Health Insurance for Green Card Holders Over 65

Most new green card holders over 65 cannot join Medicare or full Medicaid right away, because both usually involve a five year wait after you become a permanent resident. In the meantime, the main options are an ACA Marketplace plan, which can be bought after moving to the US and does not exclude pre-existing conditions, and a short term new immigrant bridge plan that covers new accidents and illnesses during the first months after arrival. Many families use both: a bridge plan from the day of arrival, then a Marketplace plan once it starts.

Key facts at a glance

• Medicare waits: under 42 CFR 406.20 and 407.10, a lawful permanent resident without enough US work history must have lived in the US continuously for five years before buying into Medicare.
• Medicaid waits: HealthCare.gov explains that most people with qualified immigration status wait five years for Medicaid, and KFF reports that from 1 October 2026 federal Medicaid eligibility narrows mainly to green card holders, Cuban and Haitian entrants and COFA residents.
• Marketplace access: HealthCare.gov lists moving to the US from a foreign country as a reason for a Special Enrollment Period, usually 60 days to enroll.
• 2026 changes: KFF reports that the 2025 budget law ended subsidized Marketplace coverage for lawfully present immigrants with incomes below 100% of the poverty level from January 2026, while keeping green card holders eligible for savings above that level.
• Sponsor exposure: USCIS states that if a sponsored immigrant receives means tested public benefits, the agency can ask the Form I-864 sponsor to repay them.

Why can't new green card holders over 65 get Medicare right away?

Medicare has two routes. Most people get premium free Part A because they or a spouse paid Medicare taxes for about 10 years. A parent who spent a working life abroad usually has no US work history, so they would need to buy Medicare instead. Federal rules allow that only for a lawful permanent resident who has lived in the US continuously for the five years immediately before enrolling.

So a 68 year old who receives a green card this month can generally buy into Medicare only after their fifth anniversary of US residence. Our guide to whether green card holders can get Medicare explains the timeline, premiums and enrollment windows in detail.

Is Medicaid available for new immigrants over 65?

Usually not at first. Most green card holders who arrive through family sponsorship must wait five years after receiving qualified status before full Medicaid is available. Some groups, such as people who first arrived as refugees or asylees, are treated differently, and the rules changed again on 1 October 2026 under the 2025 budget law, according to KFF. A few states also fund coverage for certain immigrants during the waiting period, so check with your state Medicaid agency.

There is a second reason to be careful. When you sponsor a parent on Form I-864, you sign a contract with the US government to support them, and USCIS warns that an agency paying means tested benefits can seek repayment from the sponsor. Our article on the Medicaid bar for new immigrant parents covers this in more depth. This article is general information, not legal advice; speak to an immigration attorney about your own case.

Can green card holders over 65 buy an ACA Marketplace plan?

Yes, in most cases. Green card holders are lawfully present, and people who are not enrolled in Medicare can buy Marketplace coverage. Moving to the US from a foreign country qualifies for a Special Enrollment Period, and HealthCare.gov says you usually have 60 days after the event to enroll. Marketplace plans cannot refuse cover or charge more for pre-existing conditions, which matters for older parents with diabetes, heart disease or regular prescriptions.

Cost is the hard part. Marketplace premiums rise with age, and savings depend on household income and how your family files taxes. KFF reports that from January 2026, lawfully present immigrants with incomes below 100% of the federal poverty level are no longer eligible for subsidized Marketplace coverage, and that from 2027 subsidies are limited to groups that include green card holders. A parent with little or no income may therefore face the full premium. Our comparison of Marketplace options for green card holders walks through the choices.

What about medical insurance for new green card holders over 70?

Age changes the fine print on bridge plans, according to the plan terms Ombrela shows at quote time. On IMG's Patriot Plus and Patriot Platinum, acute onset of pre-existing conditions is not covered for travelers over 70, and Patriot Plus and Patriot Lite limit travelers over 80 to a $10,000 maximum. Trawick's Safe Travels USA Comprehensive covers acute onset up to the policy maximum through age 69, up to $35,000 for ages 70 to 79 and up to $20,000 from age 80, and Trawick's Safe Travels USA plans do not cover anyone aged 90 or over.

