Who stays eligible and who doesn't?
Section 71201 of Public Law 119-21, signed July 4, 2025, says a person may have Medicare only if they are:
- a U.S. citizen or national;
- a lawful permanent resident (green card holder);
- a Cuban-Haitian entrant, as defined in the Refugee Education Assistance Act of 1980; or
- a migrant lawfully living in the U.S. under a Compact of Free Association (COFA: Micronesia, the Marshall Islands or Palau).
Before the law, being "lawfully present" was enough, and CMS lists among those statuses refugees, asylees and people paroled into the U.S. for at least a year. Those statuses aren't on the new list, so people who have them lose Medicare unless they also hold one of the four eligible statuses; CMS confirmed this expressly for people granted asylum. Applying for an eligible status isn't enough; it must be granted. This site doesn't give immigration advice.
Key dates
| Date | What happens |
|---|---|
| July 4, 2025 | The law is signed |
| Week of November 10, 2026 | Social Security begins applying the rules to new applications and notifying people whose eligibility it can't confirm |
| December 2026 | Formal termination notice from Social Security, and a CMS notice (in English and Spanish) |
| January 31, 2027 | Last day of coverage for people who don't show an eligible status |
| February 1, 2027 | Medicare coverage ends |
If you enrolled in Medicare after July 4, 2025, or your status changes later, CMS says Social Security will send a notice and coverage will end at the end of the month after the month the notice is dated. If you lose Medicare, you also lose your Medicare Advantage or Part D plan.
What do I do if I get a letter?
- Read it carefully and note the deadline to respond.
- If you are eligible, for example because you already have a green card or became a citizen and your records aren't up to date, send your documents: a U.S. passport, Certificate of Naturalization, Permanent Resident Card (I-551), Arrival/Departure Record (I-94) or Employment Authorization Document (I-766).
- Submit them through your my Social Security account at ssa.gov/myaccount ("Upload Documents"), at a Social Security office, or call 1-844-507-7131 (TTY 1-800-325-0778) and mention the letter.
- If you disagree, appeal in writing within 60 days of receiving the decision, using form SSA-561-U2 or Social Security's online appeal form.
If you lose Medicare
Social Security suggests asking your state's social services office about other programs, enrolling in a workplace plan if you or your spouse work, and using community health centers. If you later gain an eligible status, you have the 12-month special period described above, then 2 months to join a Medicare Advantage or Part D plan. See Florida Medicaid for permanent residents and Medicare for permanent residents. If you keep Medicare and want to review your options, you can request a call from a licensed insurance agent.
Related questions
Can I get Medicare as a green card holder in Florida?
Work credits and the 5-year rule.
What are the Medicare deadlines for 2027?
Every date in one place.
How do I sign up for Medicare in Florida?
Online, by phone or in person.
Sources
- U.S. Congress — Public Law 119-21, section 71201, "Limiting Medicare coverage of certain individuals"
- Social Security — Changes to Medicare eligibility
- Social Security — Changes to Medicare Eligibility Requirements, November 10, 2026
- CMS — Notice 12238, "Your Medicare benefits may end," December 2026
- Federal Register — CMS final rule of November 9, 2026 (91 FR 70992), section on limiting Medicare coverage of certain individuals
More questions in this guide
- How do I sign up for Medicare in Florida?
- Can I get Medicare before 65 in Florida?
- What are the Medicare deadlines in Florida for 2027?
- Can I get Medicare as a permanent resident (green card holder) in Florida?
- What happens if I miss my Medicare enrollment period in Florida?
- When should I sign up for Medicare if I'm turning 65 in Florida?
Part of the guide: Medicare enrollment periods in Florida · All questions
Frequently asked questions
Will I lose Medicare if I'm an asylee but already have a green card?
No. If you're already a lawful permanent resident (green card holder) or a citizen, you remain eligible. CMS explains that people granted asylum lose Medicare unless they also have a status that meets the law, and that having applied for such a status isn't enough: it must have been granted.
Does this law affect my Social Security?
No. Social Security says the law makes no changes to Social Security benefit eligibility or payment rules. It changes only who can have Medicare.
If I get a green card later, can I get Medicare back?
Yes. CMS created a 12-month special enrollment period that starts the month you give Social Security documents proving your new status. You don't pay a late enrollment penalty for using it, and you can ask for coverage back up to 6 months.
Do Cubans still have Medicare?
Citizens, permanent residents and people with Cuban-Haitian entrant status (as defined in a 1980 law) remain eligible. If you aren't sure what status your documents show, ask Social Security.
Medicare in your Florida county
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