Medicare for Immigrants and Green Card Holders

Immigrants can get Medicare. The two big questions are your work history and your immigration status. If you (or your spouse) paid Medicare taxes for generally at least 10 years — often described as 40 quarters of work — Part A is premium-free at 65. If not, you may still be able to buy Medicare: you must be 65 or older, live in the U.S., and be either a U.S. citizen or a lawful permanent resident (green card holder) who has lived in the U.S. for 5 continuous years before the month you apply.

Path 1: You Earned Premium-Free Part A Through Work

Medicare work credits — called quarters of coverage — build up through the payroll taxes you pay while working. Citizenship isn't what earns them; work is. An immigrant who worked long enough in the U.S. gets premium-free Part A at 65 the same way anyone else does. Most people qualify because they or a spouse paid Medicare taxes for generally at least 10 years.

You can also qualify on a family member's work record. Premium-free Part A can be based on your own earnings or those of a spouse, parent, or child. So if your spouse worked 10 years in the U.S. and you didn't, you may still get Part A without a premium. Our Medicare for Couples guide covers how spouses' timelines work together.

Not sure how many credits you have? Create an account at ssa.gov and check your earnings record.

Path 2: Buying Into Medicare (the 5-Year Rule)

If you don't have enough work credits, you may be able to buy Medicare. To enroll in Part B — which is also the door to buying Part A — you must meet all of these:

• Be age 65 or older;
• Be a U.S. resident; and
• Be either a U.S. citizen, or an immigrant lawfully admitted for permanent residence who has lived in the U.S. for 5 continuous years before the month of applying.

Buying in works differently than premium-free Part A:

• You don't get Medicare automatically at 65 — you must file an application with Social Security.
• You must enroll during a valid enrollment period, such as your 7-month Initial Enrollment Period around your 65th birthday. See Enrollment & Deadlines.
• To buy Part A, you must also enroll in (or already have) Part B, and you must keep paying both monthly premiums to keep the coverage.

What does buying in cost? Part B has a standard monthly premium. If you buy Part A, its premium depends on how long you or your spouse worked and paid Medicare taxes — a partial work history means a lower Part A premium. Current amounts are at Medicare.gov's costs page and on our Understanding Your Costs page.

Watch the Deadlines — Penalties Are Permanent-ish

The enrollment clock runs whether or not you're ready. If you don't sign up for Part B when you're first eligible, you may pay a late penalty for as long as you have Part B, and it grows the longer you wait. Part A also has a penalty if you delay buying it once you're eligible. If you're near 65 and near your 5-year residency mark, it's worth talking to Social Security about your timing before your window opens.

If You Can't Get Medicare Yet

Some immigrants at 65 have neither the work history nor 5 years of residency yet. Until you qualify, other coverage may bridge the gap — for example, employer coverage if you or a spouse still work (see Working Past 65), or a plan through the Health Insurance Marketplace. If your income is limited, your state may have options too — see Medicaid eligibility and Getting Help Paying.

A Note on Changing Rules

Eligibility rules tied to immigration status are set by federal law, and they have been changing. Don't rely on a friend's experience from years past — or on this page alone. Before you make plans, confirm your own situation with Social Security at ssa.gov or 1-800-772-1213, where free interpreter services are available by phone.

Common Questions