If you’re a green card holder, you may be wondering if you’re eligible for Medicare. United States permanent residents may qualify for Medicare if they’ve lived here at least five continuous years. 

You may be a green card holder for several reasons, such as:

  • You’re working in the United States.
  • You’re the immediate relative of a United States citizen.
  • You are a refugee or were granted asylum.

There may be other situations that qualify you for permanent residency. For more information, contact the United States Citizenship and Immigration Services office. You can visit them online, or call 1-800-375-5283 (TTY users call 1-800-767-1833). The hours of operation vary depending on your state; check the USCIS website to view the hours for your location.

Once you meet the residency requirements for Medicare, eligibility works the same way whether you’re a citizen or resident.  If you’re like most people in the country, you’ll be first eligible for Medicare when you turn 65 years of age. You can also qualify before turning 65 if you receive disability benefits for two years or if you have certain conditions, including end-stage renal disease or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease). Take a look at this article if you’d like more information on Medicare eligibility.

Medicare costs for green card holders

One question I often get asked is whether you can still get Medicare if you don’t have enough work history. For example, you may have recently immigrated to the United States, or you may have never worked. The good news is you can still qualify for Medicare even if you don’t have enough work credits: Your employment history affects whether you need to pay a premium for Medicare Part A (and the amount you’ll pay if you do), not whether you’re eligible for Medicare benefits.

Generally, permanent residents must pay the same Social Security and Medicare taxes as citizens. You’ll need to work at least 10 years (or 40 quarters) and pay Medicare taxes to get Medicare Part A for free. You may also be able to qualify for premium-free Medicare Part A through your spouse’s employment history. However, if neither you nor your spouse has enough work quarters, you can still sign up for Medicare. Keep in mind that you may have to pay a premium for Medicare Part A, and the amount will depend on how long you worked.

When it comes to Medicare Part B, everyone generally pays a monthly premium, which can change from year to year. You may have to pay a higher premium for Medicare Part B if you make above a certain income.

How to sign up for Medicare

Medicare enrollment can be confusing for a lot of people. There are so many different parts, and each part has different rules about when you can sign up. Luckily, when it comes to signing up for Medicare, this process is the same whether you’re a citizen or a permanent resident.

Some people are automatically enrolled in Original Medicare, Part A and Part B, when they turn 65 if they’re already receiving retirement benefits from Social Security or the Railroad Retirement Board. If this applies to you, your Medicare card should be sent to you about three months before you turn 65, and you’ll be automatically enrolled the first day of the month you turn 65 (or the first day of the prior month, if your birthday happens to fall on the first day of the month).

If you’re not yet getting retirement when you turn 65, you can sign up for Medicare during your seven-month Initial Enrollment Period, which starts three months before your 65th birthday, includes the month you turn 65, and ends three months later.

If you miss your Initial Enrollment Period, you can also sign up during the General Enrollment Period that takes place every year from January 1 to March 31. You may have to pay a late enrollment penalty for not signing up when you were first eligible.

You may also be able to sign up through a Special Enrollment Period if you were still working and had employer-sponsored coverage when you turned 65, or if you were living overseas.

You can sign up for Medicare by visiting the Social Security website, applying in person at a Social Security office, or calling Social Security at 1-800-772-1213, Monday through Friday, from 7AM to 7PM (TTY users call 1-800-325-0778). Representatives are available Monday through Friday, from 7AM to 7PM.

Once you’re enrolled in Medicare Part A and Part B, you can consider some of your other Medicare coverage options, such as:

  • Medicare Prescription Drug Plans, which provide prescription benefits and work alongside Original Medicare.
  • Medicare Advantage plans, which are a private alternative plans to Original Medicare. These plans cover the same benefits as Medicare Part A and Part B, but may also cover additional benefits, like routine vision and dental, prescription drugs, and hearing.
  • Medicare Supplement (Medigap) plans, which cover out-of-pocket costs in Original Medicare.