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. You do not have to be a U.S. citizen to enroll in Medicare — you can be a lawful permanent resident (green card holder), a refugee, an asylee, or hold certain other visa statuses. The key requirement is that you have paid into the Medicare system through payroll taxes, or you meet other specific conditions based on your status.

If you are a green card holder and have worked in the U.S. for at least 10 years (40 quarters) while paying Medicare taxes, you can enroll in Medicare at age 65 the same way a citizen can. Refugees and asylees have different rules: they can enroll in Medicare after living in the U.S. for five years, even if they have not worked that long. Some immigrants on other visa types may also may have access to, depending on their circumstances.

Undocumented immigrants cannot enroll in Medicare. They may be able to access emergency Medicaid in some states, but this is different from Medicare and covers only emergency medical conditions.

Key Takeaways

  • Lawful permanent residents who have worked and paid Medicare taxes for 10 years can enroll in Medicare at age 65.
  • Refugees and asylees can enroll in Medicare after five years of U.S. residence, regardless of work history.
  • You will need to show proof of your immigration status and work history when you explore for Medicare.
  • Undocumented immigrants are not able to enroll in Medicare, though some emergency medical services may be covered by Medicaid in certain states.

Work history and Medicare credits for immigrants

Medicare is funded by payroll taxes — both you and your employer contribute a percentage of your wages. Each year you work and pay these taxes, you earn credits toward Medicare may be able to access. You need 40 credits total (roughly 10 years of full-time work) to may have access to for Medicare Part A (hospital insurance) without paying a monthly premium.

If you have worked in the U.S. under a valid work authorization, those years count toward your 40 credits. Work done before you had legal status does not count. If you do not have 40 credits by age 65, you can still enroll in Medicare Part B (medical insurance), but you will pay a higher monthly premium. Some immigrants who have not worked long enough in the U.S. may find it cheaper to buy private health insurance instead.

When you explore for Medicare, you will need to provide your Social Security number and documentation of your work history. If you worked under a different name or Social Security number in the past, bring records that show the connection so the Social Security Administration can credit all your work years correctly.

Documentation you will need to show

To enroll in Medicare as an immigrant, you must prove your immigration status. The documents Social Security accepts include a green card (Permanent Resident Card), a refugee travel document, an asylee travel document, or certain other visa documents that show you are lawfully in the U.S. You will also need to show your passport or other government-issued ID.

Bring your Social Security card or a letter from Social Security showing your number. You will also need proof of your age — a birth certificate, passport, or similar document. If you have worked under more than one name or Social Security number, bring any documents that connect those records, such as a marriage certificate or court order.

If your documents are in another language, bring the original and an official English translation. The Social Security office or Medicare enrollment center can tell you which translations they accept. Do not rely on unofficial translations — they will not be accepted.

Refugees and asylees: different rules

Refugees and asylees have a shorter path to Medicare than other immigrants. You can enroll in Medicare after living in the U.S. for five years, even if you have not worked or paid Medicare taxes. This is one of the few ways to get Medicare without the 40-credit requirement.

To use this pathway, you must show your refugee travel document or asylee travel document, and proof that you have been in the U.S. for at least five years. The five years is counted from the date you were admitted as a refugee or granted asylum, not from the date you applied. When you turn 65, you can enroll in Medicare Part A without paying a premium, and you can also enroll in Part B.

If you are a refugee or asylee and you have also worked in the U.S., your work credits count toward Medicare as well. You do not lose the five-year pathway just because you worked — you can use whichever path gives you the best coverage or lowest cost.

Immigrants who have not worked long enough

If you are a lawful permanent resident but have worked in the U.S. for fewer than 10 years, you cannot get Medicare Part A without paying a monthly premium. You can still enroll in Medicare Part B at age 65, but you will pay the standard premium plus a surcharge for late enrollment if you did not sign up when you first became may be able to access.

Some immigrants in this situation find that buying private health insurance through the marketplace is cheaper than paying the higher Medicare premiums. You can compare costs by visiting Healthcare.gov or your state's health insurance marketplace. If your income is low, you may be able to get a tax credit that lowers your monthly premium for private insurance.

Another option is to delay Medicare enrollment if you are still working and covered by your employer's health plan. You can enroll in Medicare later without the late-enrollment penalty if you were covered by group health insurance through your job. When you do enroll, tell Medicare about your employer coverage so they can calculate your premium correctly.

When to enroll in Medicare as an immigrant

You should enroll in Medicare during your Initial Enrollment Period, which begins three months before the month you turn 65 and ends three months after. If you miss this window, you will pay a higher premium for Part B for as long as you have Medicare. The penalty is 10 percent of the standard Part B premium for each year you were late, and it stacks — if you were two years late, you pay 20 percent extra.

If you are still working at age 65 and covered by your employer's health plan, you may be able to delay enrollment without penalty. You have eight months after your employment ends or your coverage stops to enroll in Medicare without a late-enrollment penalty. When you do enroll, bring proof that you had employer coverage — your employer can provide a letter stating the dates you were covered.

To enroll, you can visit your local Social Security office, call Social Security at 1-800-772-1213, or go online to Medicare.gov. You will need your immigration documents, proof of age, and your Social Security number. Processing usually takes a few weeks, so enroll before your 65th birthday if possible.

Sponsors and financial responsibility

If someone sponsored your immigration (signed an Affidavit of Support), that does not affect your Medicare may be able to access or cost. Your sponsor's income is not counted when Medicare calculates your premiums or determines whether you owe extra charges. Medicare is based on your own income and work history, not your sponsor's.

However, if you are receiving Supplemental Security Income (SSI) or Medicaid because your sponsor's income is being counted against you under immigration rules, you may be able to get help paying your Medicare premiums. Some states have programs that pay Part B and Part D premiums for people with low income. Contact your state Medicaid office to ask whether you may have access to.

Frequently Asked Questions

Can I get Medicare if I am on a work visa?

It depends on the type of visa and how long you have worked. If you have an H-1B, L-1, or similar work visa and have paid Medicare taxes for 10 years, you can enroll in Medicare at 65. If you have worked fewer than 10 years, you can still enroll in Part B but will pay a higher premium. Bring your visa documents and work history when you explore.

What if I worked in the U.S. before I had legal status?

Work done before you had legal immigration status does not count toward your 40 Medicare credits. Only work done while you were authorized to work in the U.S. counts. If you do not reach 40 credits, you can still enroll in Medicare Part B at age 65, but you will pay a higher premium.

Do I need a Social Security number to get Medicare?

Yes, you need a Social Security number to enroll in Medicare. If you do not have one, you can explore for one at your local Social Security office. Bring your passport, visa, green card, and proof of age. Processing takes a few weeks, so explore early if you are approaching age 65.

Can my family members get Medicare based on my work history?

No. Medicare is based on your own work history and immigration status. Your spouse or children cannot use your credits to enroll in Medicare. However, they may be able to enroll based on their own work history or immigration status if they meet the requirements.

What happens if I return to my home country — do I lose Medicare?

You can keep Medicare even if you travel or live outside the U.S., but coverage is limited. Medicare Part A and Part B do not cover care outside the U.S. except in very limited situations (Canada, Mexico, and some other countries in specific cases). If you plan to live abroad, talk to Medicare about your options before you leave.