Healthcare Educators


Medicare Eligibility for Green Card Holders

by | Apr 29, 2022

As a green card holder, there are several factors you need to consider regarding your eligibility for Medicare. By understanding these factors, you can make informed decisions about your health care options. Eligibility is dependent on meeting residency requirements as well as qualifying for Medicare through age or disability.

What Makes You Eligible for Medicare

To be eligible you must have established residency in any U. S. state, territory, or possession for at least five years. Once you have residency status, you qualify for Medicare just like anyone else, by turning 65 or obtaining Social Security Disability for at least 24 months. In some circumstances, if you don’t meet these requirements but your spouse does, you may still be eligible for Medicare coverage.

What Will Medicare Cost

There are also factors that determine how much you may have to pay for Medicare. While Part A is based on years worked, the cost of Medicare Part B depends on your income.

To receive premium-free Part A Medicare coverage, you’ll need 40 work credits, or have worked in the U.S. for a minimum of 40 quarters (equal to 10 years) in your lifetime. During this time, you will have paid Medicare and Social Security taxes. If you don’t qualify for premium-free Part A benefits, you may still be able to purchase coverage.

The cost of Medicare Part B is based on how much you made in your working years rather than how long you worked. For this reason, most individuals still must pay a premium for this coverage, regardless of how long they have worked in the country.

Even if you receive premium-free Part A coverage, you are still responsible for paying other aspects of Medicare, such as Part B premiums, deductibles, and coinsurance. However, once enrolled you can consider a Medigap supplement plan, Medicare Advantage Plan (Part C) or Medicare Savings Plans to reduce these costs if you qualify.

Enrollment Deadlines and Late Penalties Apply

Whether you are a citizen or a permanent resident the enrollment process is the same. You should enroll for Medicare benefits during your Initial Enrollment Period (IEP) if you want to avoid penalties. IEP begins three months before you turn 65 and ends three months after.

You will most likely be automatically enrolled in Medicare Part A and B if you receive Social Security benefits four months or more before turning 65. If not, you’ll need to go to the Social Security Administration website and sign up for the benefits you want.

Delaying Medicare enrollment could result in late penalties for Parts A, B and D. The longer you wait to sign up, the more significant the penalties are. They continue to increase the longer you delay enrollment.

Green Card Holders on Disability Could Be Eligible for Medicare

You may qualify for Medicare earlier if you are lawful resident, living in the United States continuously for five years, and are receiving Social Security Disability benefits. If you are between the ages of 18-64, you are eligible for Medicare after receiving disability payments for at least 24 months.

What Happens if You Leave the Country

If you travel for brief periods of time outside the country, your Green Card status is not affected. Green Card holders who travel outside of the country for more than a year are considered to have abandoned their U.S. residency and, in most cases, will lose their Green Card.

If you are eligible for Medicare, it’s important to understand what is covered by Medicare while you are out of the country. Original Medicare does not cover treatment outside of the U.S. except in a few rare circumstances. If you have a Medicare Advantage plan, you could be disenrolled if you are outside the plan’s service area for more than 6 months. If you plan to enroll in Medicare and know that you will be travelling outside the country, you may want to consider a Medigap plan that offers additional coverage. Once you have enrolled it’s important to stay current with your Medicare premiums even while you are out of the country.

Do you need help understanding your Medicare eligibility and options? Contact us today. Our experienced and knowledgeable team is here to help.