If you could change one thing about the Medicare system, what would it be and why?

Question

Linda Bolan · Accepted Answer

Medicare is very complex. The cost of prescription drugs are high and it's difficult for some clients to fill their prescriptions due to the cost. It would be great if pricing was adjusted for Medicare clients

Answered by Linda Bolan on March 12, 2025

Agent Licensed in IN

Answered by Linda Bolan Medicare Insurance Agent

Lesley Burns · Answer

I would change the process of enrollment. For people who are concerned about retirement, they shouldn't also be concerned with penalties, late enrollments, and additonal fees.

Gary Church · Answer

Help those going on Medicare understand how it works. Medicare should be more understanding of seniors and people with disabilities, including those who don't have the information to make a decision. Medicare should be more compassionate.

Answered by Gary Church on September 23, 2025

Broker Licensed in Ca, AZ, NV & TX

Answered by Gary Church Medicare Insurance Agent

Mike Alexander · Answer

I WOULD CHANGE THE irma penality for part b and part d.
People who have made more income should not be subject to Irma fines.
Reality is ,yes you made more in income, but you have also paid more in taxes. Irma is like double taxation.

Lauren Fodde · Answer

If I could change one thing about the Medicare system, it would be simplifying how people compare their options. Right now, seniors are often overwhelmed with different plan choices, each with its own premiums, networks, and drug coverage. It can feel like you need a dictionary just to make sense of it all.

If Medicare could make the process more transparent and user-friendly—almost like a clear side-by-side guide where everything from provider networks to prescription coverage is easy to see—it would empower people to make confident decisions without the stress or fear of missing something important.

At the end of the day, Medicare is meant to protect people’s health and peace of mind. The easier we make it to understand, the more it does exactly that.

Brian Moore · Answer

If I could change one thing about the Medicare system, it would be simplifying how people compare their options. Right now, seniors are often overwhelmed with different plan choices, each with its own premiums, networks, and drug coverage. It can feel like you need a dictionary just to make sense of it all.

If Medicare could make the process more transparent and user-friendly—almost like a clear side-by-side guide where everything from provider networks to prescription coverage is easy to see—it would empower people to make confident decisions without the stress or fear of missing something important.

At the end of the day, Medicare is meant to protect people’s health and peace of mind. The easier we make it to understand, the more it does exactly that.

Answered by Lauren Fodde on September 25, 2025

Broker Licensed in MO & FL

Answered by Lauren Fodde Medicare Insurance Agent

Richard Moreno · Answer

The one thing I would change about the Medicare system is to have all insurance companies to have the same prescription formulary. Sometime, it is a hassle for Medicare recipients to choose a plan based on their prescription needs.

Answered by Richard Moreno on May 31, 2025

Broker Licensed in TX, CA, FL, LA, NM & OH

Answered by Richard Moreno Medicare Insurance Agent

James Carlson · Answer

Medicare should allow agents not have to review and test annually.  We should have reviews less often.  Renew every 3-5 years.

Carly Cusack · Answer

I would include services such as mental health, dental, vision, and hearing coverage in the Medicare program. If we want to keep people healthy,  we need to serve the entire person.

Ravi Natarajan · Answer

Medicaid eligibility requirements. At present, a multi-millionaire, NOT on Medicare, meaning under the age of 65, can qualify for Medicaid through Affordable Care Act as long as their earned income is low. Assets don't count towards determining eligibility for a subsidy. That is not the case for a senior...

Answered by Ravi Natarajan on October 6, 2025

Broker Licensed in MA, AZ, CA & 12 other states

Answered by Ravi Natarajan Medicare Insurance Agent

Brian Cronin · Answer

If I could change one thing, it would be making Medicare simpler and easier to understand. A lot of seniors feel overwhelmed by the number of choices, deadlines, and rules, which can lead to costly mistakes. Clearer plan designs and more standardized information would help people make better decisions with more confidence. At the end of the day, healthcare coverage shouldn’t feel this complicated.

Answered by Brian Cronin on March 23, 2026

Broker Licensed in NH & ME

Answered by Brian Cronin Medicare Insurance Agent

James ONeal · Answer

This is Such a Great Question.

One key change to the Medicare system would be to include a prescription drug benefit in traditional Medicare, similar to the way Medicare Advantage plans do. 

This would ensure all beneficiaries have access to affordable medications and eliminate the need for separate, potentially confusing, and costly Part D plans.

