Yes, the U.S. provides Medicare for green card holders who meet other eligibility requirements. A green card, or permanent resident card, may qualify a senior for Medicare benefits if they are also age 65 or older or have a qualifying disability and have lived in the U.S. for at least 5 consecutive years.
The cost of Medicare may differ for U.S. citizens and permanent residents. While green card holders can access the same Medicare benefits as U.S. residents if they meet the necessary criteria, green card holders must pay for Part A if they have worked in the U.S. for less than 10 years.
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How Medicare For Permanent Residents Works
Permanent residents must meet certain criteria specific to green card holders, in addition to satisfying the standard Medicare eligibility requirements, to receive benefits.
Eligibility
- Time of Residency: In order to become eligible for Medicare, permanent residents need to have lived in the U.S. for at least 5 continuous years. Those with fewer than 5 years of residency in the U.S. may still qualify for Medicare if they have been married to an insured green card holder or U.S. citizen for at least one full calendar year.
- Minimum Age Requirement: Permanent residents become eligible for Medicare when they turn 65. Specifically, they may enroll starting three months before and up to three months after the first day of their 65th birthday month. In lieu of turning 65, some beneficiaries qualify for Medicare due to a Medicare-approved disability or condition.
- Work History: Green card holders must work in the U.S. for 10 years to earn “free” Part A benefits, like many U.S. citizens enjoy. While permanent residents with a decade-long work history may enjoy $0 Part A monthly premiums, those with fewer years of experience can still get Medicare benefits, but at a higher cost.
When Can You Enroll?
You may enroll in Medicare in the three months leading up to and following your 65th birthday. Medicare encourages U.S. citizens to enroll at their first opportunity (when they turn 65) to avoid possible penalties and going uninsured; however, green card holders may be forced to delay enrollment if they have lived in the U.S. for less than 5 years when they turn 65.
Permanent residents may be automatically enrolled in Medicare, like U.S. citizens, if they have lived in the U.S. for more than 5 continuous years and worked in the U.S. for 10 or more years. Automatic eligibility for Medicare occurs when you turn 65 and have received social security benefits from the U.S. government through your job for at least 10 years.
What Happens If You Do Not Enroll When You’re First Eligible?
Failing to enroll in Medicare when you are first eligible can lead to hassles and fees later on. Outside of your one-time-only initial enrollment window, you must wait until the once-annual Open Enrollment Period or qualify for a special enrollment period to make changes, and you may owe a percentage of Part A and part B premiums for every month you continue to delay signing up.
Can Green Card Holders Enroll In Medicare Advantage and Medigap?
Yes, green card holders may purchase a Medicare Advantage or Medigap plan, to enjoy additional medical and drug benefits or cover out-of-pocket expenses, respectively. Green card holders must follow the same rules as U.S. citizens for either of these plans, including maintaining Part A and Part B monthly premiums to keep this coverage.
Anyone who qualifies for Original Medicare (Part A and Part B) is also eligible for either Medicare Advantage or Medigap (you may only enroll in one or the other). Permanent residents who are not yet eligible to sign up for Original Medicare upon turning 65 must wait for the next Medicare Advantage or annual open enrollment period to buy Medicare Advantage or Medigap.
Permanent Residents and Medicare Costs
Green card holders may pay a different price for Medicare, depending on whether they opt for Medicare Advantage or Medigap and meet work quota requirements.
Premium Prices
Medicare Part | 2024 Premium Cost (With Work Quota) | 2024 Premium Cost (Without Work Quota) |
|---|---|---|
Part A | $0 | $278 or $505 |
Part B | $175 | $175 |
Part C | Varies | Varies |
Part D | ~$48 | ~$48 |
Medigap | Varies | Varies |
Medicare sets its annual premium costs for Part A and Part B each October, with most beneficiaries paying $0 for Part A and a universal Part B premium fee. Medicare Advantage (Part C) and Medigap costs vary, depending on what plans are available where you live and the prices set by individual insurers for these plans. Since Medicare Part D drug coverage costs also vary by location and availability, the above figure represents an estimated national average.
Premium-Free Medicare Work Requirements
You must enroll in Original Medicare to qualify and pay for other Parts like C and D; however, most beneficiaries can enjoy premium-free Part A benefits for meeting the work requirement.
Who Is Eligible?
