Medicare for Green Card Holders: A Complete Guide

Medicare for Green Card Holders: A Complete Guide

As a Green Card holder, now that the U.S. is your new permanent home, the next crucial step is to secure a reliable health insurance plan. When it comes to Medicare, the system can seem overwhelming, with unique rules and timelines for immigrants. As a Green Card holder, if you are wondering about your Medicare eligibility, enrollment periods, or benefits, you've come to the right place.

But before we dive into the details of health insurance for lawful permanent residents (LPR) or green card holders, let's understand certain key terms which can be confusing before buying health insurance for seniors.

Understanding Key Terms Before Exploring Health Insurance Options for Green Card Holders

When evaluating health insurance options for Green Card holders—particularly for seniors—it's crucial to first understand a few foundational terms. These terms affect eligibility, coverage scope, and the way insurers interpret your residency and nationality status. Below is a breakdown of the most commonly misunderstood concepts:

Country of Residence vs. Nationality

For insurance purposes, your country of residence may or may not be the same as your country of nationality or citizenship. Here's how they differ:

  • Country of Residence:
    • The country where you maintain your primary and fixed home.
    • This is typically where you live, receive mail, and return for long-term stays or medical treatment.
    • Also the country you list on your insurance application as your current place of residence.
    • To prove your country of residence to insurers, you may provide recent utility bills, lease agreements etc. Failing to provide such documentation may render you ineligible for coverage.
  • Nationality:
    • The country that issued your passport or where you hold citizenship.
    • This does not automatically determine where you are considered a resident for insurance purposes.
    • For example, let's say you hold an Italian passport but live in France, then France is your country of residence, even if Italian is your nationality.

Why This Distinction Matters for Seniors

For senior Green Card holders, especially those who travel frequently, live abroad, or maintain dual residences, the definition of "home country" or "country of residence" is more than semantics. It has direct consequences for:

  1. Your Eligibility for Coverage
    • Most international and travel insurance plans are designed to cover you outside your home country.
    • If you mistakenly list the wrong country of residence, you may lose access to essential benefits, or worse, have claims denied.
  2. Affects Plan Type and Structure
    • Some health insurance plans for seniors include limited coverage for Incidental Trips to the Home Country—short visits typically capped at 30–60 days.
    • Other plans may provide Incidental Home Country Coverage for emergencies only.

Helpful Scenarios to put this into perspective

  1. A U.S. Green Card holder who lives full-time in Mexico and travels to Canada should purchase travel insurance as a resident of Mexico. Their nationality (U.S.) is not the relevant factor, as their country of residence is Mexico.
  2. A British citizen who retired in Spain and is visiting Japan for 2 months should buy travel insurance as a resident of Spain. If they listed the UK as their home country, they might not be covered properly.
  3. An Indian national with a U.S. Green Card who spends most of the year in India must provide documentation (like a lease or utility bills) proving India is their country of residence when applying for international insurance. Otherwise, insurers may assume the U.S. is their home country and deny certain claims.

With this understanding, let's dive right into how Medicare works for green card holders, including qualification criteria, available coverage, and strategies like short-term medical insurance for immediate needs.

What is Medicare?

'Medicare' is a federal health insurance program, primarily designed for U.S. citizens or LPR aged 65 and older, and for certain younger individuals with qualifying disabilities or serious health conditions.

It provides coverage for a wide range of healthcare services, including hospital stays, doctor visits, preventive care, and prescription medications, helping to ease the financial burden of medical expenses.

Are Green Card Holders Eligible for Medicare?