It would also allow for potential savings through bulk purchasing and negotiation, which could be reinvested into the Medicare program.

Enoch Vega · Answer

I would make Medicare simpler and easier to understand, because too many people feel confused or stressed when they’re just trying to make the right choice for their health. When the system is clearer, seniors can make confident decisions without fear of making costly mistakes.

Answered by Enoch Vega on January 11, 2026

Broker Licensed in NV, AZ, CA & 6 other states

Answered by Enoch Vega Medicare Insurance Agent

Ric Santos · Answer

I think it's the low reimbursement rates of doctors that's why they refuse Medicare patients. There should be a standard rate for all doctors if they're dealing with a Medicare patient. After all , if you're a good doctor, you'll have more patients.

Answered by Ric Santos on June 11, 2026

Agent Licensed in IL, AR, AZ & 14 other states

Answered by Ric Santos Medicare Insurance Agent

Hope Suhr · Answer

Here it is! Stop the AEP and use your birthday month as the time to change.   One month before your birthday month, and one month after.

Tony Spikes · Answer

I wished Unsolicited calls would be banded. Too many people have their plan changed without them knowing it. Most people don’t get the whole truth and don’t understand that most of the time they start over on their deductibles.

Answered by Tony Spikes on June 2, 2026

Broker Licensed in GA, AL, FL & 9 other states

Answered by Tony Spikes Medicare Insurance Agent

Steven Bleicher · Answer

The one glaring thing that I, as an agent would love to change is that the Free Special Needs (Advantage) Plan or SNP plan isn't: A) available in every county in the US &, B) has a much larger network of doctors/specialists/psychologists who are more compassionate towards the poor folks who truly require a greater assistance due to the conditions that they have suffered through all of their previous life!

Answered by Steven Bleicher on May 15, 2025

Broker Licensed in AZ

Answered by Steven Bleicher Medicare Insurance Agent

Diana Garner · Answer

I would eliminate drug & health deductibles and copays. Many plans have high premiums that beneficiaries must pay, and some have a high maximum out-of-pocket. Some beneficiaries receive financial assistance, but others who are right on the fine line often struggle to get the care they need and deserve.

Answered by Diana Garner on July 7, 2025

Broker Licensed in KY, FL, IN, OH & TN

Answered by Diana Garner Medicare Insurance Agent

Leslie Kaz · Answer

If I could change one thing about Medicare, I’d simplify the whole dang system—because right now, it’s like trying to do your taxes in another language while blindfolded.

Here's Why:
Medicare is needlessly complicated:

You've got Part A, B, C, and D—each with different rules.

Then there’s Medigap vs. Medicare Advantage, with very different networks, costs, and coverage.

Enrollment timing alone is a minefield: miss a deadline and you're stuck with penalties for life.

All of this confusion leads to:

Seniors picking the wrong plan.

Doctors not being covered.

Medications being too expensive.

Folks not getting the benefits they deserve.

If we could fix this one thing…
We’d see:

Less confusion and fewer costly mistakes.

More trust in the system.

Better health outcomes because people would actually understand their benefits.

The Bottom Line:
Medicare should work for seniors, not confuse the heck out of them. If we streamlined it—same core benefits, clear choices, easy access—it would truly feel like the safety net it was designed to be.

Dana Dane · Answer

I would like to see an open enrollment period for Medicare Supplements in all states. I would prohibit Medicare Advantage plans from using PROPRIETARY prior authorization. They use this in addition to Medicare's prior authorization guidelines. Why? I would prohibit the use of AI in the prior authorization process that some Medicare Advantage plans use. I would like to see some coverage for custodial long-term care.

Answered by Dana Dane on April 24, 2025

Agent Licensed in OR, AZ, CA & 6 other states

Answered by Dana Dane Medicare Insurance Agent

Leslie Helene Sussman · Answer

Take away the Part D penalty when a Medicare Client does not enroll in a Prescription plan.

Stephen Merrill · Answer

Tell the government to stay out of it. The Biden administration's Inflation Reduction Act just took a Hugh bite out of the medicare Prescription Drug Plan by putting a much bigger share of cost burden on the backs of the insurance carriers. A cost that was once covered by big Pharma. The insurance carriers were not part of this negotiation. Go figure!

Answered by Stephen Merrill on November 12, 2025

Agent Licensed in CA

Answered by Stephen Merrill Medicare Insurance Agent

Vachik Chakhbazian · Answer

Ensure traditional Medicare is comprehensive, simple to navigate, and affordable.
Add oral health, audiology, and vision coverage for all beneficiaries in traditional Medicare.
Increase low-income protections and reduce cost-sharing.
Add coverage for long-term care.

