Medicare and immigrants — who qualifies, and how green-card holders earn it

How Medicare works for immigrants in the US: who is eligible at 65, the 40-work-quarters rule for premium-free Part A, how lawful permanent residents qualify or buy in, why undocumented immigrants are not eligible, and the Part A/B/C/D basics.

Medicare and immigrants

Medicare is the federal health-insurance program mainly for people 65 and older (and some younger people with certain disabilities). Whether an immigrant can get it — and whether it’s free — depends on immigration status and US work history. This page explains the rules clearly.

This is general information, not legal, tax, or medical advice. Confirm your situation with the Social Security Administration or a benefits counselor.

Who is eligible

Status	Medicare eligibility
US citizen	Eligible at 65 (premium-free Part A with 40 quarters of work)
Lawful permanent resident (green card)	Eligible at 65; premium-free Part A with 40 quarters, otherwise can buy in after 5 continuous years as a permanent resident
Work-authorized non-LPR (e.g. some visa holders, DACA)	Generally not eligible for Medicare
Undocumented	Not eligible for Medicare (even if Medicare taxes were paid)

The 40-quarters rule (premium-free Part A)

Medicare Part A (hospital insurance) is premium-free if you — or your spouse — worked and paid Medicare taxes for at least 40 quarters (about 10 years). Quarters are credited based on earnings, and they can come from work done while authorized.

40+ quarters: premium-free Part A at 65.
Fewer than 40 quarters: you can still get Part A by paying a monthly premium, if you meet the status/residency rules below.

How green-card holders qualify or buy in

If you are a lawful permanent resident, are 65 or older, and have lived in the US continuously as a permanent resident for at least 5 years, you can enroll in Medicare. If you don’t have 40 quarters, you pay a monthly Part A premium (plus the standard Part B premium). Many LPRs enroll during their Initial Enrollment Period around their 65th birthday — missing it can mean late-enrollment penalties, so plan ahead.

Why undocumented workers pay but can’t collect

Workers paid on a W-2 have 1.45% withheld for Medicare (matched by the employer); self-employed people pay it through self-employment tax. This happens regardless of immigration status. But the law ties receiving Medicare to lawful status — so many people contribute to Medicare for years without being able to use it.

The parts of Medicare

Part A — Hospital insurance: inpatient hospital, skilled nursing, hospice. Premium-free with 40 quarters.
Part B — Medical insurance: doctor visits, outpatient care. Has a standard monthly premium.
Part C — Medicare Advantage: private plans that bundle A, B, and usually D.
Part D — Prescription drugs: optional drug coverage through private plans.

If you’re not eligible for Medicare

Emergency Medicaid covers emergencies (including childbirth) regardless of status.
Community health centers provide primary care on a sliding scale to everyone — see community health centers.
Depending on status and state, marketplace or state coverage may be available.
See healthcare access rights for what you can use regardless of status.

Official resources

Last verified: 2026-06-04. General information, not legal, tax, or medical advice. Eligibility rules change — confirm with the Social Security Administration or a benefits counselor for your situation.

Medicaid by state — health coverage for low-income residents
Community health centers — care regardless of status
Healthcare access rights
Cross-border tax & Social Security totalization

Frequently asked questions

Can immigrants get Medicare?

It depends on immigration status and work history. US citizens and lawful permanent residents (green-card holders) can generally get Medicare at 65. Lawful permanent residents who don’t have enough US work history can still buy into Medicare once they’ve been a permanent resident for 5 continuous years. Undocumented immigrants are not eligible for Medicare, even though many pay the Medicare payroll tax through their paychecks.

What is the 40-quarters rule for premium-free Part A?

Medicare Part A (hospital insurance) is premium-free if you or your spouse worked and paid Medicare taxes for at least 40 quarters — about 10 years. If you have fewer than 40 quarters, you may still get Part A by paying a monthly premium, as long as you meet the citizenship/residency rules.

I'm a green-card holder but haven't worked 10 years in the US — can I still get Medicare?

Yes, in most cases. If you are a lawful permanent resident, are 65 or older, and have lived in the US continuously as a permanent resident for at least 5 years, you can enroll in Medicare — but you may have to pay a monthly premium for Part A (and the standard premium for Part B) since you don’t have the 40 quarters.

Do undocumented immigrants pay for Medicare even though they can't use it?

Often, yes. Workers paid on a W-2 have 1.45% withheld for Medicare (matched by the employer), and self-employed people pay it through self-employment tax — regardless of immigration status. But eligibility to receive Medicare benefits requires lawful status, so many contributors cannot collect it.

If I can't get Medicare, what are my options?

Emergency Medicaid covers true emergencies regardless of status. Community health centers provide primary care on a sliding scale to everyone. Marketplace or state coverage may be available depending on status and state. See our healthcare-access and community-health-centers pages.

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General information, not legal advice. MigrantUSA is an independent publisher and is not a law firm; using this site does not create an attorney-client relationship, and this content is not a substitute for advice from a licensed attorney about your specific situation. US federal, state, and local government procedures, fees, and forms change. Always verify current details directly with the relevant agency before acting. For immigration, tax, or other legal matters specific to your situation, consult a licensed attorney or BIA-accredited representative.