To be eligible for Medicare, you must meet specific criteria, including the 5-year residency rule. This means you must have been lawfully living in the United States for 5 continuous years before applying for Medicare.
Another Medicare eligibility criterion is being age 65 years or older or younger than 65 with specific medical conditions.
You must also be a U.S. citizen or from another country and lawfully living in the United States, such as with a Green Card.
Preparing relevant documents can help a Medicare application process run smoothly.
To enroll in Medicare, you must provide specific documentation that the government will verify. These documents may include ones that prove your citizenship status and age, and sometimes you may need documents related to work or disability status.
Some people may immigrate later in life and have limited or no U.S. work history. While this can affect how much you pay for Medicare, you will likely qualify for coverage if you meet the 5-year residency requirement.
A U.S. residency period typically begins from the date you arrive in the United States with your Green Card and the intent to set up a permanent home. Visiting the United States on business or vacation does not count toward your 5-year residency.
Once you have been a legal, permanent U.S. resident for 5 continuous years or more, the Medicare application process should be easy.
You must complete the relevant Medicare enrollment forms, which you can do either online or in person at your local Social Security office. The forms will ask for basic information, like your name, address, and date of birth.
If you must prove that your U.S. residency status meets the 5-year rule requirements, you can use tax records, bank statements, lease information, utility bills, or other official documents.
Once you submit your application and any supporting evidence, Medicare will review it. Once Medicare approves it, you can begin using covered services.
If you need any help or support with your application, you can contact Medicare at 800-633-4227 (TTY users can call 877-486-2048). Alternatively, your local State Health Insurance Assistance Program (SHIP) could help, as it specializes in helping with many Medicare-related matters.
Once you meet all the legal requirements, you can enroll in Original Medicare, which includes Medicare parts A and B. Part A covers inpatient hospital care, while Part B, covers outpatient medical appointments.
You can also enroll in a Medicare Part D prescription drug plan if you have Original Medicare.
Alternatively, you can apply for a Medicare Advantage (Part C) plan, which private insurers manage on Medicare’s behalf. These plans bundle the offerings of Medicare parts A, B, and often D, and they may also provide additional benefits.
The Medicare 5-year residency rule requires you to legally live in the United States for 5 continuous years before becoming eligible for Medicare.
Other eligibility criteria include being over age 65 years or having a specific health condition.