Enrollment in Medicare is automatic for a person who is turning 65 and who is already getting Social Security 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. 

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.

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. 

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 http://www.ssa.gov to find out more. 

Most people don't have to pay a monthly fee, or premium, for Medicare Part A (hospital insurance) when they turn age 65 because they or a spouse paid Medicare taxes while they were working. Enrollment in Medicare Part B (medical insurance) is optional, and most people who choose Part B must pay a monthly premium. Some people with a higher income pay a higher Part B premium. The Social Security Administration will send out a notice if income is above a certain threshold. There may be a late enrollment penalty for Part B if the person doesn't join when he or she is first eligible.

For important information about Part A or B, visit http://www.medicare.gov and view or print a copy of "Medicare & You" and "Your Medicare Benefits." (Under "Search Tools," select "Find a Medicare Publication.") 

People can decide how to get their Medicare benefits. They can choose Original Medicare, one of the Medicare Advantage Plans, or other Medicare health plans. 

Original Medicare and the Medicare Advantage Plans include Part A (hospital insurance) and Part B (medical insurance). However, co-payments and deductibles vary among the different plans. A person who joins Original Medicare, and who wants prescription drug coverage, will need to choose and sign up for a Medicare Prescription Drug plan. A person who joins one of the Medicare Advantage Plans will automatically receive prescription drug coverage through that plan if it is offered, usually for an extra cost. To get help choosing a plan, call 1-800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048. 

Your state has programs that pay some or all of the Medicare premiums for people with limited income and resources. Call your state's Medical Assistance (Medicaid) Office to learn about Medicare Savings Programs, or visit http://www.medicare.gov.