to avoid paying Medicare Part B premiums, regardless of immigration status or age. In 2021, Medicare Part B (standard medical insurance) costs at least $148.50/month, based on the insured person’s income.

Neither of these core Medicare policies provides coverage for things like:

• Vision
• Dental
• Prescription medications

How Can Younger Immigrants Get Medicare Before Age 65?

There are only three ways younger immigrants can qualify for Medicare coverage prior to their 65^th birthday:

1. End-stage renal disease (ESRD), which means your kidneys failed and now you need dialysis. Once you undergo dialysis for three months in a row, you should qualify for Medicare, regardless of your age.
2. The Social Security Administration (SSA) paid you Social Security disability insurance (SSDI) benefits for 24 months. First, you must work in jobs where you pay Social Security and Medicare payroll taxes for 10+ years. Then, your health problems must make it impossible for you to work a minimum of 12 months in a row. Immigrants who manage to clear these two hurdles may apply for SSDI benefits. After 24 months on SSDI, disabled immigrants should automatically qualify for Medicare coverage at any age. However, enrollment is not automatic in many states, so you’ll still need to take that step.
3. Lou Gehrig’s disease patients approved for SSDI benefits. Immigrants must first meet the work and residency requirements to qualify for SSDI. Upon approval, Medicare enrollment and eligibility can begin immediately.