Medicare with a green card: who qualifies, and what it costs
Many families here help a parent who came later in life and holds a green card. Medicare is open to them, but on two conditions that surprise people: five years of living here first, and a Part A premium if nobody in the couple worked here long enough.
A green card holder can get Medicare at 65 after living in the U.S. continuously for five years as a lawful permanent resident. Part A is premium-free only if they or their spouse paid Medicare taxes here for about 10 years (40 quarters); otherwise they can buy Part A, or take Part B alone, and everyone pays the Part B premium. Years worked in another country count only if the U.S. has a social security agreement with that country. Visitors on a tourist visa can't get Medicare.
The five-year rule
To get Medicare at 65 you have to be a U.S. citizen, or a lawful permanent resident who has lived in the U.S. continuously for the five years before applying. A parent who received a green card at 63 qualifies at 68, not 65. Until then Medicare isn't available, whatever the family's income.
Apply through Social Security as soon as the five years are complete. Waiting past that point can bring the same late-enrollment penalties anyone else would pay; the penalty calculator shows how they add up.
Part A: free only with U.S. work
Part A, the hospital part, is premium-free for people who paid Medicare taxes in the U.S. for about 10 years, 40 quarters, or whose spouse did. A parent who came to the U.S. late in life often has neither. In that case:
- Buy Part A. In 2026 it costs $311 a month with 30 to 39 quarters and $565 a month with fewer.
- Or take Part B alone. Part B covers doctors and outpatient care at $202.90 a month in 2026, the same premium everyone pays. Without Part A there's no hospital coverage from Medicare, and Medigap and Medicare Advantage both require Parts A and B; a Part D drug plan needs either one.
Quarters keep adding up while someone works here, so a parent who works part-time for a few years can move from the higher Part A price to the lower one, or to free. Social Security keeps the count; the my Social Security account shows it.
Years worked abroad don't count
Work in another country counts toward U.S. benefits only if the U.S. has a social security agreement, called a totalization agreement, with that country, and the list is short. For a parent from a country without one, only U.S. work counts, theirs or their spouse's. Social Security's list is linked under Sources.
Visitors can't get Medicare
A parent visiting on a tourist visa isn't eligible for Medicare. I don't sell visitor or travel insurance, so I can't help with that part.
After Medicare starts
Once a permanent resident has Parts A and B, every choice is the same as for anyone else: Original Medicare with a Medigap plan and a Part D plan, or a Medicare Advantage plan. In New York, Medigap can be bought in any month with no health questions. If income is low, the Medicare Savings Program can pay the Part B premium, and Extra Help lowers drug costs; both have their own immigration rules, which I check with you.
Before Medicare, or if the five years aren't up yet, coverage depends on income and immigration status; I'll go through what New York offers for your parent's situation. By phone or in person in Clifton Park, at no fee.
By county: Albany · Saratoga · Schenectady · Rensselaer · Warren · Washington · Montgomery · Fulton · Columbia · Greene · Schoharie · Otsego · Herkimer · Hamilton · Essex · Ulster · Dutchess. Town pages: every town, grouped by county. Anywhere else in New York.
- How do I sign up for Medicare? (medicare.gov) — eligibility: 65 and a citizen, or a lawful permanent resident for 5 continuous years
- Medicare costs (medicare.gov) — Part A premium if bought, by quarters worked; Part B premium
- U.S. international social security agreements (SSA) — which countries' work credits can count
We do not offer every plan available in your area. Currently we represent 10 organizations which offer 81 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (TTY 1-877-486-2048) is available 24 hours a day, 7 days a week. Insurers' legal names and home offices: carriers page.
Common questions
Short answers to what people ask before they call.
Still have a question? Call (518) 902-8822 or book a call.
Can a green card holder get Medicare?
Yes, at 65, once they have lived in the U.S. continuously for the five years before applying as a lawful permanent resident. Citizens don't need the five years; permanent residents do.
Is Medicare free for a green card holder?
Part A is premium-free only if the person or their spouse paid Medicare taxes in the U.S. for about 10 years (40 quarters). Without that, Part A can be bought, at a lower price with 30 to 39 quarters and a higher one with fewer, or the person can take Part B alone. Everyone pays the Part B premium.
Do years worked in another country count toward Medicare?
Only if the U.S. has a social security (totalization) agreement with that country; Social Security publishes the list. Otherwise only U.S. work, the person's own or a spouse's, earns premium-free Part A.
Can my parent on a visitor visa get Medicare?
No. Medicare is for citizens and for permanent residents who meet the five-year rule. I don't sell visitor or travel insurance.
Can a green card holder buy a Medigap or Medicare Advantage plan?
Yes, once they have Parts A and B. In New York anyone with both can buy a Medigap policy in any month with no health questions. Medigap and Medicare Advantage both require Parts A and B, so someone who takes Part B alone can't use either, which is one reason buying Part A can be worth it. I go through that choice with the numbers.
Is a parent or relative turning 65 on a green card?
Tell me when they became a permanent resident and whether they or their spouse worked here. I'll tell you when they can sign up, what Part A will cost, and the plan choices after that. No fee.