If you could change one thing about the Medicare system, what would it be and why?
Answered by 21 licensed agents
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
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.
If I could change one thing about the Medicare system, it would be to tighten the oversight and regulations around soliciting and advertising to beneficiaries, because even with recent efforts to curb misleading tactics, I still see folks overwhelmed by confusing ads and high-pressure pitches that don’t always prioritize their best interests. The rules have gotten stricter—like requiring Medicare Advantage plans to get prior approval for TV ads in 2025 and holding plans accountable for third-party marketers—but beneficiaries are still bombarded with mailers, calls, and promises of “free” benefits that gloss over limitations like narrow networks or copays. Stronger enforcement, clearer standards, and maybe even a centralized opt-out system could cut through the noise, giving people a fair shot at choosing what’s right for them without the clutter of persuasive gimmicks.
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.
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.
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!
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 gonna be best when all the plans get to be different.Based on whatever the company wants to choose.