What is Medicare, commonly referred to as the “Red and Blue Cards”? It is a national health insurance program provided by the United States for individuals aged 65 and older. If you have filed taxes continuously for 10 or more years, earning at least 4 credits per year, you become eligible to enroll in Medicare within the three months prior to turning 65.
Medicare, like typical health insurance plans, involves deductibles and coinsurance that individuals need to pay. The program is divided into four parts:

Part A – Hospital Insurance: If you or your spouse has accumulated 40 working credits in the United States (one credit earned per quarter of work), equivalent to working for at least ten years with Medicare taxes paid, the monthly premium for this part may be waived. Otherwise, you may be required to pay a monthly premium of up to $400+.

Part B – Medical Insurance: Regardless of the Part A waiver or the number of working credits, every Medicare beneficiary must pay a monthly premium for Part B, approximately $105 per month. It is worth mentioning that Part B is not limited to citizens or green card holders; noncitizens aged 65 and above who have lawfully resided in the United States for at least five years can also apply for and purchase Part B, without being obligated to purchase Part A.

Part C – Medicare Advantage Plans: Since the first two parts only cover 80% of expenses, the remaining 20% requires the purchase of supplemental insurance (Medigap) and additional coverage under Part D, resulting in high monthly costs. Part C offers an alternative with lower expenses. Eligible healthcare plans within Part C must include medical benefits from Part A and Part B, and some plans may also include Part D.

Part D – Prescription Drug Plans: This part is outsourced by the government to private insurance companies. When selecting a plan, it is important to consider coverage for your commonly used medications. In addition to the monthly premium, copayments of several dollars are required for both generic and brand-name drugs.

From the above, we can see that there are two basic options for the red and blue cards: Part A + Part B + Part D and Part C. Although the graph indicates that the latter plan is cheaper, it actually comes with more limitations and may have a narrower coverage scope compared to the former. It is essential to consider individual needs in order to determine the most suitable combination.

Approximately two to three months before turning 65 (at age 64 and 9 months), the government will mail retirement benefit and Medicare application materials. It is necessary to apply within three months after turning 65, even if one does not wish to participate, a response must be provided to avoid penalties. If one does not enroll in Part B during the initial enrollment period, they will have to wait for the “General Enrollment Period” that takes place every year from January 1st to March 31st.

At the age of 65, if either spouse is still working and has individual or employer-based health insurance (with 20 or more employees), they have the option to defer Medicare Part A and Part B. They would need to complete a form to delay Part B enrollment without facing penalties.

Individuals who pay premiums for Part A must meet the following requirements to enroll in Part B:

• Age 65 or older.
• U.S. residency.
• U.S. citizenship.
• Lawfully obtained permanent residency and have resided continuously in the United States for at least 5 years before the month of the Medicare application, as a foreign national.
  If individuals do not enroll in Part A when they first become eligible, and they decide to enroll later, they may have to pay higher monthly premiums. The monthly premium for Part A can increase by a maximum of 10%. Individuals will have to pay a higher premium, which will be twice the amount of the premiums they would have paid if they had enrolled in Part A but delayed registration.

Step 1: Prepare the Documents

1.Fill out the Medicare enrollment application form.
Form download link:
https://www.servicesaustralia.gov.au/individuals/forms/ms004
2.Passport
3.Bridging visa (required during the waiting period for PR visa submission)
4.Confirmation of submission (required during the waiting period for PR visa submission)
5.PR permanent residency grant letter

Step 2: Take the prepared documents to the nearest service center for processing.

Find service center addresses:
https://findus.servicesaustralia.gov.au/
Enter your residential postcode to locate the nearest service center to your home.
Upon completion, you will receive a receipt which can be used as a temporary Medicare card until the official card is mailed to your home. If you have a bridging visa under PR, you will receive a temporary card valid for one year. After receiving the PR grant, there is no need to reapply, and you will receive an official Medicare card with a validity of 5 years.

The effective date of the Red Blue Card Medicare is determined by the application timing. If the application is made within three months before turning 65, it will become effective in the birth month. If the application is made in the month of turning 65, it will become effective one month after the birth month. If the application is made after the birth month, it will be delayed and become effective two to three months later.

