Medicare for Green Card Holders in New York: The Five-Year Rule, the Part A Premium, and What Changed in 2026

Can a green card holder get Medicare?

Yes. Lawful permanent residents are on the short list of non-citizens who can have Medicare at all. A section added to the Social Security Act on July 4, 2025 allows only US citizens, US nationals, lawful permanent residents, Cuban and Haitian entrants and Compact of Free Association migrants to be eligible for Medicare or to enroll in Medicare Advantage or Part D plans, if they meet Medicare’s other requirements.

What a green card does not do is make Medicare automatic or free. Two separate questions decide your situation: whether you have lived here long enough to enroll, and whether you or your spouse worked long enough to get Part A without a premium.

The five-year rule for buying Medicare

CMS explains it in two parts. To purchase premium Part A, you generally must live in the US and be a citizen or a lawful permanent resident who has lived here for at least five consecutive years. To purchase Part B, you must be a citizen or lawful permanent resident and have lived in the US continuously for the five years before the month you apply.

Bring proof of your US addresses for the whole five years to the Social Security appointment. If you are short of five years at 65, you cannot buy Medicare yet, and the answer in New York is usually Medicaid in the meantime, covered below.

Premium-free Part A: the 40-quarter rule

You get Part A without a premium at 65 if you are in an eligible status and you or your spouse worked the equivalent of 10 years in Medicare-covered employment, the “40 quarters” requirement, or you already receive or can receive Social Security or Railroad Retirement benefits.

If you came to the US later in life, that is the line most likely to cost you money.

Everyone pays the Part B premium, $202.90 a month in 2026 for most people, with a $283 yearly deductible. The Part A inpatient hospital deductible is $1,736 in 2026. In most cases, if you buy Part A, you must also have Part B and pay both premiums. If you choose not to buy Part A, you can still buy Part B alone.

How New York can pay your Medicare premiums

New York’s Medicare Savings Programs are the most valuable help for a green card holder who has to buy Part A, because the lower tier pays it.

New York applies no asset test to these programs, and enrolling automatically qualifies you for Extra Help with drug costs. You apply through the local department of social services, which in New York City is the Human Resources Administration, not NY State of Health. Medicare Savings Programs in detail · Check your income in 20 seconds.

What changed on October 1, 2026, and what did not

From October 1, 2026, only citizens and nationals, lawful permanent residents who are past or not subject to the five-year bar, Cuban and Haitian entrants, and COFA citizens can qualify for a Medicare Savings Program, and the state has said state-only funding is not available for it. Refugees, asylees and other non-citizens outside those groups lost the program.

For green card holders past the five-year bar, nothing was lost: the savings program is still open to you on the same income rules. If you are not sure whether your five-year bar has ended, ask HIICAP to check your dates before you apply.

The bigger 2027 change hits other statuses: people on Medicare who are not in the eligible groups are to be disenrolled 18 months after July 4, 2025, which this site dates to January 4, 2027. Green card holders are not in that group. Immigrants and coverage in 2027.

Medicare for green card holders: situation by situation

What to say on the phone to Social Security or HIICAP:

“I’m a lawful permanent resident turning 65. I’ve lived in the US since [year]. Do I have 40 quarters on my record or my spouse’s, and if not, what would Part A cost me, and can a Medicare Savings Program pay it?”

If you are not yet eligible for Medicare

If you have not lived in the US for five years at 65, New York does not leave you uninsured. New York Medicaid covers green card holders still in the five-year bar with state funds, and people 65 and older apply through HRA rather than NY State of Health. HRA treats Medicare as a condition of eligibility for older applicants: it requires proof of Medicare, and if you are not enrolled you must enroll, so once you reach five years of residence, expect HRA to ask you to sign up. Medicaid at 65 and older · Where to apply.

Don’t miss the enrollment window

Medicare has a seven-month initial enrollment period around your 65th birthday, and the Part B late penalty is 10% of the premium for every full 12 months you could have had Part B and did not, added for as long as you have Medicare. If you reach five years of US residence after your 65th birthday, ask Social Security which enrollment window applies to you, and get the answer in writing. Turning 65 · General enrollment period.