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Key takeaways
- Not all lawfully present noncitizens qualify for Medicare now.
- Immigrants who qualify have the same requirements as citizens.
- They’ll pay the same premiums and other fees as citizens.
- More than a half-dozen classes of immigrants are excluded now.
- Who is still eligible and how to get financial help for costs.
Yes. Immigrants, like U.S. citizens, can qualify for Medicare.
But for immigrants who aren’t citizens to be eligible, their immigration status in addition to their work history must meet the federal health program’s requirements. Those without legal status have never been eligible for Medicare benefits.
Until mid-2025, all lawfully present immigrant workers who have paid Medicare payroll taxes for at least 40 quarters, 10 years total, were eligible for Medicare premium-free Part A, which helps pay for inpatient hospital stays and some other expenses. That’s the same as U.S. citizens.
But the One Big Beautiful Bill Act (OBBBA), which became law in July, limited the classes of lawfully present immigrants who can qualify for Medicare coverage.
How can immigrants who are eligible qualify for coverage?
You or your spouse must have worked in the U.S. and paid Medicare payroll taxes for at least 10 years to be eligible for premium-free Part A coverage at age 65. Those who don’t qualify for premium-free Part A coverage may be eligible for the coverage by paying premiums, but only if they meet a five-year continuous residency requirement.
These are the rules for lawfully present immigrants who retain Medicare eligibility:
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If you or your spouse paid Medicare taxes for at least 40 calendar quarters, not necessarily continuously, but 10 years total, you can enroll in Medicare at age 65 and get premium-free Medicare Part A, which covers a variety of hospital costs. But that’s only if you’re a U.S. citizen or among the classes of eligible lawfully present immigrants under the new law.
Medicare-eligible “lawfully present individuals with the required work credits have no length-of-residency requirement,” says Tiffany Huyenh-Cho, director of California Medicare and Medicaid Advocacy for Justice in Aging. The national nonprofit advocates for older adults.
Married? Medicare-eligible lawfully present immigrants wed for at least one year can qualify for Medicare Part A with no premiums based on their spouse’s work history.
You can be older than the spouse whose work history is the qualifier. If you’re at least 65 years old with a spouse at least age 62 who has 40 quarters of work credits, you’ll qualify for premium-free Medicare Part A based on your spouse’s work history.
When the qualification for premium-free Part A is already met, “other factors, such as five years of residency, are not taken into consideration,” says Darren Lutz, a Social Security Administration spokesperson.
If neither you, a Medicare-eligible noncitizen with lawfully present immigration status, nor your spouse paid Medicare taxes for 10 years, you must meet the five-year continuous residency requirement.
If you’re a green card holder, also known as a lawful permanent resident — or in one of the other classes of Medicare-eligible noncitizens with lawfully present immigration status — but neither you nor your spouse meet the work requirements, you can enroll in Medicare only if you’ve lived continuously in the U.S. for at least five years and pay premiums for Part A and/or Part B doctor and outpatient services.
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