Melissa Paquet, LMSW, Outreach Resource Specialist  | Kathleen Jodoin, Medicare Coordinator 

Medicare is health insurance for people 65 and older, and for younger people who have a disability. Enrolling in and accessing Medicare benefits can be a complex and often confusing process. It can be even more challenging for older immigrants, some of whom do not have a significant work history in the United States, are not citizens, or have limited English proficiency. Eligibility for Medicare enrollment for immigrants is based on immigration status and length of time living and working in the U.S. 

Lawful residents, including naturalized citizens, are eligible for free Medicare Part A (hospital stay) if they are at least 65 years old and have worked at least 10 years in jobs where they or their spouses paid Medicare taxes. Legal immigrants who are age 65 or older but do not have 10 years of work history can purchase Medicare Part A after living legally and continuously in the U.S. for five years. Since monthly premiums for Medicare Part A can be quite high, legal immigrants who do not qualify for the premium-free Medicare Part A can also consider enrolling in a Qualified Health Plan (QHP) in the Marketplace. They can apply for financial assistance in the form of premium tax credits and cost-sharing reduction. 

Green card holders under age 65 who have disabilities may also qualify for Medicare. Typically they must first meet the same eligibility requirements for disability benefits that apply to citizens. These are based on work history, paying Social Security taxes on income, and having enough years of Social Security taxes accumulated to equal between five and 10 years. Additionally, there is a 24-month waiting period, once they are deemed disabled, before they can apply for Medicare.  

Asylees and refugees do not need to meet the five-year criteria to qualify for the income-based, state-supported MaineCare. They can apply for assistance immediately. Asylum seekers who are in the process of requesting an immigration status change can only purchase health coverage on the Healthcare Marketplace or get emergency MaineCare.  

Immigrants who qualify for Medicare need to start the process before their 65th birthday to avoid penalty fees. A good first step, four or five months before their 65th birthday, is to enroll in a Medicare seminar such as Southern Maine Agency on Aging’s free “Welcome to Medicare” and “eMedicare-Medicare Plan Finder.” Such seminars are also offered by other organizations. Then, three months before the 65th birthday, apply for Medicare through the Social Security website ( Receiving a Medicare card take about a month. While waiting for the card, assess which Medicare enrollment option would work best for particular life circumstances. This is a complex decision that involves employment status, medical history, and other factors. 

Anyone who is already enrolled in Medicare can reevaluate coverage options during the Medicare Open Enrollment period every October. However, Medicare enrollment specialists provide free, unbiased consultation, year-round, to be sure each person is enrolled in the best Medicare plan for their situation.