If you have been receiving Social Security retirement or disability benefits early enough, Medicare may enroll you automatically. If not, you generally must contact Social Security to sign up.
If you receive Social Security benefits before 65
People receiving Social Security retirement or disability benefits at least four months before turning 65 are generally enrolled automatically in Part A and Part B. Medicare normally sends the welcome package and card about three months before coverage starts.
If you are not receiving benefits
Waiting to claim Social Security retirement benefits usually means Medicare enrollment is not automatic at 65. Check the seven-month Initial Enrollment Period and apply through Social Security unless another rule applies.
Puerto Rico and residence outside the United States
Medicare's official sign-up tool explains that people living in Puerto Rico or outside the United States may receive Part A automatically but must actively enroll in Part B. Review this rule before assuming both parts will start.
Automatic Medicare before 65
Many people receiving Social Security disability benefits are enrolled after 24 months of disability benefits. People with ALS generally receive Medicare when disability benefits begin. End-Stage Renal Disease follows separate eligibility and enrollment rules.
Railroad Retirement beneficiaries
The Railroad Retirement Board handles Medicare enrollment and cards for many railroad beneficiaries. Follow the RRB notice rather than filing a duplicate application with Social Security.
What to do
Use Medicare's official sign-up questionnaire, check whether a welcome package arrives, and verify the Part A and Part B effective dates. Contact Social Security promptly if you expected automatic enrollment but did not receive confirmation.
Official sources
- Medicare.gov — how enrollment works
- Medicare.gov — receiving Social Security before 65
- Medicare.gov — get started with Medicare