After you are enrolled in Medicare, you need to take action if you want additional coverage, such as a Medicare Advantage (Part C) plan, a prescription drug (Part D) plan or a Medicare supplement insurance plan.
How Automatic Enrollment in Medicare Works
You will be enrolled automatically in Original Medicare Parts A and B if:
- You are turning 65 and are getting Social Security or Railroad Retirement Board benefits.
- You are under 65 and have received disability benefits for 24 months.
- You have Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis, or ALS) and start getting disability benefits.
You will get your Medicare card in the mail a few months before your 65th birthday or before your 25th month of getting disability benefits. You’ll get it immediately if you have ALS.

Keeping the card means you accept Original Medicare Part A and Part B coverage. You also agree to pay Part B premiums. (If you live in Puerto Rico, you need to enroll yourself in Part B; it’s not automatic.)
You must notify Medicare if you decide to refuse or delay Part B. You may want to do this if you have other health care coverage, such as through an employer or union. Follow the instructions on the back of your Medicare card.
If you enroll in Part B, you may have other Medicare coverage options.
How to Know if You Need to Enroll Yourself In Medicare Or Not
Is Medicare enrollment automatic or do you have to do it yourself? Watch this video then learn more about enrolling.
How to Enroll in Medicare Yourself
You need to take action to sign up for Medicare if:
- You are turning 65 and are not currently getting Social Security or Railroad Retirement Board benefits.
- You qualify for Medicare because you have End-Stage Renal Disease (ESRD).
- You live in Puerto Rico and want Part B coverage.
You can sign up for Medicare online. You can also enroll in Medicare by phone or in person at any Social Security office. Call 1-800-772-1213 (TTY 1-800-325-0778) Monday through Friday, 7 a.m. to 7 p.m. local time, to make an appointment.
If you live outside the United States and its territories, contact the nearest U.S. Social Security office, U.S. Embassy or consulate, or the Veterans Affairs Regional Office (VARO) in the Philippines.
How to Enroll in a Private Medicare Plan
You may choose to enroll in a private Medicare plan after you complete your initial enrollment in both Part A and Part B. You can choose a:
- Medicare Advantage plan (Part C) with or without drug coverage
- Stand-alone Medicare prescription drug plan (Part D)
- Medicare supplement insurance plan
You can find out about plans offered where you live at Medicare.gov or directly from the insurance companies that offer them. You can apply online, by phone or through a local insurance agent.
Keep in mind that if you don’t get prescription drug coverage when you’re first eligible, you may be charged a premium penalty if you join a plan later. You could also be charged more for Medicare supplement insurance if you wait to buy a plan. In some cases, you could be denied this coverage entirely based on your health history.