If you’re a green card holder approaching your 65th birthday, you might be wondering: Can I get Medicare? What are my healthcare options? How does my immigration status affect my eligibility?
The good news is that many permanent residents, also known as lawful permanent residents (LPRs) can qualify for Medicare benefits, but the process depends on specific eligibility criteria.
This guide will walk you through Medicare for green card holders over 65, what to expect with costs and coverage, and why connecting with an experienced insurance agent can make the process much easier.
Are Green Card Holders Eligible for Medicare?
Yes, green card holders (LPRs) can qualify for Medicare coverage if they meet certain eligibility requirements:
- Residency: You must have lived continuously in the U.S. for at least five years.
- Age: You must be 65 or older.
- Work History: You (or your spouse) must have earned 40 work credits (about 10 years of work in the U.S. paying Medicare taxes) to get premium-free Medicare Part A (hospital insurance).
If you haven’t earned enough work credits, you can still enroll, but you may need to pay a monthly premium for Medicare Part A.
Unlike U.S. citizens, many new immigrants, non-citizens, and green card holders have to be especially careful about understanding these requirements to avoid costly mistakes.
What If You Don’t Qualify for Premium-Free Medicare Part A?
If you don’t qualify based on your work history, you have two main options:
- Pay for Part A coverage: In 2024, the monthly premium for Part A is up to $505.
- Enroll in Part B: Everyone must pay a Medicare Part B premium (medical insurance), even if they pay for Part A.
You may also want to explore additional health coverage through:
- Medicare Advantage plans (Part C)
- Part D (prescription drug) plans
- Medicare Supplement (Medigap) policies to help pay out-of-pocket costs like deductibles and copays
In some cases, if your income is low, you may qualify for assistance through Medicaid or other health insurance programs available at the state level.
Understanding Medicare Enrollment Periods
Timing is crucial for green card holders. Here are the key periods you need to know:
- Initial Enrollment Period (IEP): Begins 3 months before your 65th birthday, includes the month of your birthday, and ends 3 months after.
- General Enrollment Period (GEP): January 1–March 31 each year if you miss your IEP (coverage starts July 1 and you may face a late enrollment penalty).
- Special Enrollment Period (SEP): Available if you have specific qualifying life events, like losing other health insurance or moving.
Missing these enrollment windows can lead to expensive penalties, gaps in medical insurance, or even denial of some benefits.
Resources like medicare.gov and the Social Security Administration (SSA) website offer basic help, but most beneficiaries find it easier to work with an experienced agent to avoid missteps.
Healthcare Options for Green Card Holders Beyond Medicare
If you’re not yet eligible for Medicare or facing a waiting period, you might consider:
- Private insurance through the Marketplace (under the Affordable Care Act)
- Medicaid (for those with low income and meeting eligibility criteria)
- Short-term health insurance plans (depending on your resident status)
- Coverage through a family member if they have a qualifying plan
The Marketplace is also an option during open enrollment periods if you’re under 65 and don’t yet qualify for Medicare.
Key Medicare Terms to Know
- Medicare Part A: Hospital insurance (may be free depending on your work credits).
- Medicare Part B: Medical insurance (doctor visits, outpatient care).
- Medicare Part D: Prescription drug coverage.
- Medicare Advantage Plan (Part C): Combines Parts A, B, and sometimes D, offered by private insurance companies.
- Medigap: Private supplemental insurance to cover deductibles and copays not covered by Original Medicare.
- 1-800-Medicare: Official Medicare phone line to get general help.
Why Speaking to an Insurance Agent Makes a Difference
Understanding Medicare eligibility as a lawful permanent resident can feel overwhelming, especially when you’re trying to figure out costs, penalties, and coverage options.
That’s where a licensed insurance agent comes in:
- Help you understand if you qualify for premium-free Medicare Part A or must pay a monthly premium.
- Guide you through the correct enrollment period to avoid penalties.
- Assist in comparing Medicare Advantage, Part D, and Medicare Supplement plans.
- Ensure you’re not missing out on healthcare options like Medicaid or Marketplace plans.
A good agent will save you time, reduce confusion, and protect you from paying too much—or worse, missing out on essential healthcare services.
FAQs: Medicare for Green Card Holders Over 65
Can green card holders over 65 get Medicare?
Yes, green card holders over 65 can get Medicare coverage if they meet certain eligibility requirements.
You must have lived in the U.S. for at least five years continuously and meet the necessary work history requirements (40 work credits, or about 10 years of work paying Medicare taxes). If you don’t have enough work credits, you can still enroll by paying a monthly premium for Medicare Part A.
What are the benefits of Medicare for green card holders over 65?
The benefits for green card holders are similar to those for U.S. citizens.
