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Green card holders have legal permission to live and work permanently in the US but are not citizens. They enjoy many of the same rights as citizens, can own property and attend public schools, but cannot vote in federal elections.
As a result of their status, green card holders often face concerns about healthcare costs due to the complexity of the Medicare system.
Medicare is a federal health insurance program that primarily serves individuals aged 65 years and above but also younger individuals with certain diseases and disabilities.
As of January 2023, there were 12.7 million lawful permanent residents (LPRs) living in the US Green card holders over 65 years of age may be eligible for federal Medicare, Medicaid, or state-sponsored programs such as Medi-Cal, along with other state and federal health insurance programs.
Medicare Eligibility for Green Card Holders
Medicare eligibility among green card holders depends on multiple factors.
First, individuals must be lawful permanent residents for at least five consecutive years to qualify for Medicare Part A, which covers hospital stays, skilled nursing facility care, and some home healthcare services. New immigrants or recent green card holders are not immediately eligible for Medicare Part A.
Second, green card holders must be 65 years or older to be Medicare-eligible. Individuals with less than five years of US residency may still be eligible for Medicare if they have been married to an insured green card holder or US citizen for at least one full calendar year.
The cost of Medicare coverage for green card holders, including Part B and Part D, can vary based on factors such as income and work history.
Can Green Card Holders Get Medicare?
Green card holders over 70 may find it difficult to obtain Medicare coverage. That’s why it’s important to understand the eligibility criteria, enrollment process, and potential caveats when it comes to Medicare for green card holders.
Eligibility:
- Green card holders can qualify for Medicare if they meet the Medicare 5-year residency rule, which requires them to have been US residents for at least five years.
- Medicare eligibility for green card holders is based on age and legal residency, not citizenship status.
Requirements for Medicare Eligibility:
- Applicants must hold a green card for at least five consecutive years before they are eligible for Medicare benefits.
- Individuals generally become eligible for Medicare at age 65. Those with disabilities or certain medical conditions, however, may qualify earlier. For other situations that may qualify green card holders, use the Medicare.gov sign in or call 1-800-MEDICARE (1-800-633-4227) to explore your options.
Work and Taxation Requirements:
To receive full Medicare benefits, green card holders and their spouses must meet specific work, taxation, and residency duration requirements.
To get premium-free Medicare Part A coverage, permanent legal residents must have worked in the US and paid Medicare taxes for at least 10 years. If they worked for less than 10 years, they face higher costs for Part A coverage.
They can also purchase Medicare Part B after five years of permanent residency with a standard monthly premium of $174.70.
Medicare Costs and Premiums:
All citizens and permanent residents in the US need to pay Medicare premiums and out-of-pocket costs.
Here’s a breakdown of the expected costs:
Part A: $0 if worked 10 or more years, $278 per month if worked 7-9 years, $505 per month if worked less than 7.5 years.
Part B: $174.70 per month.
Medigap: $150-200 per month.
Part D: $32.74 per month.
Medicare for Disabled Green Card Holders Under 65:
Permanent residents under 65 with disabilities can qualify for Medicare if they meet the same eligibility criteria as Social Security Disability Insurance (SSDI).
SSDI provides benefits to disabled individuals who have worked and paid into the Social Security system. To be eligible, they must have a qualifying disability and earn enough work credits through their previous employment.
Can I get Medicare for my spouse as well?
If your spouse is over 65, they may be eligible for Medicare coverage.
To qualify, your spouse must be a US citizen or a permanent resident who has lived in the US continuously for at least five years. If your spouse hasn’t individually paid Medicare taxes for at least 10 years, they may not qualify for premium-free Part A based on their own contributions. If it has been at least 10 years since your marriage, however, your spouse may be eligible for premium-free coverage through your contributions.
If your spouse is younger than 65 and has a disability, they might qualify for Medicare after receiving SSDI benefits for 24 months.
Contact your Social Security Administration office or visit their website for specific information and guidance regarding Medicare eligibility for your spouse based on your green card status.
Reach out to us at CoverRight for assistance with understanding eligibility and selecting the optimal Medicare plan. Schedule a call today to make informed decisions for your healthcare needs.
FAQs
Is Medicare free for eligible green card holders?
Medicare is not typically free for eligible green card holders. While most individuals of age 65 or older who have lived in the US for at least five years as lawful permanent residents qualify for Medicare, they generally need to pay premiums for Medicare Part A (Hospital Insurance) if they haven’t worked long enough to qualify for premium-free Part A. In some cases, however, individuals may qualify for premium-free Part A if they or their spouse have worked and paid Medicare taxes for at least 10 years (40 quarters).
They also need to pay premiums for Part B (Medical Insurance). Out-of-pocket costs may include deductibles, coinsurance, and copayments, depending on the services. For specific information about costs and eligibility based on your green card status, contact the Social Security Administration.
If I am a green card holder, can I also get a Medicare Advantage or Medigap plan?
Yes, as a green card holder who is eligible for Medicare, you can also enroll in a Medicare Advantage or Medigap plan. Make sure to review your options carefully and choose a plan that best meets your healthcare needs.
You can use the CoverRight Plan Finder today to explore tailored Medicare Advantage and Medigap plans for your needs
