Getting healthcare coverage can be complicated for green card holders in the United States. And Medicare is one topic that get asked about by new immigrants all the time. Some of the more common questions are: can green card holders qualify for Medicare? What are the eligibility requirements and costs? This guide will explain everything you need to know about Medicare for green card holders.
What is Medicare?
Medicare is the national health insurance program in the United States for people aged 65 and older. It also covers some younger people with disabilities. Medicare helps pay for healthcare like:
- Hospital stays
- Doctor visits
- Prescription drugs
- Preventive services like screenings and shots
- Medical equipment
Medicare has different parts:
- Part A is hospital insurance. It covers inpatient care in hospitals.
- Part B is medical insurance. It covers doctor visits, preventive care, lab tests, etc.
- Part C (Medicare Advantage) are private plans that combine Parts A and B.
- Part D covers prescription drugs.
Most people pay a monthly premium for Part B. You may also pay other monthly premiums, deductibles, coinsurance, and copays when you get care.
Are Green Card Holders Eligible for Medicare?
Lawful permanent residents, or green card holders, may qualify for Medicare if they meet certain requirements:
- You must be at least 65 years old.
- You must have been a lawful permanent resident of the U.S. for at least 5 consecutive years.
In some cases, you may qualify for full Medicare benefits if:
- You or your spouse paid Medicare payroll taxes while working for at least 10 years (40 quarters).
- You have a disability and receive disability benefits from Social Security or the Railroad Retirement Board for 24 months.
Green card holders without a work history in the U.S. can’t get premium-free Part A, but they can purchase Medicare Part A after they meet the 5-year residency requirement.
Undocumented immigrants are not eligible for Medicare. You must have lawful permanent resident status and a green card.
When Can a Green Card Holder Apply for Medicare?
You can apply for Medicare during your Initial Enrollment Period (IEP). This is a 7-month period that begins 3 months before your 65th birthday month and ends 3 months after your birthday month.
If you enroll on time, coverage will start the month you turn 65. If you do delay enrollment, you may have to pay a late enrollment penalty.
You can also enroll if you have a Special Enrollment Period due to certain circumstances like losing other health coverage. People with disabilities can enroll after receiving Social Security Disability Benefits (SSDI) benefits for 24 months.
How Much Does Medicare Cost for Green Card Holders?
The cost of Medicare coverage depends on your work history and income:
Part A:
- With 40+ work credits: $0 premium
- 30-39 work credits: $278 monthly premium
- Less than 30 work credits: $506 monthly premium
Part B: Most people pay a standard $164.90 monthly premium in 2023, based on income.
Part D: Varies by plan. Higher earners pay more.
You’ll also have deductibles, coinsurance and copays when you get medical services covered by Medicare. Supplemental insurance can help cover these out-of-pocket costs.
How Do Green Card Holders Enroll in Medicare?
You can enroll in Original Medicare online at Medicare.gov, over the phone by calling 1-800-MEDICARE, or by visiting your local Social Security office.
If you already receive Social Security benefits, you may be automatically enrolled in Parts A and B when you turn 65. If not, you’ll have to sign up yourself. Make sure to enroll on time to avoid penalties.
Once enrolled, you can choose to get your coverage through Original Medicare or a Medicare Advantage Plan (Part C). You can also purchase a standalone Part D plan or Medigap policy if desired.
Medicare and Citizenship for Green Card Holders
Enrolling in Medicare will not affect legal status, your immigration status or eligibility to become a U.S. citizen later. You must already be a lawful permanent resident for at least 5 years to qualify for Medicare as a green card holder.
Using your Medicare benefits does not make you a “public charge.” You will remain eligible to apply for U.S. citizenship at the appropriate time.
Common Medicare Questions for Green Card Holders
Here are answers to some frequently asked questions about Medicare for green card holders:
Can I get Medicare immediately after getting a green card?
No, you must live in the U.S. as a lawful permanent resident for 5 years before applying for Medicare.
What if I’m outside the U.S. for an extended time?
You may lose your permanent residency status if you spend too much time abroad. Speak to an immigration lawyer if you plan to be away for 6 months or longer.
Does my work history in my home country count?
No, only working in the U.S. and paying Medicare taxes will help you qualify for premium-free Part A benefits.