Medicare offers critical access to healthcare services, including hospital care (Part A), outpatient services and doctor visits (Part B), prescription drug coverage (Part D), and optional Medicare Advantage plans that may offer additional benefits like dental, vision, and hearing coverage. Having health insurance through Medicare protects you against high out-of-pocket costs.
Is healthcare free for green card holders?
Healthcare is not automatically free for green card holders.
While you may qualify for premium-free Medicare Part A if you or your spouse have sufficient work credits, you will still be responsible for paying monthly premiums for Medicare Part B and possibly Part D for drug coverage. If you don’t qualify for Medicare, you may have to purchase coverage through the Marketplace or seek help through programs like Medicaid, depending on your income.
How long do you have to live in the U.S. to get Medicare?
To qualify for Medicare, green card holders must have been lawful permanent residents (LPRs) for at least five continuous years.
This means you must have maintained your immigration status without significant absences from the United States during that time.
Are green card holders eligible for Medicare?
Yes, green card holders (LPRs) are eligible for Medicare if they meet the eligibility criteria of being over 65 years old, having lived in the U.S. for at least five years, and (preferably) having the required work history for premium-free Medicare Part A.
How do we get health insurance for her?
If your family member is a green card holder over 65, you have a few options:
- Help them apply for Medicare if they meet eligibility requirements.
- If not eligible yet, they can buy Marketplace health insurance or a private insurance plan.
- If income qualifies, they may be eligible for Medicaid until Medicare becomes available. Speaking to a licensed insurance agent can help you explore the best health coverage options for her situation.
Is medical insurance mandatory for green card holders?
While medical insurance is not federally mandatory for green card holders anymore (the individual mandate penalty was eliminated in most states), having health coverage is highly recommended.
Without insurance, green card holders risk extremely high medical bills. Many states also offer programs that require proof of health insurance for certain benefits.
How does Medicare work for U.S. citizens living abroad or returning from abroad?
Generally, Medicare coverage is limited to services in the United States. If a U.S. citizen or green card holder moves abroad, they cannot use Medicare internationally (with few exceptions for emergencies near U.S. borders). However, returning residents who meet the five-year residency rule and other requirements can enroll during an enrollment period.
What is a permanent resident or green card holder?
A permanent resident, often referred to as a green card holder, is a non-citizen who has been granted authorization to live and work in the United States indefinitely. Permanent residents can eventually qualify for programs like Medicare, Medicaid, and other benefits once they meet specific residency and eligibility requirements.
Can they buy Marketplace coverage?
Yes, green card holders can buy Marketplace health insurance plans through healthcare.gov or their state’s Marketplace if they are not yet eligible for Medicare. Financial assistance based on income may be available to help lower premiums and out-of-pocket costs.
What are the eligibility requirements for Medicare for green card holders over 65?
The eligibility requirements for Medicare for green card holders over 65 are:
- Must be 65 years or older.
- Must be a lawful permanent resident.
- Must have lived in the U.S. for at least five years continuously.
- Ideally have 40 work credits or be willing to pay a monthly premium for Part A coverage.
What are the requirements for green card holders over 65 to qualify for Medicare?
Green card holders must:
- Meet the five-year continuous residency rule.
- Be at least 65 years old.
- Have sufficient work history (or pay a premium if they don’t).
- Apply during the correct enrollment period to avoid penalties.
How can green card holders over 65 apply for Medicare benefits?
Green card holders can apply for Medicare benefits by:
- Contacting the Social Security Administration (SSA) online, by phone, or in person.
- Enrolling during their Initial Enrollment Period around their 65th birthday.
- Providing proof of resident status, work history, and immigration status when requested.
Working with an insurance agent can also help streamline the process and ensure no important steps are missed.
What steps do green card holders over 65 need to take to enroll in Medicare?
Here’s what to do:
- Confirm your eligibility (age, residency, and work history).
- Apply through the SSA (online at ssa.gov, in person, or by phone).
- Choose your coverage: decide if you want Original Medicare, add Part D for prescription drug coverage, or choose a Medicare Advantage plan or Medigap policy.
- Enroll during your Initial Enrollment Period or Special Enrollment Period to avoid penalties.
- Review your coverage options every year during open enrollment.
A licensed insurance agent can guide you through every step to ensure you maximize your Medicare benefits.
Ready to Get Help?
If you’re a green card holder, permanent resident, or new immigrant over 65, don’t leave your health and finances to chance.
Contact one of our licensed agents today for a free Medicare consultation.
We’ll help you navigate your Medicare for green card options, answer your questions about Medicare eligibility, and find the best plan to fit your needs and budget.
Call us now or fill out our online form to get started!