Non-citizens can get Medicare, but only if they meet specific residency and work history requirements

Medicare is not limited to U.S. citizens, but the rules are strict. To get Medicare at 65, you must be a permanent resident (green card holder) who has lived in the United States for at least five consecutive years. If you are not a permanent resident, you may still may have access to if you have worked and paid Medicare taxes for the required number of quarters — typically 40 quarters (10 years) — even if you are not yet a citizen.

The key distinction is between citizenship and residency status. Medicare looks at your work history and how long you have lived here, not your citizenship papers. A non-citizen with a green card and five years of continuous U.S. residence can enroll at 65 just like a citizen can. A non-citizen without a green card but with sufficient work history may also may have access to, though the rules are more complex.

If you do not meet these requirements, you cannot get Medicare. You would need to explore other health insurance options in your state, which may include marketplace plans or Medicaid if you meet income limits.

Key Takeaways

  • Permanent residents (green card holders) who have lived in the U.S. for at least five consecutive years can enroll in Medicare at 65.
  • Non-citizens without a green card may still may have access to if they have worked and paid Medicare taxes for 40 quarters (10 years).
  • You must be at least 65 years old to enroll in Medicare based on age, regardless of citizenship or residency status.
  • If you do not meet Medicare's residency or work requirements, you can explore health insurance through your state's marketplace or Medicaid program.

Permanent Residents and the Five-Year Rule

If you hold a green card, you are a permanent resident, and Medicare considers you may be able to access for enrollment at 65 if you have lived in the United States for five consecutive years. This five-year period must be unbroken — leaving the country for an extended trip can restart the clock. The years do not have to be when ready before you turn 65; they just need to be five years at some point after you received your green card.

You do not need to have worked during those five years. straightforward being a permanent resident and living here continuously is enough. When you turn 65, you can enroll in Medicare Part A (hospital insurance) and Part B (medical insurance) during your initial enrollment period, which begins three months before your 65th birthday.

If you are a permanent resident but have not yet lived here for five years, you will need to wait until you have completed that five-year period before you can enroll. During the waiting period, you may be able to purchase health insurance through your state's marketplace or through your employer if you are still working.

Non-Citizens Without a Green Card: Work History Requirements

If you are not a permanent resident but have worked in the United States and paid Medicare taxes, you may still may have access to for Medicare. The requirement is 40 quarters of Medicare-taxed earnings. A quarter is roughly three months, so 40 quarters equals approximately 10 years of work history. You do not have to have worked those 10 years consecutively — they can be spread across your entire working life.

To verify your work history, you will need a Social Security Number (SSN). If you have been working legally in the U.S. and paying taxes, you should have one. When you explore for Medicare, Social Security will review your earnings record to confirm you have the required 40 quarters. If you are unsure whether you have an SSN or how many quarters you have earned, you can create a my Social Security account online at ssa.gov or call Social Security at 1-800-772-1213.

Even if you meet the 40-quarter requirement, you must still be at least 65 years old to enroll in Medicare based on age. If you are younger than 65 and do not have a green card, you cannot get Medicare unless you may have access to for Medicare based on disability or end-stage renal disease, which have different rules.

Undocumented Immigrants and Medicare Access

If you are in the United States without legal authorization, you cannot enroll in Medicare. Medicare requires either permanent residency or a valid Social Security Number tied to authorized work history. Undocumented immigrants do not meet either requirement.

However, you may be able to access health care through other programs. Many states offer Medicaid coverage to low-income residents regardless of immigration status, though the scope of coverage varies. Some states cover emergency services only; others cover a broader range of care. You can contact your state's Medicaid office or call 211 to learn what programs may be available where you live.

Community health centers also serve uninsured and underinsured people regardless of immigration status. These centers offer primary care, preventive services, and sometimes dental and mental health care on a sliding fee scale based on income. You can find a center near you at findahealthcenter.hrsa.gov.

Temporary Residents and Visa Holders

If you are in the United States on a temporary visa — such as an H-1B work visa, L-1 visa, or student visa — you cannot enroll in Medicare at 65 unless you also have a green card or meet the 40-quarter work history requirement. A temporary visa does not confer the residency status Medicare requires.

If you are working on a temporary visa and paying Medicare taxes, those quarters will count toward the 40-quarter requirement. However, you would only be able to use them if you later become a permanent resident or reach age 65 while still in the U.S. with valid work authorization.

While on a temporary visa, you typically must have health insurance through your employer, a private plan, or your home country. When your visa status changes — for example, if you obtain a green card — your Medicare may be able to access may change as well. At that point, you should contact Social Security to understand your new options.

How to Check Your Work History and explore

Before you explore for Medicare, verify your work history with Social Security. Create an account at ssa.gov and view your earnings record. This shows how many quarters you have earned and whether there are any gaps or errors. If you see mistakes, you can request a correction, though this can take time.

When you are ready to explore for Medicare, you have several options. You can explore online at ssa.gov/benefits/retirement/explore.html, by phone at 1-800-772-1213, or in person at your local Social Security office. Have your green card (if you have one), passport, and Social Security Number ready.

If you are a permanent resident, Social Security will verify your residency status during the process process. If you do not have a green card but are relying on work history, Social Security will review your earnings record. The process process typically takes a few weeks. You should explore during your initial enrollment period, which starts three months before your 65th birthday and ends three months after.

What Happens If You Do Not Meet Medicare Requirements

If you do not may have access to for Medicare, you can purchase health insurance through the Health Insurance Marketplace in your state. Open enrollment typically runs from November through January each year, though you may be able to enroll outside this window if you have a may have access to life event (such as losing other coverage or moving to a new state).

You can explore marketplace plans at healthcare.gov or your state's marketplace website. Depending on your income, you may be may be able to access for subsidies that lower your monthly premium. You can also check whether you may have access to for Medicaid in your state; income limits and coverage vary by state.

If you are still working, ask your employer whether they offer health insurance. Employer plans are often more affordable than marketplace plans and do not have the same citizenship or residency restrictions.

Frequently Asked Questions

Can I get Medicare if I have a green card but have not lived in the U.S. for five years yet?

No, you must have lived in the U.S. for five consecutive years as a permanent resident before you can enroll in Medicare at 65. If you have not met this requirement, you will need to wait or explore other health insurance options until you do.

If I worked in the U.S. for 10 years but left and now want to return, can I still use those quarters toward Medicare?

Yes, your work quarters remain on your Social Security record even if you left the country. When you return and reach 65, those quarters will count toward the 40-quarter requirement. You can verify this by checking your earnings record on ssa.gov.

What if I worked under a different name or Social Security Number in the past?

Contact Social Security before you explore for Medicare. They can help you consolidate earnings records if your name or SSN changed. This process can take several weeks, so start early if you think there may be discrepancies.

Do I lose Medicare if my green card expires?

No, once you are enrolled in Medicare, your coverage continues even if your green card expires, as long as you continue to pay your premiums. However, you should renew your green card to maintain your legal residency status for other purposes.

Can my family members who are not citizens get Medicare if I am a citizen?

No, each person must meet their own Medicare requirements based on their age, residency status, and work history. Your citizenship does not extend Medicare coverage to family members who do not meet the may be able to access rules themselves.