Do you qualify for Medicare if you are not a U.S. Citizen? If you are a non-citizen living in the United States, you may still qualify for Medicare if you meet certain requirements and are a lawfully present resident. Medicare is the U.S. federal health insurance program for qualified people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease. This blog will cover:
- When a non-citizen qualifies for Medicare
- How marriage to a U.S. Citizen affects Medicare eligibility
- The Medicare 40 Work Credits Rule
- When you don’t qualify for premium-free Part A
When does a non-citizen qualify for Medicare?
Generally, to qualify for Medicare as a non-citizen you must be a lawful resident and meet the 5-year residency rule. The residency rule says you have to resided in the United States for 5 continuous years leading up to when you enroll.
What qualifies as “continuing residence”? The Social Security Administration (SSA) looks at records of entry into the United States compiled by the Department of Homeland Security. Temporary absences do not affect “continuous” residence as long as the individual intends to maintain U.S. residence, but if absences are frequent or of long duration, the agency may inquire in order to determine whether continued U.S. residency was intended. Examples of evidence of intent could include continuing to pay U.S. income taxes, maintaining a house or apartment with the individual’s furnishings and belongings, etc. If an absence is over six months, SSA requires a “strong showing” of intent to retain U.S. residence. If SSA determines that continuous residence has been broken, the new five-year period begins on the date that the individual has returned to the United States.
What about non-citizens married to a U.S. citizen?
If you are a legal permanent residence and you are married to someone with premium-free Part A entitlement, then you will be entitled to Part A after 1 year of marriage. Your Part-A entitlement in this circumstance is based on your spouse’s work history. The 5-year continuous residency rule will no longer apply.
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Part A and the 40 Quarters Rule
You still need to meet the required work history to get Part A premium free. If you meet the 5-year rule but don’t have enough work credits, then you may have to pay a premium.
What is the 40 Quarters rule? You can qualify for premium-free Part-A based on your work credits earned. You generally need 40 quarters, or approximately ten years of work paying taxes to qualify. If you do not have enough quarters but your spouse does, then you may qualify based on their work history.
Read more about the 40 work credits in our blog, Understanding the Medicare Rule on 40 Work Credits: What You Need to Know.
What if a non-citizen doesn’t qualify for premium-free Part A:
If you do not qualify for premium-free Part A, you may still qualify to purchase it for a monthly premium. You’ll pay up to $518 each month for Part A in 2025. This amount depends on how long you or your spouse worked and paid Medicare taxes. However, if you have limited income then you may get assistance paying for the Part A premium. Learn more about the Medicare Savings Program here!
