A permanent resident can get Medicare after meeting strict eligibility requirements. So, if you’ve recently received your green card and you’re wondering whether you’re eligible for Medicare, you’ve come to the right place. To begin, let’s discuss what Medicare entails.
Medicare Overview
Medicare is a federal health insurance program for residents of the U.S., including citizens and green card holders. It covers certain medical services and supplies depending on an individual’s eligibility. This program has four parts:
- Part A (Hospital Insurance): This part covers inpatient care in hospitals, hospice care, skilled nursing facility care, and certain home health care services.
- Part B (Medical Insurance): Part B covers doctor services, preventive services, and outpatient care.
- Part C (Medicare Benefits): This part includes hospital and medical insurance included in Medicare Part A and B, and additional benefits such as dental, hearing, and vision care.
- Part D (Prescription Drug Cover): This part covers the cost of prescription drugs and is available through private health insurance companies.
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Medicare Eligibility Requirements
Generally, you can be eligible for Medicare if:
- You’re age 65 or older.
- You have a qualifying disability, and you’ve been receiving Social Security Disability insurance (SSDI) benefits for at least 24 months.
- You have a disability or certain medical conditions, such as End-Stage Renal Disease (permanent kidney failure requiring transplant or dialysis), or amyotrophic lateral sclerosis (ALS).
- You are a U.S. citizen or a permanent resident with at least five years of continuous residence in the United States.
- You (or your spouse) have worked in the United States for at least ten years and paid Medicare taxes.
When Can A Green Card Holder Get Medicare?
Generally, you can apply for Medicare as soon as you turn 65 years of age. But because this health program has complex plans with varying enrollment and coverage rules, it is normal to feel confused about the right time to sign up.
The Initial Enrollment Period is usually the first chance to apply for Medicare. This seven-month window opens three months before your 65th birthday and closes three months after your birthday month. If you’re unable to enroll within this timeframe, you may have to wait until the General Enrollment Period from January 1 to March 31.
However, late enrollment comes with a monthly penalty that increases every time you take longer to enroll.
You may also be eligible to sign up for Medicare during the Special Enrollment Period. You won’t have to pay a late enrollment penalty when you sign up during this period. However, you have limited time to apply.
How To Enroll In Medicare for A Permanent Resident?
Both U.S. citizens and permanent residents use the same method to sign up for Medicare. However, some applicants may automatically receive Part A and Part B Medicare without signing up for the program.
For example, if you’re 65 years old, retired, and already getting disability benefits or retirement benefits from the Social Security Administration (or the Railroad Retirement Board), you’ll automatically be eligible for Part A Medicare coverage.
Applicants who can’t automatically enroll for Medicare can apply online at the Social Security website. The process involves the following steps:
- Determining your eligibility for the program
- Choosing your Medicare coverage
- Signing up for Medicare
- Selecting the ideal Medicare plan
When Does Medicare Coverage Start After Signing Up?
The starting date of Medicare coverage varies depending on when you signed up for the program. Here’s how that works.
- If you sign up for Medicare during the first three months of the Initial Enrollment Period, your coverage will begin on the first day of the month you turn 65
- If you sign up for Medicare during your birthday month or three months after, your coverage will start the following month after your enrollment.
- If you sign up for Medicare during the General Enrollment Period, your coverage will start the month after your enrollment.
- If you sign up for Medicare during the Special Enrollment Period, your coverage will begin on the first day of the month after your enrollment or any other later date of your choice.
How Much Does Medicare for Green Card Holders Cost?
The cost of Medicare depends on several factors. These include:
1) The Type of Medicare Coverage
The four parts of Medicare cover different medical services. For example, Part A Medicare offers inpatient care in hospitals and skilled nursing facilities, while Part B Medicare covers ambulance services, Durable Medical Equipment, among other benefits. As a result, these covers differ in costs.
Keep in mind that most people do not pay Part A premiums because they already paid Medicare taxes while working. But if you didn’t pay these taxes while working, the cost of Part A Medicare, as of 2023, is $506 monthly.
