What is Medicare?
Medicare is a U.S. federal government health insurance system primarily for people of 65 years of age and above.
Medicare has several parts:
- Part A covers major things like hospitalizations, surgeries, etc.
- Part B covers other outpatient benefits like visits to the doctor's office, lab visits, X-ray procedures, etc.
- Part D covers prescription drugs and other such items.
My elderly parents have recently immigrated to the U.S. and have received the green card through my sponsorship. Can they get Medicare?
No. New immigrants to USA are NOT eligible for benefits like Medicare.
Regular residents of the U.S. (citizens, permanent residents, etc.) can get Medicare Part A if they have worked in the U.S. for at least 40 quarters (10 years for most people) and are above the age of 65. This rule was made in 1996 during the Bill Clinton administration, as part of the Welfare Reform Act.
New immigrants are not provided Medicare Part A benefits. If immigrants are permanent residents for 5 years, have continuously resided in the U.S. for that duration, and are 65 years of age or above, they can BUY Medicare coverage from the U.S. Government.
Part B and Part D have to be purchased by everyone - even those who are U.S. citizens, born in the U.S., or have worked in the U.S. all their life. (Again, the eligibility to buy this depends on the same criteria as in Part A.)
In short, new immigrants can't get Medicare benefits.
Until they are eligible to purchase Medicare, what kind of insurance can I purchase?
Please look at the Greencard Holders Medical Insurance article below. Please note that none of those plans are meant to be a replacement for Medicare and they do not necessarily cover everything that Medicare would otherwise cover.
Please look at the FAQ article about New Immigrants Medical Insurance below to understand the healthcare situation in the U.S.
Please call +1 (800) MEDICARE to get more information about when exactly they would be eligible to buy Medicare.
When they are eligible to purchase Medicare, how much will it cost?
As of 2019, the costs are as follows:
Part A: $437.00 per month
Part B: $135.50 per month
Part D: Cost depends upon the plan you choose and your income
In short, the cost is $572.50 per month, plus Part D cost per month.
If I buy Part A + Part B + Part D, will it cover everything?
Absolutely not. Medicare has many copays, coinsurance and deductible. Depending upon the duration of hospitalization stay etc., the copays can be huge, even in thousand of dollars. That is why there are insurance plans called Medicare Supplement plans (Medigap plans) sold by various private health insurance companies. There are many levels of such plans available, varying from Plan A through Plan N.
Once I enroll into all parts of Medicare and the best Medicare supplement plan, will it cover everything?
No. Medicare supplement plans do not cover many things such as long-term care, vision or dental care, hearing aids, eyeglasses or private-duty nursing.
The costs listed above seem too expensive to me. Instead of buying Medicare, can I just continue with new immigrants health insurance?
No. It is entirely your responsibility to keep track of when you would first become eligible to purchase Medicare. Once you are eligible to purchase Medicare, you should purchase it immediately and you are no longer eligible for other health insurance plans designed for new immigrants. Anyway, once you have lived in the U.S. for 5 years, you are not a new immigrant.
What if I don't enroll into various parts of Medicare when I am first eligible?
If you don't enroll into various parts of Medicare when you are first eligible, and if you want to enroll into any of them later, you will incur the penalties and some of those penalties will continue to apply as long as you have Medicare. Later you apply, more penalties will keep accruing. Therefore, it is the best thing to enroll into all parts of Medicare when you are first eligible. You can find more information about the penalties on Medicare web site including the late enrollment penalty calculator.
I don't like this situation. When they are not eligible for Medicare, many things including pre-existing conditions are excluded. When they are eligible for Medicare, it is too expensive and still everything is not covered. In either case, I may have to pay a lot out of pocket. Is there any solution?
Unfortunately not. You will still end up paying money out of your pocket for various healthcare related things that your elderly relatives may need. When you sponsor their green card, you accept a lot of liabilities under the Affidavit of Support you sign before U.S. government agrees to give them green card.
If my parents are going to be in the U.S. for only few months in a year, can I get Medicare just for that exact duration?
Medicare is not meant to work like short term travel medical insurance that you just buy whenever you like for the exact number of days. You can't enroll into Medicare whenever you like and discontinue whenever you like. You are expected to keep and pay for it year round as it is meant for U.S. residents.
Even after my parents are permanent residents in the U.S. for 5 years, it seems that I can't just contact Medicare the next day and enroll them into it. They told me that the next general enrollment period would be from next January 1 through March 1 to start the coverage from July 1. What insurance can we have until then?
We can't really comment on exactly what date they would be eligible to enroll into different parts of Medicare. However, until their Medicare coverage starts, they can keep insurance plans such as International Major Medical or The Bridge Plan.