Here's the short answer. To buy Medicare, a person must be 65 or older, live in the U.S., and be either a U.S. citizen or a green card holder who has lived here for 5 continuous years. Federal Medicaid money is generally limited to emergency care for people without a qualifying immigration status. Some states run separate programs paid for with state money. Those programs differ by state and can change. The only way to know what is open to you is to ask your state agency.
En español: Medicare para indocumentados. En general, una persona sin estatus migratorio calificado no puede inscribirse en Medicare. Esta página explica qué dicen las reglas federales y cómo preguntar por programas estatales.
Why Medicare is closed to some older adults
Medicare is a federal program tied to citizenship or lawful permanent residence. There are two ways in:
- Work credits. Premium-free Part A generally needs 10 years of Medicare taxes paid, by you or a spouse. Work credits count, but a person must also meet the citizenship or residence rule to enroll.
- Buying in. You must be 65 or older, live in the U.S., and be a citizen or a green card holder with 5 continuous years here.
For the full details, read Medicare for Immigrants.
What federal Medicaid covers
Federal law allows Medicaid to pay for care for people without a qualifying immigration status only when it is needed to treat an emergency medical condition, and only if the person meets the state's other Medicaid rules. That is often called Emergency Medicaid. It is not full health insurance. See Emergency Medicaid.
Lawfully present immigrants may face different rules. For example, some green card holders have a sponsor whose income counts. See Medicaid Sponsor Deeming.
Where state-funded programs fit
Federal rules do not stop a state from using its own money. CMS has described "state-only programs" that give added services to people who are not eligible for full Medicaid. What these programs cover, who can join, and the ages they serve are set by each state. They can start, change or end. Federal officials have also said they are reviewing how states pay for some of this care.
MediPrimer does not list each state's program, because the details change and we only publish facts we can confirm from federal sources. Ask your state agency directly.
The Marketplace is not an option for everyone
Undocumented immigrants can't get Marketplace coverage. They may apply on behalf of family members who are eligible. See Mixed-Status Families and the Marketplace.
How to find out what is open to you
- Start with your state Medicaid agency. Use the State Medicaid directory. Ask: "Do you have a state-funded program for adults 65 and older who don't qualify for Medicaid because of immigration status?"
- Ask about emergency coverage. A hospital's financial counselor can help you apply during or after an emergency.
- Try a community health center. These clinics may charge by income. Ask about their rates.
- Ask for a language line. You have the right to help in your language. See Medical Interpreter Rights.
- Call a SHIP. Your State Health Insurance Assistance Program gives free, unbiased counseling.
Common questions
Can an undocumented person 65 or older get Medicare?
Generally no. To buy Medicare you must be a citizen or a green card holder with 5 continuous years in the U.S.
¿Medicare cubre a personas indocumentadas?
En general, no. Para comprar Medicare hace falta ser ciudadano o residente permanente con 5 años continuos en EE. UU. Medicaid federal solo paga la atención de emergencia. Pregunte a su estado por programas estatales.
Will the hospital turn me away in an emergency?
No. A hospital that takes Medicare and has an emergency room must check and treat you in an emergency, including active labor, whether or not you can pay.
Official sources
- CMS.gov: Original Medicare (Part A and B) eligibility
- SSA.gov: Social Security Act §1903 (payments to states)
- Medicaid.gov: CMS letter SMD 25-003 on emergency Medicaid
- HealthCare.gov: Coverage for immigrants