Being a permanent resident, also known as a green card holder, has several advantages. For example, you may obtain certain government-funded healthcare coverage, such as Medicare and Medicaid. However, to receive any of these social benefits, you must meet specific eligibility requirements.
Medicare Vs. Medicaid Insurance for Green Card Holders Explained
Medicare and Medicaid are public healthcare programs available to U.S. citizens and qualified noncitizens such as green card holders. These programs cover several healthcare services, some lab tests, medical equipment, and supplies. However, these programs differ in coverage, eligibility requirements, funding, and more.
Here’s how Medicare and Medicaid compare.
Medicare Vs. Medicaid Health Coverage Comparison
Medicare primarily covers individuals 65 and older and younger individuals with qualifying disabilities or medical conditions. As a result, this program has four parts that cater to the different needs of eligible individuals. These parts include:
- Part A (Hospital Insurance): This part covers hospital care, skilled nursing facility care, hospice care, and some home health care.
- Part B (Medical Insurance): This part covers some medical equipment and supplies, outpatient care, doctor services, and preventive services
- Part C (Medicare Benefits): This part combines parts A and B and covers other services, including dental, vision, and hearing care
- Part D (Prescription Drugs): This part covers prescription medications and is available through private insurance companies
On the other hand, Medicaid provides coverage to individuals with low-income levels, including pregnant women, people with disabilities, and children. Some of the services this program covers include:
- Inpatient and outpatient hospital services
- Long-term care
- Hospital care
- Laboratory and X-ray services
- Rehabilitation services
- Home health care services
- Doctor visits and services
- Dental and vision care
- Hearing aids
- Family planning services and supplies
- Diagnostic and screening services
- Prescription drugs
- Mental health services
Medicare Vs. Medicaid Eligibility Requirements
The general Medicare eligibility requirements include the following:
- Being a U.S. citizen or a lawful permanent resident for at least five continuous years in the U.S.
- Being 65 or older, OR;
- Having a qualifying disability and received Social Security Disability Insurance for at least 24 months, OR;
- Having certain medical conditions such as end-stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
- Having worked and paid Medicare taxes for 40 quarters (or ten years) to be eligible for premium-free Medicare Part A
On the other hand, a permanent resident may acquire Medicaid coverage at any age, depending on their eligibility category. For example, Medicaid covers children, pregnant women, disabled individuals, and the elderly.
Other Medicaid eligibility requirements include:
- Being a U.S. citizen or a lawful permanent resident.
- Being a resident of the state in which you are seeking Medicaid coverage.
- Meeting your state’s income and assets requirements.
Additionally, green card holders have a five-year waiting period after becoming permanent residents to be eligible for Medicaid. However, there are a few exceptions to this rule. For instance, permanent residents admitted to the U.S. as refugees or asylees don’t have to wait five years to apply for Medicaid.
When to Apply for Medicare as a Permanent Resident?
There are specific timelines for applying for Medicare coverage depending on different situations. Ideally, you can apply for medical coverage as a permanent resident if:
- you have lived in the U.S. as a permanent resident for at least five continuous years, and;
- you’re 65 or older, or;
- you have a qualifying disability or medical condition such as end-stage renal disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS)
The best time to apply for Medicare is during the Initial Enrollment Period. This is a seven-month duration that starts three months before your 65th birthday and ends three months after your birthday month.
Alternatively, you may apply for coverage during the General Enrollment Period between January 1st and March 31st if you miss the first chance to enroll. However, you may have to pay monthly penalties for late enrollment.
Depending on your situation, you may be eligible to enroll in Medicare during the Special Enrollment Period. In this case, you won’t have to pay monthly penalties for late enrollment. However, this period has a limited timeframe.
When to Apply for Medicaid as a Permanent Resident?
Unlike Medicare, you can apply for Medicaid anytime if you meet the eligibility requirements. These requirements may vary depending on the state you live in. However, there are some general eligibility rules a permanent resident must meet. These are:
- Being a lawful permanent resident for at least five years, unless otherwise exempted
- Being a resident of the state in which you’re seeking Medicare coverage
- Meeting the income and assets requirements of your state
Besides eligibility, you may need to consider other factors when deciding the best to apply for Medicaid. For example, you may need Medicaid if:
- You’re older and in need of long-term care
- You have a chronic illness
- You’re pregnant
- You need coverage for some medical services and equipment not covered by other health insurance plans
Do Permanent Residents Need Health Insurance?
It’s not mandatory to have health insurance for green card holders. However, this medical insurance for green card holders comes in handy when you require medical services, given that the U.S. has one the most expensive healthcare systems in the world.
Luckily, most permanent residents and other new immigrants qualify for several health insurance covers. Besides Medicare and Medicaid, permanent residents can find other suitable immigrant health insurance plans through the following insurance options for immigrants:
1) Private Health Insurance Companies
Private health insurance companies offer various medical insurance plans with varying costs. In addition, they may cover numerous medical services that public insurance plans don’t cover, making them ideal alternatives for permanent residents seeking personalized health coverage.
2) Marketplace Health Insurance
Permanent residents may enroll in health insurance plans that comply with the Affordable Care Act. These plans are available at the Health Insurance Marketplace – a platform where individuals can buy different health insurance covers depending on their eligibility and needs.
