4 Things Non-U.S. Citizens Need To Know About Medicare

Early this year, I wrote a blog post on Social Security retirement benefits for non-U.S. citizens. This week I will talk about Medicare and some specific rules for non-U.S. citizens.

For people who are not familiar with it,  Medicare is a government's health insurance program mainly for people age 65 or older. It has four parts, Part A ( hospital insurance), Part B (medical insurance), Part C ( Medicare Advantage), and Part D (Medicare prescription drug coverage). Part C and D are basically two different choices in addition to Part A and B, so we will focus mainly on Part A and B here.   Here below are several things I think non-U.S. citizens need to know about Medicare.

1. Only green card holders can potentially qualify for Medicare if you are not a U.S. citizen.  

Unlike Social Security retirement benefits, you have to be either a U.S. citizen or a lawful permanent resident and meet other requirements mentioned below to be eligible for Medicare. 

2. Green card holders are eligible for (1) Part A with no cost at age 65 if you or your spouse receives or is eligible to receive Social Security benefits, and (2) Part B by paying a monthly premium. 

It is the same rule for U.S. citizens. The cost of Part B depends on your income and filing status from 2 years ago. For example, based on your yearly income and filing status in 2016, your 2018 monthly premium ranges from $134 to $428.6 per month which you could learn more about it here.  

3. Green card holders who are not eligible for Part A for free can buy Part B with or without Part A if you are a lawful permanent resident at age 65 or older living in the U.S. without a break for the 5-year period immediately before the month you file for enrollment in Part B.

In most cases, you cannot buy Part A without paying for Part B. The 5-year rule is specifically for lawful permanent residents. 

The monthly premium of Part A is either $232 or $422 per month in 2018 depending on how many quarters of Medicare taxes you have paid which you could learn more about it here

4. The late enrollment penalty for Part A and B starts when you are first eligible. 

Here are the rules regarding the late enrollment penalty for Part A and B directly from Medicare.gov:

Part A: "If you aren't eligible for premium-free Part A, and you don't buy it when you're first eligible, your monthly premium may go up 10%. You'll have to pay the higher premium for twice the number of years you could have had Part A, but didn't sign up."

Part B: "In most cases, if you don't sign up for Part B when you're first eligible, you'll have to pay a late enrollment penalty. You'll have to pay this penalty for as long as you have Part B. Your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn't sign up for it."

Some new immigrants may be not eligible for Medicare when they reach age 65 due to the citizenship, residency, or the 5-year requirement mentioned above. The key is to know that when you become eligible and figure out whether it makes sense to pay it early to avoid the penalty. 

Like Social Security, Medicare is also a very complex topic. There are many specific rules and exceptions. The best places to learn more about it are www.ssa.gov and www.medicare.gov. Social Security Administration has a brochure about Medicare in general here, and Medicare.gov has a brochure specifically for Enrolling in Medicare Part A & Part B here. Medicare.gov also provides an online calculator to help you determine your eligibility and premium amount.  I highly recommend you contact them directly if you have any specific questions based on your particular situation. 


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