Medicare for Immigrants: Who Will Lose Coverage on February 1, 2027

The Centers for Medicare and Medicaid Services (CMS) confirmed a significant change in Medicare for immigrants: those who are not citizens or permanent residents and do not fit into one of the four groups allowed by law will lose coverage starting February 1, 2027. The Social Security Administration (SSA) will send preliminary notices in November 2026.

Why it matters: the notice arrives this month and there is little time to respond. Those who do not demonstrate that they still qualify will receive a formal termination notice in December.

The change is in the final Medicare physician payment rule for 2027 (CMS-1848-F), which CMS announced on November 4 and will be published in the Federal Register on November 9. It applies to Section 71201 of the federal law enacted on July 4, 2025, which CMS calls the “Working Families Tax Cuts”.

Who Still Qualifies

Only the following can have Medicare (Part A and Part B):

• U.S. citizens or nationals.
• Lawful permanent residents (green card holders).
• Individuals with “Cuban or Haitian entrant” status.
• Individuals who legally reside in the U.S. under a Compact of Free Association (COFA) agreement.

Who May Lose Coverage

Before the law, any non-citizen “lawfully present” could qualify, for example, individuals with asylum, refugees, and individuals with humanitarian parole (permission to remain) for at least one year. These groups no longer qualify, unless they fit into one of the previous four categories, for example, if they obtain a green card.

The Social Security Administration estimates that it will send around 300,000 preliminary notices, but not all will lose Medicare: those who prove they still qualify will keep it. The CMS Actuary’s Office estimates that around 32,000 people will lose coverage starting in 2027, approximately 0.05% of enrollees.

What the Notices Say

The preliminary notice will ask individuals to contact the Social Security Administration and submit updated proof if they believe they still qualify. It will also explain how to request and correct their immigration record with USCIS. In December, CMS will send another notice with messages in 14 languages. The Social Security Administration translates most of its notices into Spanish and offers free interpreters.

Losing Medicare does not automatically take away Social Security retirement or disability benefits: the law did not change those requirements, and those who receive them will continue to collect them.

What You Can Do

• Read any letter from the Social Security Administration about your Medicare carefully.
• Respond quickly with documents that prove you still qualify.
• If there is an error in your immigration record, request a copy of your file from USCIS and correct it.
• If you are denied coverage, you have 60 days from receiving the notice to request a reconsideration (which can be extended for good cause).
• Seek help by calling 1-800-MEDICARE, the Social Security Administration, or, for free, the state health insurance assistance program (SHIP).

If the Social Security Administration later determines that you did qualify, Medicare may be reinstated retroactively, although you may owe Part B or Part A premiums for that period. CMS clarifies that coverage is not maintained during the appeal and that the law does not allow for an extension of the deadline.

Sources: CMS, fact sheet on the 2027 final rule and text of the final rule in the Federal Register (CMS-1848-F). Data consulted on November 5, 2026.