Lawful Permanent Residents: Eligibility For Medicare Benefits

Enrolling in Medicare as an immigrant is a complex process, and older immigrants—many of whom do not have a significant work history in the US, are not citizens, or have limited English proficiency—may find it challenging to navigate. Lawful Permanent Residents (LPRs) are eligible for Medicare, but they must meet certain requirements. LPRs must have five years of continuous residence in the US before enrolling in Medicare and must be 65 or older. They also need to have worked at least 40 quarters (10 years) in jobs where they or their spouses paid Medicare payroll taxes. LPRs who are under 65 but have disabilities may also qualify for Medicare, but they must first meet the same eligibility requirements for SSDI (disability benefits) that citizens do.

Requirements for Medicare Part A

Lawful Permanent Residents (LPRs) are eligible for Medicare Part A, but they must meet certain requirements. Firstly, LPRs must have held their status for at least five years before they can enrol in Medicare Part A. This is a continuous residency requirement.

To be eligible for premium-free Medicare Part A, an individual must have worked for a specified number of quarters (at least 10 years) in jobs where they or their spouse paid Medicare payroll taxes. They must also be at least 65 years old. If an individual is receiving monthly Social Security or Railroad Retirement Board (RRB) benefits, they will automatically receive Part A at 65 without needing to file a separate application. Those not receiving these benefits must file an application for Medicare by contacting the Social Security Administration.

Legal immigrants over the age of 65 without this work history can purchase Medicare Part A after legally residing in the US for five years. Immigrants under 65 with disabilities may also qualify for Medicare Part A but must first meet the eligibility requirements for SSDI (disability benefits) that apply to citizens. These requirements include work history and having paid Social Security taxes for 5-10 years.

LPRs with sufficient work credits can qualify for premium-free Part A and do not face any length of residency requirements.

Medicare Part B costs for immigrants

Lawfully present immigrants in the US can get Marketplace coverage and may qualify for premium tax credits and other savings on Marketplace plans. This includes immigrants with "Qualified Non-Citizen" status, such as Lawful Permanent Residents (LPRs) or green card holders. To get Medicaid and Children's Health Insurance Program (CHIP) coverage, LPRs generally have to wait five years after getting "qualified" immigration status. However, there are exceptions for refugees, asylees, and LPRs who previously held these statuses.

Regarding Medicare, permanent residents aged 65 or older who have worked in the US for at least 40 quarters (10 years) in jobs where they or their spouses paid Medicare payroll taxes are eligible for premium-free Medicare Part A. Legal immigrants in this age group who do not meet the work history requirement can purchase Medicare Part A after legally residing in the US for five years. Additionally, legal immigrants (non-citizen permanent residents) under 65 with disabilities may qualify for Medicare, but they typically must first meet the eligibility requirements for SSDI (disability benefits), including work history and paying Social Security taxes.

For Medicare Part B costs, lawfully present individuals, including LPRs, with qualifying work credits can enroll in both Part A and Part B without any length of residency requirements. This means that LPRs with sufficient work history can access Medicare Part B without having to wait. However, it is important to note that Medicare enrollment and its benefits can be complex, and older immigrants may face challenges due to limited English proficiency or other factors.

While lawfully present individuals can receive premium tax credits and cost-sharing reductions, it is important to consider the potential late enrollment penalties for both Part A and Part B if choosing Marketplace coverage before switching to Medicare. The costs associated with Medicare Part B will vary based on coverage, services, and providers. Individuals with limited income and resources may be able to receive assistance from their state in paying premiums and other costs.

Medicaid eligibility for immigrants

Lawfully present immigrants can get health coverage through the Marketplace and may qualify for premium tax credits and other savings on Marketplace plans. They may also be eligible for Medicaid and the Children's Health Insurance Program (CHIP) if they meet state income and residency rules.

To get Medicaid and CHIP coverage, many qualified non-citizens (such as many Lawful Permanent Residents, also known as LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after getting "qualified" immigration status before they can get Medicaid and CHIP coverage. There are exceptions to this rule, for example, refugees, asylees, or LPRs who used to be refugees or asylees don’t have to wait 5 years.

