Medicare 2026

Medicare Eligibility Is Narrowing for Some Noncitizens: What the 2025 Law Changed

A federal law signed on July 4, 2025 changes who can be entitled to or enrolled in Medicare. If you are a U.S. citizen, this change does not affect your Medicare. If you are a noncitizen, or you help a family member who is, this explainer walks through what the law does, who it affects, and what to watch for.

What the law says

Section 71201 of Public Law 119-21 (H.R. 1), signed on July 4, 2025, says a person may be entitled to or enrolled in Medicare only if they fall into one of four categories:

• A U.S. citizen or U.S. national;
• A lawful permanent resident (green card holder);
• A Cuban and Haitian entrant; or
• A person lawfully residing in the United States under a Compact of Free Association (COFA).

Medicare's September 2026 fact sheet, "Your Medicare in 2027: What's New & Changing," states the same four categories as the test for getting Part A and Part B benefits or joining a Medicare health or drug plan.

What changed from before

Before this law, a noncitizen who met Medicare's other requirements — generally, enough work history and the right age or disability status — could qualify if they were "lawfully present" in the United States. That was a broader group of immigration categories, and it included, for example, people granted asylum and admitted refugees. Under the new law, lawful presence by itself is no longer enough; a person must fit one of the four categories listed above.

CMS has also pointed out two things the law did not change:

• It did not change Social Security (title II) benefit rules. A noncitizen who is lawfully present in the United States may continue to receive Social Security payments even if they no longer qualify for Medicare.
• It did not eliminate the existing rule that a lawful permanent resident who is not entitled to premium-free Part A must have lived in the United States continuously for the 5 years before applying in order to buy Part A or enroll in Part B.

Timing for people already enrolled

For people who were already entitled to or enrolled in Medicare on July 4, 2025, the law says the new rule begins to apply 18 months after the date of enactment. CMS has said that people outside the four listed groups who were enrolled as of July 4, 2025 will no longer be eligible for Medicare on the date that is 18 months after July 4, 2025.

The law also required the Commissioner of Social Security to complete, within one year of enactment, a review of current Medicare enrollees to identify people who do not meet the new categories, and to notify each affected person — as soon as practicable, and in a way designed to make sure they understand it — that their Medicare entitlement or enrollment will end.

In a proposed rule issued July 16, 2026, CMS described SSA's notice: it tells people that SSA records indicate they do not meet one of the eligibility criteria, and it instructs them to contact SSA and provide updated evidence of eligibility if they believe the information is incorrect. If you receive such a notice and you think your immigration status does fit one of the four categories, that notice is the moment to respond with documents, not to wait.

Other 2027 Medicare basics worth knowing

While you orient yourself, a few national program facts for 2027 are already set:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (it is $2,100 in 2026).
• No Part D plan may charge a deductible higher than $700 in 2027.
• The Part D base beneficiary premium for 2027 is $41.33; this is a national figure used in the late-enrollment penalty calculation, while actual plan premiums are set plan by plan.
• Annual Enrollment runs October 15 through December 7, 2026, with choices taking effect January 1, 2027.
• SSA announced a 3.6 percent cost-of-living adjustment for benefits payable beginning January 2027.

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income-related brackets, have not been announced; CMS typically releases them in the fall.

People with Medicaid or Extra Help

If you have full Medicaid or qualify for the Extra Help program for Part D, you have a monthly Special Enrollment Period, available since 2025, to move to Original Medicare with a stand-alone Part D plan, or to switch stand-alone Part D plans. Full-benefit dual-eligible individuals can also join an integrated Dual Eligible Special Needs Plan (D-SNP) in any month.

Thinking about coverage choices, neutrally

As you review options during Annual Enrollment, you'll see two general paths: Original Medicare (often paired with a stand-alone Part D plan and, for some people, a Medigap policy), or Medicare Advantage, which bundles Part A, Part B and usually Part D through a private plan. Original Medicare offers broad provider access nationwide and predictable federal rules, while Medigap can help cover cost-sharing but has its own premiums and enrollment rules. Medicare Advantage plans typically use networks and prior authorization, and may include extra benefits, but specifics vary. Neither path is universally better; the right fit depends on your health, providers, prescriptions and budget.

Where to go next

For official information on enrollment periods, eligibility and your personal record, use Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week. If SSA sends you a notice about eligibility under the 2025 law, follow the instructions in that notice and contact SSA directly.