None of these plans cover ongoing treatment of a known condition. For a parent over 70 with regular medical needs, a bridge plan is protection against a new emergency, not a replacement for continuing care.

How do bridge plans cover the first months after arrival?

A new immigrant bridge plan is a travel medical policy that can start on the day your parent lands. Marketplace coverage usually begins on the first of a following month, and paperwork after a move takes time, so the first weeks are often uncovered. A bridge plan fills that gap for new injuries and sudden illnesses, and several plans also include emergency evacuation.

• IMG Patriot Lite, Patriot Plus and Patriot Platinum: ages 14 days to 99 years, can be bought after arrival; not sold to citizens of Botswana, Gambia, Ghana, Kosovo, Niger, Nigeria or Sierra Leone or to people whose home country is Cuba, Iran, North Korea, Syria, Venezuela or a few others, and not purchasable from New York.
• Trawick Safe Travels USA, USA Cost Saver and USA Comprehensive: must be bought within 364 days of arrival; not available to people whose home country is on a long list that includes much of Europe.

These plans are temporary. They suit recent arrivals for the first months, not green card holders who have lived here for years. Use our medical cost estimator to see why even a short uninsured period can be expensive.

Which option fits senior citizen parents?

A simple rule helps most families. If your parent is healthy and arriving soon, start a bridge plan on the arrival date and apply for a Marketplace plan within the Special Enrollment Period. If your parent has a chronic condition, prioritize the Marketplace plan, because pre-existing conditions are covered, and use a bridge plan only for the days before it starts. Revisit the decision each year at open enrollment.

Then plan for year five. Mark the anniversary of your parent's arrival as a lawful permanent resident, and start the Medicare conversation with Social Security a few months before it.

Download our free New green card senior coverage planner below. It helps you record the arrival date and status, map the Medicare and Medicaid waiting periods, check Marketplace timing, compare bridge plans, list medications and doctors to transfer, and put every key date on one calendar.

How to get covered

Enter your parent's age, arrival date and citizenship on our new immigrant insurance quote page to see which bridge plans they can buy. Premiums depend on age, trip length, policy maximum and deductible, so compare live quotes and read the pre-existing condition terms before you choose.

Frequently Asked Questions

Can a new green card holder over 65 get Medicare?

Not usually at first. Without about 10 years of US work history, a green card holder can buy Medicare only after living in the US continuously for five years, under 42 CFR 406.20 and 407.10. A spouse's work record can sometimes qualify them for premium free Part A earlier, so check with Social Security if a spouse has worked in the US.

What is the best health insurance for new immigrants over 65?

It depends on health and income. A Marketplace plan is usually the stronger choice for a parent with ongoing conditions, because pre-existing conditions are covered, though premiums can be high without savings. A bridge plan is often lower priced and starts immediately but covers only new accidents and illnesses. Many families combine the two during the first months.

Do bridge plans cover pre-existing conditions for seniors?

Generally no. The bridge plans Ombrela compares exclude pre-existing conditions, and acute onset cover, which pays for a sudden flare of a known condition, is limited or unavailable at older ages. For example, IMG's Patriot Plus and Platinum exclude acute onset after 70, and Trawick's Safe Travels USA Comprehensive caps it at $35,000 for ages 70 to 79.

Will using Medicaid or Marketplace savings affect the sponsor?

It can, depending on the program. USCIS says an agency can ask a Form I-864 sponsor to repay means tested public benefits a sponsored immigrant receives. Which programs count is set by law and can change, so confirm with an immigration attorney before a parent applies for Medicaid or other assistance. This is general information, not legal advice.

The first five years are the hardest part of covering an older parent, and a plan made early costs less than a bill paid late. Compare new immigrant plans on Ombrela and start coverage on the day your parent arrives.