Legal Alien Eligible for Medicare Without Working in US

Question

I am a 35 year old US citizen with a good job, company provided health care, benefits, etc... My wife is a 50 year old Japanese citizen registered as a legal permanent resident alien. We have been living in the U.S. for nearly 15 years. She prefers not to be granted U.S. citizenship, mostly because if something ever happened to me, she would much rather be living back at home in Japan rather than here in the U.S. In order for her to be a citizen of the U.S., she would have to relinquish her Japanese Citizenship.

She has held a part time job waiting tables for about 5 years. The income is small, but honest, and is really a better mental break for her to "get out of the house," than it is as an income provider. We have recently found out the business she works at may be closing. This would not be a big deal financially, except:

I was told by someone NOT in the legal profession that she needs to work in the U.S. for ten years in order to be eligible for Medicare when she turns 65. My company generally cuts dependents off the company health care plan when they become Medicare eligible.

What I do not want to have happen is for her to turn 65, get cut off my company health insurance plan, and then find out she is ineligible for Medicare. I will be working for a considerable amount of time after she is Medicare eligible (age-wise), and would be comfortable knowing that when she turns 65, she can turn to Medicare.

Should she lose her job as a result of her place of business closing, does she need to work for a few more years in order to become eligible for Medicare when she turns 65? Is Medicare granted for all aliens and citizens over 65, or just those who've worked for 10+ years?

Answer 1

Generally, yes, you do have to have 10 years of work for Medicare, though the formula is based on "credits" and is a bit more complicated. See https://www.ssa.gov/planners/credits.html#h1.

It can in some cases be possible to "count" overseas work towards eligibility, due to agreements with certain countries. See https://www.ssa.gov/planners/retire/international.html. However, according to the Agreement Pamphlet for Japan:

Although the agreement between the United States and Japan allows the Social Security Administration to count your Japanese credits to help you qualify for U.S. retirement, disability or survivor benefits, the agreement does not cover Medicare benefits. As a result, we cannot count your credits in Japan to establish entitlement to free Medicare hospital insurance.

Note: I am also not in the legal profession, which is also the case for most people on this site. Even of those who are lawyers, they're not your lawyers, and nothing you see on this site is legal advice.

Answer 2

First, note that she can qualify for Medicare through your credits, but only if you are at least age 62 (the minimum Social Security benefit age), so that would still not help her until she is 77.

She doesn't have enough credits to qualify for premium-free Medicare Part A (until she is 77), but once she is 65, she can still purchase Medicare Part A by paying the premium if she wants.

Another option would be to buy a private health insurance plan from your state's health insurance exchange (Obamacare marketplace). She would still qualify for the subsidy (premium tax credit) if your income is low enough, even after she turns 65, because she does not qualify for premium-free Medicare (until she is 77). However, not getting Medicare when she first qualifies for it would increase her Medicare premiums later if she decides to get it.