Nearly 100% of Medicare beneficiaries pay $0 monthly premiums for Part A benefits. Eligibility for premium-free Part A benefits simply requires a work history of 10 or more years while paying into social security, commonly taken out of one’s paycheck as a federal income tax benefit.
Since Medicare Parts A and B work in tandem, you must continue to pay Part B premiums, even if you enjoy $0 Part A benefits, to qualify for other coverage like Part C, Part D, or Medigap. You become eligible for partially-premium-free Original Medicare benefits when you turn 65.
Who Is Not Eligible?
Green card holders must pay monthly premiums for Part A if they have not met the minimum work requirement for premium-free coverage yet. Once you have lived in the U.S. for 5 years continuously, you become automatically eligible for Medicare when you turn 65. However, you may still owe Part A premiums if you have not worked in the U.S. for 10 years or more.
You may also owe additional penalties for delaying enrollment in Part A until you can meet the minimum work requirement for premium-free benefits. While you may be ineligible for premium-free Part A if you have fewer than 10 years of work history in the U.S. when you turn 65, you become eligible for Medigap at the same time, which can help cover premium costs.
How To Enroll In Medicare as a Permanent Resident
- See If You Qualify for Automatic Enrollment: You will be automatically enrolled in Medicare Part A and Part B if you are a green card holder working in the U.S. for the past 10 years and paying social security benefits for at least four months before your 65th birthday.
- Enroll During Your Initial Enrollment Period: If you are not auto-enrolled, you can sign up for Original Medicare through SSA.gov. Signing up when you turn 65 and are first eligible is ideal, since you may incur penalties for delaying enrollment. Otherwise, you must wait until the next open enrollment or qualify for a special enrollment period.
- Start Paying your Premiums to Get Coverage: While you may receive premium-free Part A benefits, you must begin making monthly premium payments for Part B to activate Original Medicare coverage.
How To Enroll In Medicare Advantage as a Permanent Resident
- Decide Whether You Need Medicare Advantage: Medicare Advantage plans can offer additional healthcare benefits like dental, vision, and hearing services, and many also cover prescription drugs. You must purchase a Medicare Advantage plan separately from a private insurer, and pay a monthly premium on top of Original Medicare costs.
- Plan Ahead and Compare Plans: If you are considering Medicare Advantage, be sure to create a budget for this expense and note the initial 6-month enrollment window around your 65th birthday to sign up. You can browse participating Medicare Advantage providers at Medicare.gov.
- Enroll During Your Initial Enrollment Period: You are eligible to sign up for a Medicare Advantage plan as soon as your Part B coverage starts. Since Medicare Advantage is optional, you will not be charged a penalty for delaying enrollment. However, you can only enroll, drop, or switch plans after initial enrollment during once-annual or special enrollment periods.
How To Enroll In Medigap as a Permanent Resident
- Consider Whether You Need Supplemental Insurance: For an additional premium, Medigap helps cover out-of-pocket expenses like premiums, deductibles, and copays. Plans are named by letters A-N, standardized by Medicare to cover the same benefits no matter where the plan is offered; however, not all states carry all of the lettered plans. You may not enroll in Medigap and Medicare Advantage simultaneously.
- Shop Plan Options in Your State: Each state offers different Medigap options, with some states offering multiple choices for the same lettered plan and others providing limited options, if any. You can browse Medigap plans in your state at Medicare.gov.
- Enroll During Your Initial Enrollment Period: You may sign up for Medigap at the same time as Original Medicare, during the 6-month initial enrollment window around your 65th birthday. Outside of initial enrollment, you may add or drop Medigap during annual enrollment, though doing so may cost more and delay its financial benefits.
Putting It All Together
Accessing Medicare for green card holders is similar to the process of getting Medicare as a U.S. citizen. Permanent residents must have lived in the U.S. for 5 continuous years when they turn 65 to earn Medicare benefits. Green card holders may also qualify for Medicare if they have been married to a U.S. citizen for at least one full calendar year.
Permanent residents must meet a minimum work quota of 10 years to earn premium-free Part A benefits. Green card holders who have lived in the U.S. for at least five years but not yet met the work quota must pay monthly premiums for Original Medicare. All beneficiaries must adhere to the same deadlines for initial and open enrollment. Medicare does not influence citizenship.