2) Your Income
Your income also determines the cost of your Medicare coverage. For instance, if your income in 2021 was $97,000 or less (if you filed individually) or $194,000 or less (if you filed jointly), you’ll pay the basic premium of $164.90 plus an additional income-related monthly adjustment amount in 2023.
3) Your Medicare Advantage Plan
A Medicare Advantage Plan, also called Medicare Part C, combines all the benefits of Part A and Part B Medicare and includes additional benefits such as dental, vision, and hearing coverage. For this reason, the cost of an individual’s Medicare Advantage Plan varies depending on their benefits.
For example, if your income in 2021 was above $97,000 but no more than $123,000, you’ll pay $12.20 plus your plan premium in 2023.
4) Enrollment Date
If you fail to enroll for Medicare during the Initial Enrollment Period, you may be subjected to monthly penalties for late enrollment. As a result, your premiums will increase.
The late enrollment penalty cost is determined by the duration of time during which you were without creditable prescription drug coverage. Presently, the penalty is calculated by multiplying the number of full, uncovered months you were eligible for Medicare drug coverage but did not enroll by 1% of the “national base beneficiary premium” ($32.74 in 2023).
This amount is then rounded to the nearest $0.10 and added to your monthly premium. Given that the “national base beneficiary premium” may rise annually, the penalty may also increase each year. If you enroll in Medicare drug coverage, the plan will inform you of any penalty due and your new premium.
Is Medicare For Green Card Holders Free?
Like most U.S. citizens, permanent residents of the U.S. may be eligible for premium-free Medicare Part A because they (or their spouses) paid Medicare taxes for at least ten years while working.
Part A Medicare covers the following medical services:
- Inpatient care in a hospital
- Skilled nursing facility care
- Nursing home care
- Hospice care
- Some services in home healthcare
Permanent residents who aren’t eligible for premium-free Part A Medicare may be required to pay monthly premiums for this coverage. Usually, the amount varies depending on how long these seniors or their spouses worked and paid Medicare taxes.
Green card holders with qualifying disabilities or medical conditions can also get free Part A Medicare without meeting the ten-year work requirement. Additionally, they may be eligible to sign up for this coverage before age 65.
Other parts of Medicare (B, C, and D) aren’t always free. For this reason, eligible permanent residents may have to pay monthly premiums and other deductibles that vary depending on their coverage, Medicare Advantage Plan, and income, among other factors.
Can New Immigrants Qualify for Medicare?
New immigrants are not eligible for Medicare immediately upon arrival to the U.S. because they often don’t meet the Medicare eligibility criteria. For example, new immigrants don’t meet the ten-year work history proving that they paid Medicare taxes for at least 40 work credits.
Keep in mind that 40 quarters of work equal a 10-year work history.
Additionally, they must have lived in the U.S. continuously for at least five years and be a U.S. citizen or a lawful permanent resident to be eligible.
Fortunately, immigrants seeking health insurance coverage have other options besides Medicare. For instance, some immigrants with qualifying immigration status may be eligible for Medicaid, Children’s Health Insurance Program, or other private healthcare insurance coverage.
If you’re a new immigrant, it’s best to seek guidance from your immigration attorney or an insurance expert about your healthcare coverage options.
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Things You Need To Know About Medicare for Permanent Residents
Here’s a summary of the important things you need to know about Medicare for a permanent resident:
1) Eligibility
Being a permanent resident doesn’t mean you’re automatically eligible for Medicare. This is because there are other eligibility requirements that you must meet. For instance, you must meet the residency requirements, meaning you have lived in the United States for at least five years, to be eligible for Medicare as a permanent resident. Additionally, you must be 65 or older, have certain disabilities, or have a qualifying medical condition such as end-stage renal disease to be eligible.
2) Enrollment
As a permanent resident, you may enroll in Medicare when you’re first eligible at 65 during the Initial Enrollment Period. Alternatively, you may enroll during the General Enrollment Period, although you may have to pay penalties for late enrollment.
3) Medicare Cost
Green card holders may have to pay premiums, deductibles, and copayments for Medicare even if they may be eligible for premium-free Part A Medicare.
