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Are Non-U.S. Citizens Eligible for Medicare?

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Four Ways a Non-U.S. Citizen Can Qualify for Medicare

Medicare is a form of health insurance provided by the U.S. government for individuals age 65 and older, as well as those with qualifying disabilities. While this valuable benefit is typically only available to U.S. citizens and legal permanent residents, there are some circumstances under which a non-U.S. citizen may qualify for coverage. Following are several scenarios in which non-U.S. citizens can qualify for Medicare benefits.

1. Legal permanent residents (green card holders)

Non-U.S. citizens who hold legal permanent resident status are typically eligible for Medicare benefits. In order to qualify, you must present proof that you hold a Permanent Residence Card (i.e., a green card) and meet Medicare’s age or disability requirements. In addition, you must have paid into the Medicare system via payroll taxes throughout your working years.

2. Non-U.S. citizens married to U.S. citizens

Non-U.S. citizens married to citizens may be eligible for Medicare under certain circumstances. If your citizen spouse has earned enough Social Security credits throughout his or her working years and you have been married for at least one year, you may qualify for benefits. As a non-citizen spouse, your Medicare eligibility begins at age 65 as long as your qualifying spouse is age 62 or older. You must provide proof of marriage as documentation. The main benefit of qualifying for benefits under your spouse is that you can receive premium-free Medicare Part A coverage.

If you’re a non-citizen spouse, you may be able to qualify for Medicare on your own if you have maintained permanent residency in the United States for at least five consecutive years. However, if you’re a non-citizen who doesn’t qualify under your spouse, you’ll likely need to pay for Medicare Part A premiums, which are currently around $500 per month.

3. Non-citizens with a work history

You may be eligible for Medicare at age 65 as a non-citizen if you’ve worked in the United States and paid Medicare taxes for at least 40 quarters (10 years), even if you aren’t a permanent resident. It’s important to keep track of your work history and Social Security contributions to know whether you qualify.

4. Refugees and asylees

Refugees and asylees who have been granted legal status in the United States are generally eligible for Medicare after a waiting period (typically five years from the date they were granted asylum or refugee status).

Enrolling in Medicare as a Non-U.S. Citizen

Once you determine you’re eligible for Medicare coverage as a non-U.S. citizen, you must enroll in order to receive benefits. There’s no specific deadline to enroll in Medicare Part A as a non-resident spouse as long as you meet the eligibility requirements.

Medicare Part B requires you to wait until one of the following enrollment periods:

  • Initial enrollment period – The Medicare initial enrollment period typically begins three months before your 65th birthday and extends for three months following your birthday month. During that timeframe, you can enroll in Medicare Part A and B through the Social Security Administration’s website at ssa.gov.
  • General enrollment period – The typical Medicare Part A enrollment period runs from January 1 through March 31 each year. Enrollment for Part B typically occurs in April.
  • Special enrollment period – If your spouse is working and you’re covered under their employer-sponsored health insurance plan, you may use a special enrollment period to gain coverage. This period typically takes place either 60 days prior to your spouse’s coverage ending or once the non-citizen spouse reaches age 65.

Are you struggling to navigate the complexities of Medicare as a non-U.S. citizen? Don’t worry; Creative Planning International is here for you. We work with non-citizens and cross-border families to help them maximize their wealth and avoid costly mistakes. As expat fiduciary advisors, we understand the complexities faced by non-residents who have worked in the United States or are married to U.S. citizens. For help navigating your Medicare options, request a meeting with a member of our team.

This commentary is provided for general information purposes only, should not be construed as investment, tax or legal advice, and does not constitute an attorney/client relationship. Past performance of any market results is no assurance of future performance. The information contained herein has been obtained from sources deemed reliable but is not guaranteed.

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