Common Medicare Issues When You Have a Green Card

Know Your Healthcare Options

U.S. legal residency Green Card
You could be eligible for Medicare if you have a Green Card. Jon Feingersh/Blend Images/Getty Images

Not everyone is eligible for Medicare. You have to be 65 years or older or have a qualifying disability. More importantly, you must also be a citizen or a legal resident of the United States. For the purposes of Medicare, this means you are a permanent legal resident with a green card and have lived in the U.S. for at least five consecutive years.

Medicare enrollment differs slightly for U.S. citizens and legal residents.

Understanding when you can take advantage of the program and when you need to seek out another insurance option is key to planning for a healthy future.

Enrollment Periods

The majority of people sign up for Medicare when they turn 65 years old. In this case, you sign up for the program starting three months before your 65th birthday and up to three months after. This is known as the Initial Enrollment Period (IEP) and lasts for seven months.

Depending on when you become a legal resident, you may or may not be eligible during this IEP. Even at or after 65 years of age, you are not fully eligible until you also have that green card in hand. Once you have held that green card for five years, you can finally apply for Medicare.

If you become a permanent legal resident after age 65, you still get an IEP that lasts seven months, only the start and end dates differ. The day you meet ALL eligibility criteria acts like your birthday in the traditional IEP.

You may enroll in Medicare starting three months before and up to three months after that date.

Missing your IEP could result in paying late penalties when you eventually do sign up for Medicare. Anyone who misses their IEP must wait to sign up for Medicare during the General Enrollment Period, January 1 through March 31 every year.

Part A Premiums

Taxes affect how much you pay for Medicare. For many Americans, Part A -- hospital insurance -- is premium-free. If you or your spouse has not contributed 40 quarters (10 years) in Medicare taxes through an American employer, however, you will be required to pay for your Part A benefits.

People who enter the United States near or over 65 years will not have the opportunity to work 40 quarters before they are fully eligible. They will be required to pay every month for Part A Medicare benefits. In 2016, this will cost $226 per month for people who worked between 30 and 39 quarters and $411 per month for those who worked less than 30 quarters. A separate monthly premium is paid for Part B benefits, aka medical insurance.

Non-Medicare Healthcare Options

While you wait for Medicare eligibility, you may want to consider other healthcare options.

  • If you are working, your employer may offer a private health plan.
  • For lawfully present immigrants not eligible for Medicare, a Health Insurance Marketplace plan may be a viable option.
  • For immigrants over 65 years old, you may consider buying temporary health insurance made available for non-U.S. citizens. These plans, referred to as inbound immigrant policies, are intended to bridge your coverage while you wait for Medicare eligibility. For that reason, they are intended to be used for five years or less.

    Sources: Immigration status and the Marketplace. Accessed January 9, 2016.

    Social Security Administration. Program Operations Manual System (POMS). Revised April 23, 2015. Accessed January 4, 2016.

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