Note: If eligible for Supplemental Security Income (SSI), which provides financial assistance to low-income and low-asset elderly individuals, automatic eligibility for the White Card is also granted in addition to the Red Blue Card.

Medicaid (White Card) is a government low-income insurance and healthcare assistance program primarily targeted towards low-income households. If you are considering applying for insurance for newly immigrated parents, eligibility for the White Card should be assessed based on income and assets.

1. Income Limitation for applicants aged 19-64: Total household income should be at or below 138% of the federal poverty level. The federal poverty level is determined based on household size in the 48 states and the District of Columbia. For example, in 2022, the income limit is $13,590 for a single adult, $27,750 for a household of four, and $46,630 for a household of eight.
2. Asset Limitation for individuals aged 65 and above, blind individuals, or individuals with disabilities: Permissible assets include one property (and other non-valuable personal belongings) and one vehicle. The value of life insurance/pre-need contracts should not exceed $1,500, and other assets, such as bank deposits and stocks, should not exceed $2,000 (or $3,000 for married couples).
3. Other eligibility criteria: Beneficiaries of Supplemental Security Income (SSI), pregnant women, individuals with disabilities, residents of nursing homes, and individuals diagnosed with breast or cervical cancer.

If the basic eligibility criteria mentioned above are met, applicants can enjoy 100% medical benefits, which means medical consultations, hospitalization, and medications are provided at no cost.

There is no specific time limit for applying for Medicaid’s White Card. Applications can be submitted at any time during the year. In most cases, White Card benefits become effective immediately upon approval. Some emergency cases may even allow reimbursement of medical expenses incurred prior to the application, depending on the state’s regulations.

Register an account on HealthCare.gov and provide personal, household, and income information, similar to purchasing health insurance through the marketplace. If the Marketplace determines that you meet Medicaid eligibility, your information will be transferred to the relevant state department responsible for Medicaid, and they will contact you. Some states allow direct online application through the state’s Marketplace.
Apply directly to the Medicaid agency of each state by mail or in person. You can find the official websites or contact information for each state’s Medicaid program on HealthCare.gov.

When applying for the White Card, you generally need to prepare the following documents:

Proof of identification: Documents verifying age, residence, citizenship, green card status, etc.

Proof of income and assets: Documents showing wage income, bank accounts, retirement savings accounts, and other personal assets.

Information on regular expenses, such as rent or mortgage payments, property taxes, utilities, etc.

How to Renew the White Card:

The frequency of White Card renewal varies by state, with most states requiring renewal every 12 months. You will receive a letter notifying you of the renewal deadline and providing instructions for renewal.

During the renewal process, you will need to resubmit proof of identity, income, and other necessary documents for reevaluation of eligibility.

How to Cancel the White Card:

White Card beneficiaries have an obligation to report changes in income or other relevant circumstances to the Medicaid agency. If your income increases or you no longer meet the eligibility criteria for the White Card, you are required to report these changes within a specified time frame.

Some states allow cancellation of the White Card by updating your insurance information through your Marketplace account. Alternatively, you can contact your local Medicaid agency (https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/) to update your information.

White Card benefits generally end on the last day of the month in which the cancellation is requested, and you will receive written confirmation. If you have purchased another health insurance plan, it is advisable to choose an appropriate date to ensure a smooth transition.

The Red Blue Card and the White Card are independent health insurance plans that cover medical services such as doctor visits, hospitalization, and medications (without going into detailed comparisons of quality). However, if an individual qualifies for both programs (dual eligibles/Medi-Medis), such as low-income/low-asset households aged 65 and above, they can participate in both insurance plans simultaneously. Some details of the two programs may interact with each other, but generally, the monthly fees associated with the Red Blue Card are covered by the White Card.

When seeking medical consultations, both cards should be presented. The primary responsibility for medical expenses and medication lies with the Red Blue Card Medicare, while the White Card Medi-Cal covers the remaining balance and any other out-of-pocket costs.

More doctors accept the Red Blue Card, but certain services, such as long-term care and dental care, may not be covered. In such cases, the White Card can help cover these additional expenses. In summary, having both cards eliminates concerns about significant medical costs!