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Becoming A US Citizen? What You Should Know About Medicare

Medicare provides many benefits to those over 65, but what is your eligibility as an expat or a new U.S. citizen to Medicare.  Danielle Kunkle Roberts of Boomer Benefits sets out the rules and how to join Medicare as well as the costs of doing so.

Written exclusively for Expat Network by Danielle Kunkle Roberts of Boomer Benefits


Hundreds of thousands of people apply to become a U.S. citizen each year. In fact, in 2017, nearly one million immigrants applied for citizenship according to the National Partnership for New Americans (NPNA).

With the number of applicants rising every year, the application processing time has lengthened as well. Some experience wait times lasting about a half of year, while others are forced to wait nearly two years due to the overwhelming amount of applications.

The good news is that this gives you plenty of time to learn about your new health insurance. If you are 65 or older, here is what you should know about Medicare as a new U.S. citizen.


When You Can Apply for Medicare

As a new U.S. citizen, you will be eligible to apply for Medicare. If you become a U.S. citizen before your turn 65, you will be able to apply for Medicare as early as three months before you turn 65.

However, if you are already 65 by the time you become a U.S. citizen, you may have to wait until the annual General Enrollment Period (GEP) to apply for Medicare. The GEP starts on January 1st and ends on March 31st each year. When you apply for Medicare during the GEP, your Medicare start date will be July 1st of that year.

For those who are new immigrants or green card holders who haven’t yet obtained U.S. citizenship, you are considered eligible to apply for Medicare once you have lived in the U.S. continuously for five years.

If you become a U.S. citizen at an age much younger than 65, you will need to obtain health insurance another way, such as through the Healthcare Exchange, until you are eligible to apply for Medicare.


What You Will Pay for Medicare Part A

Medicare Part A is what covers your in-patient hospital stays. Most U.S. citizen earn premium-free Part A. For one to obtain premium-free Medicare Part A, you need to have had paid into Medicare and Social Security for at least 40 quarters, or 10 years.

So for example, if you become a U.S. citizen at 50 years old, that gives you enough time to start working and paying into Medicare, so that by the time you are 65, you can obtain premium-free Part A.

However, if you are already 65 at the time you naturalize, you will either have to delay Medicare and accumulate the necessary amount of work credits, or you will have to purchase Medicare Part A. You may also be eligible for premium-free Part A through your spouse if he or she has the necessary work credits and a few other requirements.

Someone who has anything less than 30 work credits will have to pay $437 per month for Medicare Part A in 2019. If you were able to accumulate at least 30 quarters, but not the entire 40, you will pay $240 per month for your Part A coverage.


What You Will Pay for Other Parts of Medicare

Medicare Part B is what will cover your medically necessary doctor services. Everyone has to buy Part B, no matter what time in life you became a U.S. citizen. Most people pay $135.50 per month for Medicare Part B in 2019. This is the base standard for Part B.

Once you have Part A and Part B, you will be allowed to purchase either a Medicare Advantage (Part C) or Medigap plan. Premiums for these types of plan are based on many things such as age, gender, location, carrier, and plan type. These plans are optional plans that help to lower out-of-pocket costs.

Medicare Part D is what covers your retail prescription drugs. Medicare Part D premiums are based on the location, carrier, and plan. There are Part D plans for as low as $15 a month in most areas.

If you don’t qualify for premium-free Part A, you can choose to enroll in just Part B. However, if you do this, you will only be able to get Part D in addition to your Part B coverage; you won’t be eligible for a Medicare Advantage or Medigap plan. Also, if you deny Part A, and later decide you want to enroll in it, you will owe a late penalty on top of your monthly premium.


How to Enroll in Medicare

There are many ways to apply for Medicare. You can apply in person at the Social Security office, online at the Social Security website, or by phone to request an application. Depending on your situation, the Social Security Administration may require you to apply in person rather than the other two methods.

If you are a U.S. citizen, you should have no trouble applying for Medicare online. However, if you are an immigrant without citizenship and qualify for Medicare, you will likely be required to apply in person at the Social Security office. Once you are all set, you will be able to use your Medicare immediately.