Once they meet certain criteria, green card holders become eligible to get enrolled into Medicare. Let's understand these crucial criteria in detail:

Eligibility Criteria for Green Card Holders

  1. Legal Residency: To qualify, you must have been a lawful permanent resident of the United States for at least five continuous years. This implies holding a Green Card or the permanent residency status for a minimum of five years before applying for Medicare benefits.
  2. Age: Individuals generally become eligible for Medicare at the age of 65. However, if you have a qualifying disability or certain medical conditions (such as end-stage renal disease or ALS), you may qualify for Medicare before age 65.
  3. Eligibility for Hospital Insurance as part of Medicare Part A: Medicare Part A (which provides hospital insurance, explained later in the article) is primarily designed for seniors or certain younger individuals with disabilities. It is usually premium-free if you or your spouse have paid Medicare taxes through work for at least 40 quarters, equivalent to about 10 years of service. These work credits are earned by paying Social Security taxes through payroll deductions.
  4. If you do not have enough work credits, you can still obtain Part A by paying a monthly premium.

Lawful Permanent Residents' (LPR) or green card holders' eligibility criteria may vary by their state of residence and income levels.

For the most accurate and up-to-date information about your eligibility, visit the official Medicare.gov website or call 1-800-MEDICARE (1-800-633-4227).

When Can a Green Card Holder Apply for Medicare?

Once LPRs or green card holders meet all necessary eligibility criteria, they can apply for Medicare during specific enrollment periods. These periods are essential to avoid penalties for late enrollment.

Initial Enrollment Period (IEP)

The Initial Enrollment Period (IEP) starts three months before your 65th birthday, includes your birthday month, and extends three months afterward. This 7-month window is your best opportunity to enroll without facing late fees and penalties.

General Enrollment Period (GEP)

If you miss your IEP, you can still apply during the General Enrollment Period (GEP), which runs from January 1 to March 31 each year. However, keep in mind that late enrollment may result in higher premiums or gaps in coverage.

How to Apply for Medicare for Green Card Holders

Applying for Medicare as a green card holder is a straightforward process through the Social Security Administration (SSA).

Here's a step-by-step guide:

Step 1: Gather Documentation

Ensure you are in possession of documents to prove your green card status and residency history in the U.S.

Step 2: Complete Application

You can apply online, by phone, or in person at your local Social Security Administration office.

Step 3: Provide Information

Be prepared to provide personal and immigration-related information during the application process.

Medicare Benefits for Green Card Holders

Once enrolled, green card holders can access a wide range of healthcare benefits, depending on the plan they choose. These benefits help reduce out-of-pocket medical costs.

Medicare Part A: Hospital Insurance

Covers inpatient hospital stays, skilled nursing facility care, hospice care, and certain home healthcare services.

Medicare Part B: Medical Insurance

Covers outpatient services like doctor visits, preventive services, medical supplies, and some home health care.

Medicare Part C: Medicare Advantage

A private insurance alternative that combines Part A and Part B coverage, often including additional benefits like prescription drugs, vision, and dental.

Medicare Part D: Prescription Drug Coverage

Covers prescription medications through private insurance plans. This can be a valuable addition to your Medicare coverage.

Understanding Your Health Insurance Options as a Green Card Holder

If you're a Green Card holder, your health coverage options depend on your specific situation. While Medicare offers long-term health coverage for those who meet the eligibility criteria and possess the LPR status, there might be a period when you're waiting to become eligible, and that's where travel medical insurance can help.

Travel Medical insurance is great for:

  • New Green Card holders who just arrived in the U.S. and aren't yet covered by regular healthcare programs, for a short period of time.
  • Green Card holders who live mostly outside the U.S. but are visiting here for a short time.

These plans help cover unexpected medical emergencies during your stay in the U.S. But please bear in mind that these plans don't usually cover ongoing care or the acute onset of pre-existing conditions, and they don't meet ACA (Affordable Care Act) requirements.

If you live, work, and pay taxes in the U.S., these travel plans likely won't be a fit for you. In that case, Medicare or other health insurance options would be better to explore.

Health Coverage Before Medicare & Green Card Approval

If you are:

  • Waiting to obtain a green card post the age of 65, or
  • A new green card holder, ahead of your 65th birthday and initial enrollment period

Travel medical insurance can be a crucial safety net. This type of short-term medical coverage can protect you from unexpected medical expenses during the waiting period.

Why Is Travel Medical or Visitors Insurance Recommended?