Carol Thompson · Answer

To not change plans annually and instead maybe do 2-3 years. The annual changes occur too quickly and just when beneficiaries grasp an understanding the plan changes or can change.

Jack Mayer · Answer

I would lower the part B premiums by more than half and I would like to see dental that goes with original Medicare

Barbara Barnes, CMIP® · Answer

I would change the people running it. There are ways that we could make original Medicare work efficiently for all patients without needing it to be so confusing and without needing to split it between original Medicare and Medicare advantage. If we put professional managers in charge of Medicare, who are tasked with making it run smoothly and efficiently, it would be a very different system than we have today. our government simply is not equipped to run a healthcare payment system for millions of people.

Answered by Barbara Barnes, CMIP® on May 24, 2025

Agent Licensed in PA

Answered by Barbara Barnes, CMIP® Medicare Insurance Agent

Karen Ansell · Answer

There are many things I would change about Medicare.
 I would have regular Medicare cover dental, vision and hearing aids.
Medicare Advantage plans should have better customer service.

Michael Kim · Answer

I would have Medicare Advantage Plans available in rural areas. I don't think this will happen unless carriers starts to sell in these areas, but not enough people to be profitable for the carriers.

So that's why in these places, only Medicare Supplement Plans are available.

Cheryl Lyons · Answer

👉 Add a true annual out-of-pocket maximum to Original Medicare (Parts A & B)

Right now:

Medicare Part A and

Medicare Part B

have no cap on how much someone can spend in a year.

That means:

A long hospitalization

Expensive chemotherapy

Repeated outpatient procedures

could result in unlimited 20% coinsurance under Part B.

Why this is the biggest weakness

Nearly every other form of insurance has a maximum out-of-pocket limit:

Medicare Advantage plans are required to have one.

Employer insurance has one.

ACA marketplace plans have one.

But Original Medicare doesn’t — unless you buy a Medigap policy like Medigap Plan G.

That creates two problems:

1️⃣ Financial risk for people who can’t afford Medigap premiums
2️⃣ Inequity, because protection depends on whether you can buy supplemental coverage

What the change would do

If Original Medicare had, for example, a $5,000–$6,000 annual cap:

People without Medigap would have real financial protection

The system would be easier to understand

It would reduce fear of catastrophic medical debt

Fewer people would feel pressured to move to Medicare Advantage purely for the out-of-pocket limit

Why this matters especially for people like you

Since you mentioned having Plan G and Part D earlier, you already understand how complex Medicare layering can be.

The current structure:

Parts A & B

Medigap

Part D

Or Medicare Advantage

is confusing and financially uneven.

A built-in cap in Original Medicare would simplify decisions and protect the most vulnerable beneficiaries.

Lillian Hill · Answer

To simplify one of the major pain points in Medicare, I would standardize the drug formularies. Doing so would protect people with chronic conditions who depend on consistent access to their medications, people on fixed incomes who cannot absorb sudden tier changes or unexpected pharmacy bills, and people who rely on stable medication routines that should not be disrupted by shifting plan rules. 

It would also support caregivers who are trying to help aging parents navigate a system that often feels unpredictable, as well as every beneficiary who simply wants to understand what they are signing up for without fear of hidden costs or mid‑year surprises. By making formularies uniform, transparent, and predictable, Medicare would eliminate a major source of confusion and frustration—and ultimately restore trust in a system that millions rely on for their health and financial stability.

John L Herman Jr · Answer

Make it more consistent.  Insurance Carriers change Plans too often…do not have the same benefits as other Carriers.  But assuming Medicare stays as confusing as it is today…then make Brokers more available to educate people in settings that are available to more Seniors.

Letting Brokers “sell” Medicare is too easy…meaning they allow rookies to enroll clients…and even have Insurance Carriers slamming people with phone calls selling Plans by people with limited qualifications.

Larry Pereiro · Answer

I believe Medicare could improve their engagement with the Senior Market by  first of all making sure that Social Security Offices refrain from giving advise about Medicare other than "You should talk to a licensed and certified Medicare agent in your area about the options you have. 
Then they could also regulate the call centers to insure their compliance with non-pressured, non-biased presentations that simply allow the educational process to allow the senior market to make an informed decision about their Medicare Options.

