Partly false claim: Seniors must pay for Medicare and supplemental insurance while ‘illegals get it all for free’

A viral image on social media asks why seniors have to pay for Medicare and Supplement Insurance while “illegals get it all for free.” The post from January 27, 2019 has over 37,000 shares as of March 5, 2020 ( here ).

The claim is false. Seniors on Social Security must pay for Medicare and supplemental insurance, but undocumented immigrants do not get the same health insurance coverage, or health care, for free.

The U.S. federal health insurance program for senior citizens is made up of different parts. Medicare Part A (hospital Insurance) can sometimes be free, but only for some seniors.

Medicare Part B (medical insurance) has a monthly premium. The Medicare Advantage Plan (formerly known as Part C) and Medicare Part D (prescription drug coverage) also have monthly premiums. These plans are both run by private insurance companies.

Seniors who want Medicare Supplement Insurance, also known as Medigap, must pay for it. These policies sold by private companies are meant to help pay some of the gaps that may arise between coverage and healthcare costs like copayments, coinsurance and deductibles.

One of the basic requirements for being an eligible beneficiary of Medicare is to be a U.S. citizen or to be lawfully present in the United States (see page 3 of here ).

According to Section 5561 of the Balanced Budget Act (BBA), the Centers for Medicare & Medicaid Services (CMS) are prohibited to pay for Medicare services rendered to “an alien who is not lawfully present in the U.S.”

Undocumented immigrants also cannot access the Affordable Care Act’s marketplace health coverage ( here ).

Medicaid, which covers one in five Americans, is a government sponsored program that is intended to provide public health insurance to people with low income and limited resources, including those on Medicare ( here ). The eligibility criteria vary in each state ( here ).

It is possible for undocumented immigrants to get free access to medical emergency treatment. Medicare-participating hospitals must provide stabilization and screening services to any patient with an emergency medical condition, regardless of ability to pay ( here ).

Some locally funded programs also provide healthcare coverage to undocumented immigrants. Six states, including California and New York, and the District of Columbia use Medicaid state-only funds to cover low-income children regardless of their immigration status ( here ). California extended its healthcare coverage in 2019 and became the first state to use Medicaid funds to also cover young undocumented immigrants from the ages 19 to 25.

Laws are in place to limit the U.S. taxpayers to paying for undocumented immigrants only in “extreme circumstances” ( here ). According to the Kaiser Family Foundation (KFF), these emergency costs represent 1% of the overall cost of Medicaid ( here ).

Generally, undocumented immigrants face many hurdles to getting health care in the United States. These include legal restrictions, inability to afford private insurance, and not seeking other options due to fear of deportation ( here ).

The KFF reports that 47% of undocumented immigrants are uninsured. The think tank Public Policy Institute of California (PPIC) says the number is 60% to 70%. Undocumented immigrants are excluded from government marketplaces like Medicare and ACA. Only emergency treatment is required to be administered to people regardless of their immigration status.


Partly false: Seniors on Social Security must pay for Medicare and supplemental insurance, but undocumented immigrants do not get the same health insurance coverage, or health care, for free