The short answer
Lawful permanent residents (green-card holders) can get Medicare, but the path depends on work history and time in the U.S. If you or a spouse worked and paid Medicare taxes for 40 quarters, you can get premium-free Part A like anyone else. If not, you can still buy into Medicare — as long as you've been a lawful permanent resident for at least five continuous years.
That five-year residency requirement is the piece unique to immigrants, and it catches people who come to the U.S. later in life expecting to enroll right at 65.
The 5-year residency rule
To buy into Medicare without enough work credits, you generally must be a lawful permanent resident and have lived in the U.S. continuously for five years. If you haven't yet hit five years of residency at 65, you may need to wait until you meet that requirement before you can enroll by paying premiums.
If you or your spouse has the 40 work credits, the residency wait doesn't apply the same way — you'd qualify for premium-free Part A on that record. Our guide to getting Medicare with fewer than 40 work credits covers the spouse-record and buy-in options.
What it costs and how to enroll
Without enough work credits, you pay a monthly Part A premium (reduced if you have some credits) plus the standard Part B premium. Once eligible, you enroll through Social Security, and your Initial Enrollment Period timing works like everyone else's — the seven months around your 65th birthday, assuming you meet the residency requirement.
Because the rules layer eligibility, residency, and cost together, it's an area where a careful review pays off. Our government help center points to programs that can lower Medicare costs for those who qualify.
Frequently Asked Questions
Can green-card holders get Medicare?
Yes. With 40 work credits (yours or a spouse's) you can get premium-free Part A. Without them, you can buy into Medicare if you've been a lawful permanent resident for at least five continuous years.
What is the 5-year residency requirement?
To buy into Medicare without enough work credits, you generally must be a lawful permanent resident who has lived in the U.S. continuously for five years.
How much does Medicare cost for immigrants without work credits?
You pay a monthly Part A premium (reduced if you have some credits) plus the standard Part B premium. Programs may lower these costs for those who qualify.
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