Who Can Get Medicare as an Immigrant
Medicare is available to immigrants, but the rules depend on your immigration status and how long you have lived and worked in the United States. If you are a U.S. citizen or permanent resident (green card holder), you can enroll in Medicare at 65 just like any other American. If you are not yet a permanent resident, your path to Medicare is narrower but not always closed.
The core requirement is that you must have worked and paid Medicare taxes (the 2.9% payroll deduction) for at least 40 quarters — roughly 10 years — to receive Medicare Part A (hospital insurance) without paying a monthly premium. Immigrants who have worked legally under a Social Security number accumulate these quarters the same way citizens do. If you have not worked 40 quarters, you may still purchase Part A coverage, but the monthly cost is higher.
Your immigration status matters most for Part B (medical insurance) and Part D (prescription drug coverage). Permanent residents and citizens can enroll in these parts at 65 with no additional restrictions. Undocumented immigrants and those on temporary visas cannot enroll in Medicare at all, regardless of age or work history.
Key Takeaways
- Permanent residents and U.S. citizens can enroll in Medicare at 65 if they have worked and paid Medicare taxes for at least 40 quarters (about 10 years).
- Work history is tracked through your Social Security number, and only legal work under that number counts toward the 40-quarter requirement.
- If you have fewer than 40 quarters of work history, you can still buy Part A coverage, but the monthly premium is significantly higher than for those who may have access to for free Part A.
- Undocumented immigrants and people on temporary visas cannot enroll in Medicare, even if they have worked in the United States for many years.
- You must be a permanent resident or U.S. citizen to enroll in Part B and Part D; these parts are not available to other visa holders.
How Work History Is Counted for Immigrants
Medicare counts only work performed under a valid Social Security number. If you worked in the United States without authorization or without a Social Security number, those years do not count toward your 40 quarters, even if you paid taxes through an Individual Taxpayer Identification Number (ITIN). This is a common source of confusion for immigrants who have worked for decades but may not have had legal work authorization for all of it.
To check your work history, you can create an account on ssa.gov and view your Social Security Statement. This statement shows the quarters you have earned each year. You should review it before you turn 65 to make sure the record is correct. If you spot errors — missing years of work, or years credited to the wrong person — you can file a correction with the Social Security Administration. Corrections can take several months, so start this process at least a year before you plan to enroll in Medicare.
If you became a permanent resident after working in the United States, your prior work history under your Social Security number still counts. You do not lose credit for quarters worked before you had your green card, as long as you were working legally under that Social Security number at the time.
Immigration Status and Medicare Enrollment
Your immigration status determines whether you can enroll in Medicare at all. The rules are strict and do not have exceptions for long-term residents or people with deep ties to the United States.
| Immigration Status | Can Enroll in Medicare | Requirements |
|---|---|---|
| U.S. Citizen | Yes | Age 65 or older; 40 quarters of work history (or pay higher Part A premium) |
| Permanent Resident (Green Card) | Yes | Age 65 or older; 40 quarters of work history (or pay higher Part A premium) |
| Temporary Visa (H-1B, L-1, F-1, etc.) | No | Not may be able to access, regardless of work history or age |
| Undocumented | No | Not may be able to access, regardless of work history or age |
| Refugee or Asylee | Yes | Age 65 or older; 40 quarters of work history (or pay higher Part A premium) |
If you are on a temporary visa and want to enroll in Medicare, you must first become a permanent resident or U.S. citizen. This process can take years. During that time, you may need to purchase private health insurance or use your employer's plan if available. Some temporary visa holders can transition to permanent residency through employment sponsorship, family sponsorship, or other pathways, but Medicare enrollment cannot happen until that transition is complete.
What to Do If You Have Fewer Than 40 Quarters
If you have worked legally in the United States for fewer than 10 years, you do not automatically may have access to for free Part A coverage. However, you have two options: you can purchase Part A coverage with a monthly premium, or you can delay enrollment until you reach 40 quarters (if you continue working).
The monthly premium for Part A without 40 quarters is set each year by Medicare and is higher than the standard premium for those who do may have access to. As of recent years, this premium ranges from roughly $250 to $500 per month depending on how many quarters you have completed, but the exact amount changes annually. You should contact Medicare directly at 1-800-MEDICARE to learn the current premium for your situation.
