Abuelita can only have Medicare if she meets several somewhat strict requirements. Newly arrived immigrants do not qualify for the federal program that offers healthcare just because they are over 65 years old. There are more requirements in order to receive Medicare.
An immigrant who has been naturalized as a citizen of the United States, or who has permanent residence (a green card) can be a Medicare beneficiary when they turn 65 only if they have worked in the United States for at least 40 quarters, or 10 years.
You can also be part of the program if you are married and your spouse meets the qualification requirements.
In that case, you can access Medicare if:
- You have been a legal citizen of the United States for at least 5 years.
- You have been married to the beneficiary for at least one year.
You cannot access Medicare if:
- You are in the country on a visa.
- If your spouse meets the requirements, but you are not a citizen or do not have permanent residence.
Medicare provides medical care to 57 million people over 65 and adults with disabilities.
New immigrants who have lived in the country for five years can apply via their spouse or on their own, but if they have not paid taxes and social security from working in the United States, they must pay a premium to receive Medicare Part A, which can be around $500 per month. If this person decides to take out Medicare Part B, it will be about $100 more.
So, what are the options for new immigrants over 65 who cannot access Medicare?
Older documented immigrants who do not qualify for Medicare can obtain health insurance through the insurance markets established by the Affordable Care Act (ACA).
Depending on what state he or she is living in, an older adult can inquire about this at their federal or state healthcare marketplace (cuidadodesalud.gov).
However, insurance tends to cost more with age. Even the bronze plans, which are the most cost-effective, can entail premiums of $800 or more for seniors.
Even though Obamacare establishes that insurance companies cannot discriminate or deny coverage to people with pre-existing conditions (the majority of adults over 65 have at least one chronic condition), the premiums, or monthly healthcare plan payment, for this demographic group are always higher.
Federally qualified community healthcare centers can be another option for medical care for seniors without Medicare. These centers already care for around 2 million program beneficiaries throughout the country and have specialists trained in dealing with the health problems of this sector.
Keep in mind that, as legal immigrants, seniors have to follow the same rules as the rest of the population. In most states, they don't have to pay a penalty if they don't have health insurance. The individual mandate establish by ACA was repealed as of January 2019.
Sources: Medicare, cuidadodesalud.gov, AARP, Consumer Reports, NACHC.
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