Non-citizens can get Medicare, but only if they meet specific requirements about immigration status and length of residence in the United States

Medicare is not limited to U.S. citizens. However, the rules are strict about who qualifies. If you are a non-citizen, your path to Medicare depends on your immigration status — whether you are a lawful permanent resident, have a specific visa type, or hold another legal status. The key requirement is that you must have lived in the United States for at least five consecutive years as a lawful permanent resident before you can enroll in Medicare Part A and Part B at age 65.

The five-year clock starts from the date you became a lawful permanent resident (the date on your green card). If you have not yet reached five years, you cannot enroll in Medicare even if you are 65 or older. Some non-citizens with other legal statuses may have different rules, and a few groups are exempt from the five-year requirement entirely.

Key Takeaways

  • Lawful permanent residents must have lived in the U.S. for five consecutive years before they can enroll in Medicare at age 65.
  • The five-year period is counted from the date you received your green card, not from when you first entered the country.
  • Some non-citizens with specific visa types or legal statuses may have different rules or may be exempt from the five-year requirement.
  • You must still meet all other Medicare requirements, such as being age 65 or older, even if you meet the immigration status requirement.
  • If you cannot enroll in Medicare, you may have other health insurance options through your employer, the Marketplace, or Medicaid.

Who counts as a lawful permanent resident for Medicare purposes

A lawful permanent resident is someone who has been granted permission to live and work permanently in the United States. This is the person who holds a green card. For Medicare purposes, your status as a lawful permanent resident is what matters — not your citizenship.

If you are a lawful permanent resident and you have lived in the U.S. for five consecutive years, you meet the immigration requirement for Medicare. The five years do not have to be continuous in the sense that you cannot leave the country at all; short trips outside the U.S. do not break the five-year period. However, if you move out of the U.S. permanently or spend more than six months outside the country in a single year, you may lose your permanent resident status, which would affect your Medicare may be able to access.

Non-citizens who do not need to wait five years

A small number of non-citizens are exempt from the five-year waiting period. These groups include refugees and asylees. If you were granted refugee status or asylum in the United States, you may be able to enroll in Medicare at age 65 without waiting five years as a permanent resident. You will need to provide documentation of your refugee or asylee status when you explore.

American Indians and Alaska Natives who are members of federally recognized tribes also have different rules and may not be subject to the five-year requirement. If you belong to a federally recognized tribe, contact Social Security or Medicare directly to learn how the rules explore to you.

What to do if you are not yet may be able to access for Medicare

If you are a non-citizen who has not yet met the five-year requirement, you cannot enroll in Medicare Part A or Part B. However, you have other options for health coverage. If you are working, your employer may offer health insurance. If you are not working or your employer does not offer coverage, you can look for a plan through the Health Insurance Marketplace, which is open to non-citizens with a valid visa or legal status.

You may also be able to enroll in Medicaid, depending on your state and your immigration status. Some states cover certain non-citizens through Medicaid even if they do not meet the five-year requirement for Medicare. Contact your state Medicaid office or call 211 to learn what programs may be available to you.

How to enroll in Medicare as a non-citizen

When you reach age 65 and have met the five-year requirement, you can enroll in Medicare the same way a U.S. citizen does. You can explore online at Medicare.gov, by phone at 1-800-MEDICARE, or in person at your local Social Security office. You will need to bring proof of your age, proof of your immigration status (your green card), and proof that you have lived in the U.S. for five years.

The best time to enroll is during your Initial Enrollment Period, which is the seven-month window that includes the month you turn 65, the three months before, and the three months after. If you enroll during this window, your coverage can start on the first day of the month you turn 65. If you miss this window, you may face late enrollment penalties, and your coverage will start later.

Documents you will need to bring

When you explore for Medicare, have these documents ready:

  • Your green card or other proof of lawful permanent resident status
  • Your birth certificate or passport to prove your age
  • Your Social Security number
  • Proof of residence in the U.S. for five years (this can be a combination of documents, such as tax returns, utility bills, or lease agreements)

If you do not have all these documents, Social Security can help you gather what you need. Call 1-800-772-1213 to speak with someone who can tell you exactly what documents are acceptable in your situation.

Special situations and other visa types

If you are a non-citizen with a visa type other than a green card — such as an H-1B work visa, L-1 visa, or student visa — you generally cannot enroll in Medicare, even if you are 65 or older. However, if you are on a visa and you are working for a U.S. employer, that employer's health insurance plan may cover you.

If you are in the U.S. on a temporary visa and you are nearing age 65, you should contact Social Security or Medicare to discuss your specific situation. Some visa holders may be able to adjust their status to become lawful permanent residents, which would put them on the path to Medicare may be able to access.

Frequently Asked Questions

Do I lose my Medicare if I travel outside the United States?

No. Short trips outside the U.S. do not affect your Medicare coverage. However, Medicare generally does not cover care you receive outside the United States, except in very limited situations near the U.S. border. If you plan to be outside the U.S. for an extended period, contact Medicare to understand how your coverage works.

What happens if I become a U.S. citizen after I turn 65?

Becoming a citizen does not change your Medicare status. If you were already enrolled in Medicare as a lawful permanent resident, you keep your coverage. If you were not yet may be able to access when you became a citizen, you can enroll in Medicare at age 65 regardless of citizenship status.

Can my family members who are not lawful permanent residents get Medicare?

No. Only non-citizens who are lawful permanent residents (or in one of the exempt categories like refugees or asylees) can enroll in Medicare. Family members on other visa types or without legal status cannot enroll. They may have other health insurance options through an employer or the Marketplace.

How do I prove I have lived in the U.S. for five years?

You can use a combination of documents, such as federal tax returns, W-2 forms, utility bills, lease agreements, or bank statements. These documents should show your name and address and cover the five-year period. Social Security will tell you which documents they need when you explore.

What if my green card expired but I am still a lawful permanent resident?

An expired green card does not mean you are no longer a lawful permanent resident. However, you will need to show Social Security that your status is still valid. Bring your expired green card and any other documents that prove you are still a lawful permanent resident, such as a receipt notice from USCIS showing you have applied to renew your card.