In addition, 35 states, the District of Columbia, the Commonwealth of the Northern Mariana Islands, American Samoa, and the U.S. Virgin Islands have chosen to provide Medicaid coverage to lawfully residing children and/or pregnant people without a 5-year waiting period. Twenty-eight of these states also cover lawfully residing children or pregnant people in CHIP.

Lawfully present individuals, unlike citizens, can receive premium tax credits and cost-sharing reductions, even if their income is below 100% of FPL if they are ineligible for Medicaid because of their immigration status. Eligibility for QHP premium tax credits and cost-sharing reductions is based on Modified Adjusted Gross Income (MAGI) rules, which do not include asset tests.

LPRs, individuals in Temporary Protected Status (TPS), and other lawfully present individuals with work credits that qualify them for premium-free Part A also do not face any length of residency requirement. Because they qualify for premium-free Part A, these individuals can enroll in both Part A and Part B without any length of residency requirement.

Medicare and citizenship applications

Enrolling in the Medicare program and accessing its benefits can be complex and is often confusing for older adults. The process can be even more challenging for older immigrants, some of whom do not have a significant work history in the United States, are not citizens, or have limited English proficiency.

Medicare Part A focuses on healthcare received in an inpatient setting at a hospital, while Medicare Part B covers healthcare costs in an outpatient setting, such as a doctor's office. Permanent resident green card holders with higher incomes may pay an additional premium for Medicare Part B. Immigrant eligibility for Medicare can affect your premiums; delaying enrollment may result in penalties and higher costs when you do enroll.

To be eligible for Medicare, immigrants must be lawful permanent residents (LPRs) or green card holders and have five years of continuous residence in the United States immediately prior to Medicare enrollment. This five-year waiting period does not apply to refugees, asylees, or LPRs who used to be refugees or asylees. Legal immigrants over 65 without this work history can purchase Medicare Part A after residing legally in the US for five years. Legal immigrants (non-citizen permanent residents) under 65 with disabilities may qualify for Medicare, but they must first meet the same eligibility requirements for SSDI (disability benefits) that citizens do, including work history and paying Social Security taxes.

It is important to note that while Medicare is available to those who qualify, it is not considered a "public charge." Applying for or receiving Medicaid or CHIP benefits will not affect your chances of becoming a Lawful Permanent Resident or US citizen. However, receiving benefits you are not entitled to can complicate your citizenship application.

Work credits for green card holders

Lawful Permanent Residents (LPRs) or green card holders can receive Medicare under certain conditions. Firstly, they must have worked in the US for a minimum of 40 quarters (10 years), where they or their spouses paid Medicare payroll taxes. Secondly, they must be at least 65 years old. If these criteria are met, LPRs can enrol in premium-free Medicare Part A.

Legal immigrants who are 65 or older without the requisite work history can still purchase Medicare Part A after legally residing in the US for five years continuously. Legal immigrants (non-citizen permanent residents) under 65 with disabilities may also qualify for Medicare, but they must first meet the eligibility requirements for SSDI (disability benefits) that apply to citizens. These requirements include a work history, the payment of Social Security taxes on income, and the accumulation of sufficient years of Social Security taxes, equating to between 20 and 40 work credits (5-10 years).

To obtain a green card through employment, foreign nationals can apply for an employment-based (EB) "preference immigrant" category. These categories include EB-1, EB-2, and EB-3, encompassing multinational managers and executives, professionals with advanced degrees or exceptional ability, skilled workers, and professionals. Applicants must submit Form I-485, Application to Register Permanent Residence or Adjust Status, and meet other requirements such as being physically present in the US at the time of filing.

Green card holders, or LPRs, are generally eligible for various public benefits, including Medicaid, SSI, Social Security, food stamps, public and affordable housing, and unemployment benefits. To receive Medicaid and CHIP coverage, LPRs typically face a five-year waiting period from the time they obtain "qualified" immigration status. However, there are exceptions for specific groups, such as refugees, asylees, and victims of trafficking.

Frequently asked questions