Medicare · Cornerstone
New to Medicare, the four things to know before you sign up
Last reviewed June 11, 20263 min readBy the Goodsurance editorial team Reviewed by the Goodsurance editorial team
Turning 65 comes with a stack of mail, a deadline nobody clearly explains, and a decision that quietly shapes your costs for years. It is genuinely a lot, and most of the regret people feel later traces back to a handful of things they wish someone had told them up front. This page is that short list. Each item links to a fuller page if you want the detail, but if you read only one thing before you sign up, read this.
1One: your enrollment window is real, and missing it is permanent
Your Initial Enrollment Period is seven months long: the three months before the month you turn 65, your birthday month, and the three months after. This is the window to sign up without a penalty, and it is the one deadline that carries a lasting price. Miss it without a valid reason and you can face a late-enrollment penalty on Part B that is added to your premium for as long as you have Medicare, not a one-time fee but for life.
Two practical notes. Enroll in the first three months of the window if you want coverage in place the day you turn 65, because signing up later pushes your start date back. And if you are still working with employer coverage, there is a legitimate way to delay (item four); this penalty is for people who simply miss the window, not for people who delay correctly.
Your seven months
2Two: decide your path, because it is hard to undo later
This is the decision that matters most, and the reason to think about it now is that one direction is much easier to enter than to leave. There are two broad paths: Original Medicare plus a Medigap supplement plus a standalone drug plan (wide provider access and predictable costs, at a higher monthly premium), or a Medicare Advantage plan (bundled coverage, often including drugs and extras, usually at a lower premium but within a network).
Neither is the universal right answer. The reason to decide deliberately is the underwriting trap: when you first enroll you generally have a guaranteed right to buy a Medigap policy, but if you start on Advantage and later want to switch to Original Medicare with a supplement, you may have to pass medical underwriting and can be turned down. The door is wide open at the start and can narrow later.
- Wide provider access, no network
- Predictable costs, higher monthly premium
- Bundled, often with extras, lower premium
- Within a network; costs vary as you use care
3Three: nothing is automatic unless you are already drawing Social Security
People miss their window because they are waiting for a signal that never comes. If you are already receiving Social Security before 65, you are usually enrolled in Parts A and B automatically and a card arrives in the mail. If you are not yet drawing Social Security, nothing happens on its own: no card, no letter, no prompt, and the responsibility to enroll during your window is entirely yours. If you are not certain which group you are in, assume you have to act.
If you already draw Social Security at 65, a card arrives in the mail. If you are not yet drawing it, nothing happens on its own, no card, no letter, no prompt, and enrolling in your window is entirely on you. If unsure, assume you have to act.
4Four: Medicare does not cover everything, so plan for the gaps
The last surprise is what Medicare leaves out. Original Medicare has no annual cap on what you can pay out of pocket, which is the main reason most people add either a Medigap supplement or an Advantage plan rather than going with Parts A and B alone. It also does not cover routine dental, vision, or hearing, and it does not cover long-term custodial care. None of these gaps is a reason to panic, but each is a reason to plan, because the time to arrange coverage for a gap is before you are standing in it.
One more thing: there is free, unbiased help. Every state has a SHIP (State Health Insurance Assistance Program) that offers no-cost Medicare counseling, and a licensed agent can walk you through the choices at no cost. Using that help is how a lot of people get the first decision right.
Common questions about Medicare
Quick answers to common questions
Tap any question to expand. Each question links to a fuller standalone answer.
Does Medicare cover skilled nursing facility care?
Yes, on a short-term basis.
Medicare Part A covers skilled nursing facility (SNF) care after a qualifying inpatient hospital stay of at least 3 days, when you need daily skilled care like nursing or therapy. In 2026 you pay $0 for days 1 through 20 of each benefit period, $217 per day for days 21 through 100, and all costs after day 100. Coverage is for skilled care while you recover, not for long-term or custodial care (help with daily activities like bathing or dressing), which Medicare does not cover. Long-term nursing home care is generally paid through Medicaid or private funds.
Does Medicare cover hearing aids?
No, not under Original Medicare.
In 2026, Original Medicare (Parts A and B) does not pay for hearing aids or the exams to fit them. Part B does cover diagnostic hearing and balance exams when your doctor orders them to help diagnose or treat a medical condition, and for those you pay 20% after the $283 deductible. Many Medicare Advantage plans, however, include a hearing benefit that helps pay for routine hearing exams and hearing aids, often through a specific network or allowance. If hearing coverage matters to you, it is worth comparing Advantage plans or a standalone hearing plan.
Does Medicare cover vision care?
Mostly no for routine care.
In 2026, Original Medicare does not cover routine eye exams for glasses or contact lenses, and it does not pay for the glasses or contacts themselves. It does cover some medical eye care: yearly glaucoma screenings for people at high risk, diabetic retinopathy exams, treatment for eye diseases, and cataract surgery (including one pair of standard glasses or contacts afterward). For those covered services you pay 20% after the $283 Part B deductible. Many Medicare Advantage plans add a routine vision benefit covering eye exams and an allowance for glasses.
Does Medicare cover home health care?
Yes, when you qualify.
Medicare Parts A and B cover home health care if a doctor certifies that you are homebound (leaving home takes a major effort) and need part-time skilled care, such as skilled nursing, physical therapy, occupational therapy, or speech therapy. A Medicare-certified home health agency must provide the care under a plan your doctor reviews. You pay $0 for covered home health visits in 2026, and 20% for any durable medical equipment. Medicare does not cover 24-hour home care, meal delivery, or homemaker services like cleaning when that is the only care you need.
References
- Medicare.govEnrollment periods, the two coverage paths, and what Medicare does not cover.
- SSA, Social Security AdministrationAutomatic enrollment and signing up. ssa.gov
- SHIPFree Medicare counseling by state. shiphelp.org