Travel medical insurance or ‘visitors insurance’ (often used interchangeably) is recommended for green card holders whose country of residence is different from the United States. The United States has some of the highest medical costs in the world, and without proper insurance, medical expenses can quickly accumulate, causing a strain on your retirement fund.

These are short-term plans for LPRs visiting the U.S. for a short period of time. These typically cover emergency medical expenses, including hospitalization, doctor visits, and emergency medical evacuation, providing a reliable solution.

Please note that if the green card holders plan to stay in the U.S. for a long period of time or establish residency here, then these plans provide a temporary solution until they apply & qualify for Medicare. And for such cases the best plans available with VisitorsCoverage can be used for 364 days maximum, at a stretch.

Here’s a snapshot of the different types of coverage provided by Visitors or Travel Medical Insurance:

Travel Medical InsuranceCoverage
Emergency Medical CoverageCovers emergency medical care, including hospitalization and doctor visits.
Emergency Medical EvacuationCovers the cost of medical evacuation to your home country or a specialized medical facility.
Prescription DrugsHelps cover the cost of prescription medications while waiting for Medicare Part D, but only for eligible medical expenses.
Repatriation of RemainsProvides coverage for the transportation of remains to home country in case of death.
Acute Onset of Pre-Existing ConditionsCovers sudden flare-ups of pre-existing conditions that require emergency treatment.
Emergency Dental CareSome plans cover dental emergencies, such as injuries or pain, but not routine treatments.
Accidental Death and Dismemberment (AD&D)Provides compensation if you experience death or serious injury due to an accident. The compensation is a lump sum payment for incidents, such as loss of vision, a limb, or death of the insured.

Please note that this is not a complete list of coverages; each travel medical insurance may have its own inclusions and exclusions and limits on how much the plan covers. Always read the policy document to understand the coverage details.

We understand the unique challenges that green card holders may face when it comes to healthcare. We have thus curated a selection of travel medical insurance plans that can help bridge the gap until you qualify for Medicare.

Top Travel Medical Insurance Plans

These plans offer flexible and affordable solutions for Green Card holders either visiting the U.S. or awaiting Medicare eligibility (before initial enrollment period):

Note: Premiums and coverage details for Medicare plans and travel medical insurance may vary depending on the plan and provider.

If you’re still unsure about where to start, the friendly customer success team at VisitorsCoverage is here to help you find the right coverage for your situation—no pressure, just support.

Frequently Asked Questions

Q:

Can you get Medicare with a Green Card?

Yes, Green Card holders can qualify for Medicare once they meet certain eligibility requirements, including age and residency.

Q:

Do Green Card holders get free medical care?

Medical care in the U.S. is not free. However, Green Card holders may be eligible for certain government programs, such as Medicaid, if they meet the criteria.

Q:

What are the benefits of Green Card holders over 65?

Benefits for Green Card holders over 65 can include Medicare eligibility, Social Security benefits, and state-specific senior benefits if they meet the required criteria.

Q:

Can Green Card holders get Medicaid?

Green Card holders can be eligible for Medicaid after a 5-year waiting period upon obtaining qualified immigration status.

Q:

Do Green Card holders get a Social Security pension?

Yes, Green Card holders who meet the necessary work requirements can qualify to receive Social Security benefits.

Q:

Can Green Card holders get health insurance before turning 65?

Yes, if Green Card holders are not yet eligible for Medicare, they can obtain health insurance through the Health Insurance Marketplace or if they are traveling on their green card to the USA from abroad and their home country is different from the U.S., then they may apply for travel medical insurance for short-term coverage, until they qualify for Medicare.

Q:

Do Green Card holders need to apply for Medicare?

Yes, Green Card holders must apply for Medicare during the Initial Enrollment Period (IEP), or the General Enrollment Period (GEP) if they miss the IEP. It's important to apply on time to avoid penalties.

Q:

What should I do if I miss my Initial Enrollment Period for Medicare?

If you miss your IEP, you can still enroll during the General Enrollment Period (GEP), which runs from January 1 to March 31. However, keep in mind that late enrollment may result in higher premiums.

Luna
VisitorsCoverage Support