Immigration Status & Medicare Eligibility

Medicare, which is a federal health insurance program covering approximately 40 million Americans, is administered by the Centers for Medicare and Medicaid Services. It covers qualified immigrants, naturalized citizens and citizens born in America who are over the age of 65 and some individuals who are younger with serious disabilities, kidney failure and Lou Gehrig's Disease.

Types of Medicare

• There are three types of Medicare: Medicare Part A, which contributes to inpatient hospital, nursing and home health care; Medicare Part B, which contributes to outpatient treatment, medical equipment and supplies; and Medicare Part D, which covers prescription drugs.

Eligibility

• Most U.S. citizens and permanent residents can receive Medicare benefits if they have had a job that paid into the Medicare system for 10 years. To qualify for Medicare, applicants must also fall into one of the following categories: be at least 65 years old and be qualified for Social Security retirement benefits, have received Social Security Disability benefits for at least two years, receive railroad retirement or disability benefits, or have one of a few qualifying medical conditions.

Enrollment

• U.S. citizens and permanent residents who are already receiving Social Security checks are automatically entered and their benefits will start at the beginning of the month in which they turn 65. Individuals who are not receiving Social Security payments or who are eligible before they turn 65 need to apply via the Social Security Administration website or local office. There are specific waiting periods, benchmarks and programs that individuals must have qualified for in order to receive Medicare for one of the qualifying sicknesses or disabilities. The application process can take 1 to 3 months, so it is important to apply before the benefits are needed.

The Welfare Act

• The Department of Health and Human Services Welfare Act of 1996 defined three categories of immigrant status: qualified, not qualified and lawfully present. While different public programs have different qualifications, non-citizen immigrants who are classified as "qualified" are eligible for Medicare, including: refugees, those granted asylum, lawful permanent residents (anyone with a green card), Cuban/Haitian entrants, victims of domestic abuse, victims of trafficking, people paroled by the Department of Homeland Security for one year and those already granted withholding from deportation. It is important to note that a non-citizen must meet the "qualified" status criteria and the other eligibility requirements stated above (i.e., age, illness, disability).

Misconceptions

• Medicare and Medicaid are often confused; however, the programs are very different. Medicare is a federal program designed to increase medical funds to senior citizens and qualified non-citizens. Medicaid, however, is a joint program run with the federal government and each state that reaches a wider range of individuals, including low-income children and parents, pregnant women, senior citizens and other pre-specified groups. While federal law has a strict set of minimum requirements, states can establish looser eligibility rules, and some expand to cover qualified, non-qualified and lawfully present immigrants. It is possible to be eligible for both programs.

Warning

• Non-U.S. citizens and immigrants who are not classified as "qualified" but have stayed in the U.S. for at least five years should contact Social Security with additional questions about eligibility. Immigrant eligibility is expected to expand in scope under new health care legislation.