Medicare Basics

Frequently Asked Questions

8. How does a person enroll in Medicare?

Enrollment in Medicare is automatic for a person who is turning 65 and who is already getting Social Security or Railroad Retirement Board (RRB) benefits, or who will start getting them at age 65. A Medicare card will be mailed out about three months before the 65th birthday. If a person isn't getting Social Security benefits when he or she turns age 65, the person will have to sign up for Medicare.

Enrollment is also automatic for a person who has been entitled to Social Security disability benefits for at least 24 months. A Medicare card is mailed out about 3 months before the 25th month of disability benefits.

Automatic enrollment includes Part A and Part B. If people don't want Part B, they should follow the instructions that come with the card, and send the card back. If they keep the card, they keep Part B.

(Watch the video for important information about Medicare Enrollment periods. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)

If you live in Puerto Rico or a foreign country and get benefits from Social Security or the RRB, you’ll automatically get Part A the first day of the month you turn 65 or after you get disability benefits for 24 months. However, if you want Part B, you’ll need to sign up for it. If you don’t sign up for Part B when you’re first eligible, you may have to pay a late enrollment penalty for as long as you have Part B. Contact your local Social Security office or the RRB for more information.

A person with amyotrophic lateral sclerosis (also known as Lou Gehrig's disease) will get a Medicare card about 4 weeks after qualifying for Medicare.

A person with end-stage renal disease, or ESRD, does not need to be receiving Social Security disability benefits to qualify for Medicare, and may still be working.

The Centers for Medicare and Medicaid Services (CMS) administers Medicare, but the Social Security Administration (SSA) is responsible for enrolling most people in Medicare. The Railroad Retirement board is responsible for enrolling railroad retirees. For questions about Medicare enrollment, or to apply for Medicare benefits, call SSA at 1-800-772-1213, or go to to find out more.