If you choose to work longer to reach 40 quarters, you can delay enrollment. Each additional quarter of work adds credit toward the 40-quarter threshold. Once you reach 40 quarters, you become may be able to access for free Part A at your next enrollment period. This strategy makes sense only if you are still working and earning income that justifies the delay.
Permanent Residents and Citizenship Requirements
Permanent residents (green card holders) have the same Medicare rights as U.S. citizens once they turn 65 and meet the work history requirement. You do not need to become a citizen to enroll in Medicare. However, you must have a valid green card and a Social Security number to complete the enrollment process.
When you enroll, Medicare will ask for proof of permanent residency. Bring your green card and your Social Security card to the Social Security office, or submit copies when you enroll online or by phone. If your green card has expired, you should renew it before enrolling in Medicare, as an expired card may not be accepted as proof of status.
If you are a permanent resident and plan to travel outside the United States for extended periods, be aware that Medicare coverage generally does not work outside U.S. borders. Some plans offer limited emergency coverage abroad, but routine care is not covered. Before traveling, review your plan's coverage rules and consider purchasing supplemental travel insurance if you will be away for more than a few weeks.
Refugees, Asylees, and Special Immigrant Status
Refugees and asylees are treated like permanent residents for Medicare purposes. If you were granted refugee or asylee status and have worked legally in the United States for 40 quarters, you can enroll in Medicare at 65 with no additional requirements. Your refugee or asylee status is sufficient proof of may be able to access; you do not need to become a permanent resident first, though many refugees and asylees do eventually pursue permanent residency or citizenship.
Other special immigrant categories — such as Special Immigrant Visas (SIVs) for Afghan or Iraqi nationals, or T visas for trafficking survivors — may also may have access to for Medicare if they meet the work history requirement. The rules vary by visa type. If you hold a special status and are unsure whether you can enroll, contact the Social Security Administration at 1-800-772-1213 to confirm your may be able to access before you turn 65.
How to Enroll When You Are Ready
Enrollment in Medicare happens through the Social Security Administration, not through a separate immigration office. You can enroll online at ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. You will need your Social Security number, proof of citizenship or permanent residency (passport, green card, or naturalization certificate), and proof of age (birth certificate or passport).
The standard enrollment period is the three months before your 65th birthday, your birth month, and the three months after. If you miss this window, you can still enroll, but you may face a late enrollment penalty that increases your Part B and Part D premiums permanently. The penalty is small if you enroll only a few months late, but it grows the longer you wait. If you are still working and covered by an employer plan at 65, you may have a special enrollment period that lets you enroll without penalty after you leave that job.
Bring all documents in their original form or certified copies. If your documents are in another language, bring the originals and ask the Social Security office whether they need a certified translation. Processing typically takes two to four weeks once you submit your process.
Frequently Asked Questions
Can I get Medicare if I am on an H-1B visa?
No. Temporary visa holders, including H-1B, L-1, and F-1 visa holders, cannot enroll in Medicare regardless of how long they have worked in the United States or how many quarters they have completed. You must become a permanent resident or U.S. citizen first. If you are sponsored for permanent residency by your employer, you can enroll in Medicare once your green card is approved.
What if I worked in the U.S. without authorization years ago and now have a green card?
Work performed without authorization does not count toward your 40 quarters, even if you paid taxes. Only work performed under a valid Social Security number counts. If you have worked legally for 40 quarters since obtaining authorization, you can enroll in Medicare. If not, you can purchase Part A coverage at a higher monthly premium.
Do I need to be a U.S. citizen to enroll in Medicare?
No. Permanent residents, refugees, asylees, and some other special immigrant categories can enroll in Medicare without becoming citizens. You must be 65 or older and have 40 quarters of work history (or be willing to pay a higher premium for Part A). Citizenship is not required.
What happens to my Medicare if I move back to my home country?
Medicare generally does not cover care outside the United States. If you move abroad permanently, you should contact Medicare to discuss your options. You may be able to keep your coverage for emergency situations, but routine care will not be covered. Some immigrants maintain Medicare coverage even while living abroad in case they return to the U.S. for medical treatment.
How do I check if I have 40 quarters of work history?
Create an account on ssa.gov and view your Social Security Statement. It shows the quarters you earned each year. Each year you work and pay Medicare taxes, you earn up to four quarters. If you spot errors, file a correction with the Social Security Administration at least a year before you plan to enroll in Medicare.