Medicare for H1B visa holder?

I am a home dialysis program social worker and I have a patient who has been legally working in the US on an H1B visa for the past 5 years and as a result has been paying into Social Security for the past 5 years.

When she first was admitted for dialysis one year ago (and for the record, several months before I became her social worker), a 2728 was completed and she was summoned by the social security office to apply for Medicare a month later. She was told by Social Security that she had to enroll and so she signed up for Medicare part A. She didn’t sign up for part B because due to her income level, her part B premium would be 267.90 and she decided that was too expensive.

But how can she be covered by Medicare if she isn’t a permanent legal resident or citizen? and if she can be covered by Medicare, does that also mean that she can apply for SSDI if she finds herself unable to work? What are the regulations around immigration status and these entitlement programs? The only time I see immigration status highlighted is when looking up SSI…

It should be noted that patient continues to works full time, has full health insurance benefits through her employer and ideally would like to disenroll from Medicare if at all possible…

Here’s the policy about eligibility for Medicare. It refers to citizens and aliens lawfully admitted for permanent residence who have lived continuously in the U.S. for at least 5 years. Are you sure your patient does not have a “green card” (as a legal permanent resident)?

If she doesn’t want Medicare, she can ask for her application to be withdrawn. If Part A has paid anything, she would have to repay that money.

Immigration law is complicated. An immigration attorney could answer questions about what would happen to your patient if she’s in the U.S. legally on a work visa and becomes unable to work. It might be to her advantage to check to see what it would take to become a legal permanent resident.