Two paths for a permanent resident
| Your situation at 65 | Part A | Part B |
|---|---|---|
| You or your spouse have 40 work credits | No premium | You can enroll; you pay the standard premium ($202.90 a month in 2026) |
| 30 to 39 credits and 5 years in a row living in the U.S. | Reduced premium: $311 a month in 2026, and you must also enroll in Part B | You can enroll |
| Fewer than 30 credits and 5 years in a row living in the U.S. | You can buy it: $565 a month in 2026, and you must also enroll in Part B | You can enroll in Part B alone, without Part A |
| Fewer than 40 credits and less than 5 years in a row in the U.S. | Not yet | Not yet |
The 5-year rule is in federal regulations (42 CFR 406.20 and 407.10): to buy Part A or enroll in Part B alone, a permanent resident must have lived in the U.S. continuously for the 5 years just before. If you get premium-free Part A through your or your spouse's work, that rule doesn't apply, and you can enroll in Part B. See Medicare eligibility and Medicare Part A.
What changed with the 2025 law?
The federal budget law signed July 4, 2025 (Public Law 119-21, section 71201) says only U.S. citizens or nationals, lawful permanent residents, Cuban-Haitian entrants and COFA migrants can have Medicare. Permanent residents stay on the list. Social Security said it would begin applying these rules to new applications the week of November 10, 2026. If you have another status, such as refugee or asylee without a green card, see Will some immigrants lose Medicare because of the 2025 law?
How to sign up in Florida
- Check your credits. Create a my Social Security account at ssa.gov/myaccount or ask Social Security how many credits you and your spouse have.
- Have your documents ready. Your Permanent Resident Card (I-551) and Social Security number. Social Security may ask for proof of your status.
- Apply in your Initial Enrollment Period. The 3 months before the month you turn 65, that month and the 3 months after, at 1-800-772-1213 (press 7 for Spanish) or a Social Security office. If you haven't met the 5-year residence rule yet, enroll when you do.
In Florida, about 5.2 million people age 5 and older speak Spanish at home (Census Bureau, 2024), so help in Spanish is widely used. For help with costs, see Medicare Savings Programs in Florida and Florida Medicaid for permanent residents. To review plans from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
Will some immigrants lose Medicare in 2027?
Who stays eligible and the February 1, 2027 date.
How do I sign up for Medicare in Florida?
Online, by phone or in person.
What if I miss my enrollment period?
Penalties and your next chance.
Sources
- eCFR — 42 CFR 406.20, premium Part A (5-year rule)
- eCFR — 42 CFR 407.10, Part B eligibility
- U.S. Congress — Public Law 119-21, section 71201
- Social Security — Changes to Medicare eligibility
- Federal Register — CMS final rule of November 9, 2026, section on limiting Medicare coverage of certain individuals
- Social Security — Sign up for Medicare
- Census Bureau — Language spoken at home, Florida, 2024 (S1601)
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?
- Will some immigrants lose Medicare because of the 2025 federal law?
- 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
How many years do I need to work in the U.S. to get Part A without a premium?
Usually 40 work credits, about 10 years of work paying Medicare taxes. Your spouse's work record also counts. With 30 to 39 credits, you can buy Part A at a reduced premium ($311 a month in 2026) if you've lived in the U.S. 5 years in a row.
Does the 2025 law take away Medicare if I have a green card?
No. The 2025 law limits Medicare to U.S. citizens and nationals, lawful permanent residents, Cuban-Haitian entrants and Compact of Free Association (COFA) migrants. Permanent residents remain eligible under the same work and 5-year residence rules.
I have a 2-year conditional green card. Could I lose Medicare?
You can have Medicare while your status is valid. CMS explains that if conditional status expires and isn't extended, Social Security can end your Medicare after sending you a notice. Keep your status current and tell Social Security if it changes.
Can I sign up in Spanish?
Yes. Call Social Security at 1-800-772-1213 and press 7 for Spanish, weekdays 8 a.m. to 7 p.m., or visit a Social Security office with your Permanent Resident Card. The online application is in English only.
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