Medicare exists in Puerto Rico. However, requirements for receiving Medicare Part B, or medical insurance, in addition to Part A, or hospital insurance, differ slightly from those for residents of U.S. states. Plans offering prescription coverage through Medicare Part D are also available in Puerto Rico.
Residents of Puerto Rico must apply for enrollment in Medicare Part B even if they are already receiving Social Security retirement benefits. Residents of the 50 U.S. states who receive those retirement benefits, on the other hand, are automatically enrolled in both Parts A and B of Medicare. Medicare Part B requires the payment of premiums, so even those who are automatically enrolled may choose to opt out of the program.