Brenda Watson · Answer

Medicare advantage. I would require all Medicare, advantage plans to be standardized, just like Medicare, supplements are standardized. It makes it very difficult for these seniors to figure out which plan is going to be best when all the plans get to be different. Based on whatever the company wants to choose.

Answered by Brenda Watson on July 30, 2025

Broker Licensed in OK & AR

Answered by Brenda Watson Medicare Insurance Agent

Jajuan Knox · Answer

If I could change one thing about Medicare, it would be to make it simpler and more transparent for everyone. Right now, there are so many plans, rules, and coverage details that it can be really confusing, even for people who do their homework. Making it easier to compare plans, understand costs, and see what’s covered would help people make better choices and avoid unexpected bills, which could make Medicare much less stressful for everyone.

Answered by Jajuan Knox on February 20, 2026

Broker Licensed in FL, AK, AL & 49 other states

Answered by Jajuan Knox Medicare Insurance Agent

Brenda Skasko · Answer

More consistency each year, as the complex and confusing changes, (especially for those not being assisted by a licensed agent), are causing unnecessary expenses for the folks that have worked their whole lives to enjoy their retirement.

Answered by Brenda Skasko on November 18, 2025

Broker Licensed in DE, MD & PA

Answered by Brenda Skasko Medicare Insurance Agent

Sandy Hammond · Answer

The one thing I would like to change about Medicare is the late enrollment penalties. I do not believe that they are fair, since Medicare can be so confusing and Social Security is not allowed to give any type of direction as to what one needs to do when, when it comes to enrolling into Medicare. You don't know what you don't know.

Answered by Sandy Hammond on July 20, 2025

Agent Licensed in OH, IN & KY

Answered by Sandy Hammond Medicare Insurance Agent

Chris Prang · Answer

There are numerous things that I would change. But if I had to start with one, it would be replacing the existing Medicare Supplement options with Medicare Supplements that are based on unchanging annual deductible amounts that apply/go towards both Part A and Part B.

Presently, depending on age, there are 10-12 Medicare Supplements to choose from. But there are really only two that people pick from...  the Plan G and the Plan N. And a very small percentage pick the High-Deductible G. So, it's clear, Medicare doesn't need 10-12 options. 

The deductible options would be something like $500, $1,000, $1,500, $2,000. These deductible amounts would never change each year like the Part A and Part B deductibles do and like the High-Deductible G does as well. 

This would be much simpler and easier to understand.

Scott Klag · Answer

If I could change one thing about Medicare, I would simplify the entire process and do away with call centers offering plans to unsuspecting seniors. Medicare is extremely complex and if you don't have proper guidance, you may make a serious financial mistake.

Answered by Scott Klag on April 21, 2025

Agent Licensed in OH

Answered by Scott Klag Medicare Insurance Agent

Ted Sims · Answer

Medicare could be way simpler for everybody if we cut the fluff and focused on real education.  Simplify the Medicare parts and names for seniors to better understand what they really mean.

I would also like to see better education for agents and seniors alike, so they understand their real choices.   Maybe some sort of checklist that is required covering things like:

MA vs. Med Supp Head-to-Head Basics  
Network vs Freedom of choice
Out of pocket costs for both plans
Predictability of yearly costs

Then the gaps each plan actually leaves.

Ken Brzezinski · Answer

Hearing Vision and Dental should have been included in Basic Medicare. Old people grow old faster when they can't hear or see. Teeth designed for a lifetime wear out in old people.

Sarah Murphy · Answer

Once thing I would change is networks for Medicare Advantage plans. Navigating Medicare can be difficult enough, but having to worry about networks.

David Morris · Answer

If I could change one thing about the Medicare system, it would be to make the coverage options simpler and easier for seniors to understand. Many people turning 65 are overwhelmed by the differences between Medicare Advantage, Medicare Supplement plans, Part D prescription coverage, enrollment periods, and penalties. The amount of information can be confusing and stressful, especially for people who are already dealing with health concerns or retirement decisions.

A simpler system with clearer explanations and more standardized coverage comparisons would help seniors make more confident decisions and avoid costly mistakes. It would also reduce confusion about provider networks, prescription coverage, and out-of-pocket costs, allowing beneficiaries to focus more on their healthcare and less on navigating complicated insurance rules.

Natalia Arvelo Camacho · Answer

Stop the lies that medicare advantage and Original Medicare is the same. Not all Doctors take advantage plans but all of them have to take original Medicare