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.
This is the usual situation for green-card holders who immigrated later in life — including parents sponsored by their US-citizen children. They often reach 65 without 40 US work quarters, so they must both wait out the 5-year residency clock and pay the buy-in premium below.
What Medicare costs in 2026
If you qualify by residency but lack the 40 quarters, you buy in to Part A. The monthly Part A premium for 2026 depends on how many Medicare work quarters you (or your spouse) have:
| Medicare work quarters | 2026 Part A monthly premium |
|---|---|
| 40+ quarters (about 10 years) | $0 — premium-free |
| 30–39 quarters | $311 (reduced buy-in rate) |
| Fewer than 30 quarters | $565 (full buy-in rate) |
Everyone enrolled in Medicare also pays Part B (doctor and outpatient care): the standard 2026 premium is $202.90 per month, with a $283 annual deductible. Part A’s inpatient hospital deductible is $1,736 per benefit period in 2026. Higher-income enrollees pay a surcharge on Parts B and D (the income-related monthly adjustment amount, or IRMAA).
Premiums and deductibles are 2026 figures from the CMS “2026 Medicare Parts A & B Premiums and Deductibles” fact sheet (see Official resources).
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: 2026-07-10. General information, not legal, tax, or medical advice. Eligibility rules change — confirm with the Social Security Administration or a benefits counselor for your situation.
Related procedural information
- 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