3) Employer Health Insurance Sponsorship
Some employers offer health insurance coverage to their employees, including permanent residents, as part of their benefits package. The insurance may cover dental, vision, and mental health care services, among others.
Is Medi-Cal Insurance Available for Green Card Holders?
Medi-Cal is California’s Medicaid program covering individuals and families with low-income levels. It provides free or low-cost healthcare services to eligible individuals living in California, including permanent residents. But first, applicants must meet certain eligibility requirements. These include:
Age
California’s Medicaid covers 65 or older seniors or younger individuals under 21. However, individuals from other age groups may be eligible for cover under certain circumstances. For instance, the program covers pregnant women, blind or disabled individuals, and individuals in nursing or intermediate care homes. It also covers immigrant parents or guardians of children eligible for Medi-Cal by age.
Residency
You must be a resident of California to be eligible for Medi-Cal, whether you’re a U.S. citizen or lawful permanent resident. You may also get Medi-Cal coverage if you’re a refugee living in the U.S. temporarily.
Income Level and Family Size
The income eligibility requirement for California’s Medicaid depends on the size of your family. Generally, you may be eligible for income-based Medi-Cal if you and your family earn less than 138% of the poverty level.
You can also get Medi-Cal if you belong to one of the following categories:
- You enrolled in California’s food stamp program called CalFresh
- You are a beneficiary of the Supplemental Security Income (SSI) and State Supplementary Payment (SSP) programs
- You and your family enrolled in CalWorks, a program that provides financial assistance to families that have children
- You enrolled in California’s Refugee Assistance Program
- You enrolled in Foster Care or Adoption Assistance Program
What Benefits Does Medi-Cal Cover?
Medi-Cal provides coverage for preventive medical care and essential health benefits, including:
- Ambulatory services
- Maternity and newborn care
- Doctor’s visits
- Mental health and substance abuse treatment services
- Dental and vision care
- Rehabilitative and habilitative services
- Chronic disease management
And more.
Green Card Holder Health Insurance FAQs
Can a Green Card Holder Get Health Insurance for Parents?
As a green card holder, you may purchase health insurance for your parents if they are also green card holders or U.S. citizens. However, their eligibility may vary depending on several factors, such as age, residency, and income level. In addition, your parents may be eligible for healthcare programs such as Medicare, Medicaid, or other health insurance plans from Health Insurance Marketplace.
Do Permanent Residents Get Social Security Benefits?
Yes, permanent residents are entitled to Social Security benefits if they work and pay taxes to earn Social Security credits. The Social Security credits allow permanent residents to qualify for government benefits. For example, a disabled permanent resident who meets the medical and insured requirements may qualify for Social Security Benefits.
What Health Insurance Can I Get With a Green Card?
As a green card holder, you may be eligible for some government-sponsored health insurance programs such as Medicare and Medicaid. You may also qualify for private health insurance coverage or health plans from Health Insurance Marketplace.
Are Immigrants Eligible for Health Insurance Premium Subsidies?
Immigrants in the U.S. may be eligible for premium tax subsidies when purchasing health care coverage through the Marketplace. These tax credits vary depending on the applicant’s income, immigration status, and the type of subsidy.
For instance, lawful permanent residents may be eligible for premium tax credits if they earn income below a specific percentage of the federal poverty level.
Are Recent Immigrants Eligible for ACA Subsidies?
Generally, lawfully present immigrants may qualify for Affordable Care Act subsidies after meeting other eligibility criteria. The premium tax credits help individuals to pay for health insurance coverage through the Health Insurance Marketplace.
Are Undocumented Immigrants Eligible for ACA Coverage?
Unfortunately, undocumented immigrants aren’t eligible for healthcare coverage under the Affordable Care Act. To be eligible, an immigrant must be lawfully present in the U.S. Examples of immigrants that may be eligible to buy a plan on the Health Insurance Marketplace include green card holders, refugees, and asylees.
However, undocumented immigrants can access emergency medical services and may be eligible for coverage from healthcare plans outside the Health Insurance Marketplace.
Can Green Card Holders Apply for Obamacare?
Green card holders are lawfully present in the US. For this reason, they can apply for health insurance under the Affordable Care Act, also known as Obamacare. Other requirements green card holders need to meet to apply for Obamacare are as follows:
- Being ineligible for Medicare
- Meeting the set income level
- Residing in the United States
Can I Get Health Insurance If I am not a U.S. Citizen?
You may obtain health insurance as a noncitizen in the U.S., depending on your immigration status. Generally, you may apply for healthcare coverage under the Affordable Care Act (ACA) if you’re a lawful permanent resident, refugee, or asylee. However, you may acquire health insurance coverage from private companies if you’re a nonimmigrant with temporary visa status.
Can I Add my Foreign Spouse to My Medicare?
In general, your foreign spouse must meet Medicare eligibility requirements to enroll. First, they must be lawful permanent residents of the U.S. who have lived in the country continuously for at least five years. Next, they must have worked and paid Medicare taxes for at least 40 quarters (equivalent to ten years).
However, if your spouse doesn’t meet the work history requirement, but you do, they may still be eligible for Medicare coverage. Lastly, your foreign spouse must be 65 years old, or have a qualifying disability or medical condition to get Medicare coverage.
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