What if I’m divorced or widowed?
You may be able to keep Medicare eligibility from an ex-spouse’s work history. Speak to the Social Security Administration for help.
Can I also get Medicaid as a green card holder?
You may qualify for Medicaid coverage in addition to Medicare if you have limited income and assets. Each state has different rules.
Does Medicare affect citizenship?
No, enrolling in Medicare will not affect a green card holder’s eligibility to later become a U.S. citizen, as long as they already meet lawful permanent residency requirements.
Are new immigrants eligible for Medicare?
No, new immigrants are not eligible for Medicare coverage right away, as they must first live in the U.S. as lawful permanent residents for at least 5 consecutive years before applying.
What is Medigap (Medicare Supplement Insurance)?
Original Medicare pays for much of your healthcare costs, but not 100% of them. Medigap, also called Medicare Supplement Insurance, is private insurance that helps pay some of the out-of-pocket costs not covered by Parts A and B.
Medigap plans cover things like:
- Medicare Part A deductibles and coinsurance
- Medicare Part B deductibles and coinsurance
- Copays for hospital and skilled nursing facility care
Some key reasons people choose Medigap include:
- Lower out-of-pocket costs than Original Medicare
- Covers copays, deductibles, and coinsurance
- Works alongside Medicare at any healthcare provider nationwide that accepts Medicare
- Guaranteed renewable every year even if you have health issues
However, Medigap plans do have downsides to consider as well:
- You must pay a separate premium for the plan
- No extra benefits beyond filling Medicare coverage gaps
- Doesn’t include prescription drug coverage
Comparing Medigap vs Medicare Advantage pros and cons can help you determine the best supplemental coverage.
Medicare Part C (Medicare Advantage)
Medicare Part C, or Medicare Advantage, is an alternative way to get your Medicare benefits. Medicare Advantage plans are offered by private insurance companies approved by Medicare.
Medicare Advantage plans provide the same coverage as Original Medicare Plans (Parts A and B) but often have additional benefits like dental, vision, hearing aids, and more.
Here’s how Medicare Advantage differs from Original Medicare:
- Insurance Provider – Private insurance companies vs. Original Medicare
- Costs – Out-of-pocket costs differ. Plans have a maximum annual limit.
- Coverage – All-in-one plan vs. separate Parts A, B, + add-ons
- Providers – Usually a network vs. any provider accepting Medicare
- Travel – Some plans offer coverage out-of-network or out-of-state
Some key reasons people choose Medicare Advantage include:
- Some plans offer extra benefits like dental and vision
- Convenience of an all-in-one plan
- Potential Coverage when traveling out of network/state
- Increased ancillary benefits compared to Medigap plans
Medicare Advantage offers advantages but also has some drawbacks to consider. It’s a good idea to compare both health insurance options here.
Finding Help with Medicare as a Green Card Holder
Finding Medicare for immigrants can be challenging. Getting help from an insurance agent or legal assistance group serving immigrants can make the enrollment process easier.
There are many details to understand about eligibility, enrollment, costs, and benefits. Speaking to experts ensures you apply correctly and choose the right Medicare coverage. They can also assist with comparing Medicare Advantage Plans, Medigap policies, and prescription drug plans.
With the proper information and guidance, green card holders can access the Medicare benefits they are entitled to. Healthcare coverage provides important financial protection and peace of mind. Consult trustworthy resources to fully understand how Medicare works for permanent residents of the United States.
What If I Don't Qualify for Medicare?
If you do not meet the eligibility requirements for Medicare as a green card holder, you still have options for private health insurance and coverage.
One option is to shop for plans on the Health Insurance Marketplace. The Marketplace offers private individual health plans to U.S. citizens and permanent residents. You can enroll during the annual open enrollment period or if you have a qualifying life event.
Some key things the Marketplace offers:
- Private health plans from leading insurance companies
- Choice of bronze, silver, gold, and platinum plans
- Tax credits and subsidies available to reduce premiums
- Online enrollment through user-friendly sites like HealthSherpa.com
Purchasing an individual health plan can provide essential medical coverage if you are ineligible for Medicare and don’t have employer insurance. Comparing plan options and costs can help you find an affordable health insurance policy.
