Isn't it time for Medicare to completely overhaul how it approaches senior care?

Question

Larry Dalton · Accepted Answer

This is a long-time debate. Some feel we need to privatize Medicare, and others feel we need to let the government control it under a one-plan-for-all. Health decisions are very private, and with that being said, many areas in the Medicare system need to be adjusted or approved, along with the idea of using newer technology.

Answered by Larry Dalton on April 17, 2025

Broker Licensed in OK & TX

Answered by Larry Dalton Medicare Insurance Agent

Mark Maliwauki · Answer

It needs a serious look. You can't have an organization that big and not have regular reviews of performance and outcomes. It should have a major review at the end of every Medicare enrollment year.

Andrew Bennett · Answer

In my opinion it is way past time.  Why do we have Parts A & B?  It's because 100 yrs ago when Medicare was created it followed the Blue Cross and Blue Shield model.  One was hospital coverage and one was medical coverage.  Those coverages merged many decades ago on the commercial side of the business, but never with Medicare.

As we know Medicare doesn't cover dental procedures...but isn't the mouth part of the body?  I know Dentists are not Medical doctors, but the whole body should be covered.  Why have an exclusion like this?  

What about Long Term Care payments to relative caregivers?  That would be so much less expensive than Nursing home care.  

The biggest problem to making any headway on this is political.  Forget what might solve problems, be more efficient, or just be a good thing for the American people.  The last two election cycles we have elected leaders whose administrations are running the show around them.  We have a congress where the "Freedom Caucus" is the tail that wags the dog (a tiny minority that controls the majority).  We also have billionaires that will fund primary challenges to those who don't tote the line.  

In order to make real progress on real issues we need to get the big money out of political campaigns, limit the role of PAC money (Political Action Committees), and create a "window" of campaign time so these things don't stretch on forever.  

So...it's hopeless until we kick the billionaires out of the process.

Steven Bleicher · Answer

Considering the current state of the spat between the two political parties, that is not going to happen anytime soon. Sorry.

Steve Houchens · Answer

Being a senior myself I am very pleased with the coverage that I received, although like everything in life most things can be improved upon. Health care in general could probably use some improvements in many ways.

Answered by Steve Houchens on April 10, 2025

Agent Licensed in KY & TN

Answered by Steve Houchens Medicare Insurance Agent

Aaron Solomon · Answer

Medicare is health insurance. It is no different than your employer’s health insurance. When you get a MAPD plan it provides extra benefits.your typical Medicare plan has a cost value of about $12000 per year. It is paid.  For by your Part B charge and Medicare tax.
If you want it for free, you would need to get crease your personal taxes.

Leslie Kaz · Answer

Yes, it’s time for an overhaul. Medicare’s core structure doesn’t match today’s senior care needs. A system that prioritizes prevention, tech, and comprehensive benefits would better serve an aging, tech-savvy population. But the scale of change required—financially, politically, administratively—means it’ll likely come in fits and starts, not a grand redesign. For now, your best bet is leveraging Advantage plans or advocating for specific reforms like DTx coverage.

Answered by Leslie Kaz on April 28, 2025

Agent Licensed in CA, AL, AZ & 7 other states

Answered by Leslie Kaz Medicare Insurance Agent

Fred Manas · Answer

Yes, many argue that it's time for a significant overhaul of how Medicare approaches senior care, citing various issues like cost, coverage gaps, and the complexity of the current system. Many believe that Medicare needs to become more comprehensive, affordable, and easier to navigate for beneficiaries. 
Here's a more detailed look at the arguments for reform:
1. Financial Strain and Cost:
High costs: Medicare, even with its coverage, can still be financially burdensome for many seniors, especially with prescription drug costs and long-term care needs. 
Sustainability: Many sources project that Medicare's Trust Fund will be depleted in the coming years, raising concerns about the long-term sustainability of the program. 
Unnecessary costs: Some argue that the current system, particularly Medicare Advantage, can lead to inflated costs through administrative overhead and unnecessary procedures. 
2. Coverage Gaps:
Lack of long-term care: Medicare generally doesn't cover the cost of long-term care services, which can be a significant expense for seniors. Limited coverage for essential services: Many argue that Medicare needs to expand coverage to include essential services like dental care, vision care, and audiology, which are not currently covered. 
3. Complexity and Navigation: Difficulty understanding plans: Medicare has various parts and numerous plans, making it difficult for seniors to navigate and understand their coverage options. Lack of coordination: The current system can lead to fragmented care and a lack of coordination among different healthcare providers. 
4. Medicare Advantage Concerns: Provider network limitations: Medicare Advantage plans often have limited provider networks, which can restrict access to specialists and facilities. 
Prior authorization requirements: Many Medicare Advantage plans require prior authorization for certain tests and treatments, which can delay care and be inconvenient for beneficiaries. 
5. Profitability of MA plans.

Vachik Chakhbazian · Answer

Traditional Medicare and even Medicare Advantage may not fully meet the diverse and evolving needs of all seniors, particularly those with chronic conditions or significant health needs. 

The current system can be confusing and difficult to navigate, leading to errors and potential financial losses for beneficiaries. 

Reforms to Medicare are likely to face political opposition and may require significant compromise.

Toni Chavez · Answer

Hello,

Thanks for your question.

Center for Medicare Services is always making this better for Medicare Beneficiaries.

Many enhancements are continuously being enhanced just as the Drug Donut Hole was
Eliminated starting in 2025, which now allows for over 3 million medicare beneficiary to afford their drugs.  


Be well,
Toni Chavez
Medicare Broker

Charles Borg · Answer

No. It’s been working fine for a long time, so why change it now? Are you having a problem!? What changes would you like to see?

Larry Pereiro · Answer

This is a great question, and yes it is, just like next year will be an opportunity to work on those issues again. Medicare, as does all health care services should consistently review and even adjust what is done and or recommended to fit the need of the consumer.

Answered by Larry Pereiro on June 2, 2025

Agent Licensed in IN

Answered by Larry Pereiro Medicare Insurance Agent

Josh Vojtush · Answer

With 67+ million people on Medicare, it's an extremely large system. Any changes will have drastic impact across many industries. While change is absolutely necessary, it cannot be something that happens haphazardly.

Answered by Josh Vojtush on April 8, 2025

Broker Licensed in OH, FL, IL & MI, NC, SC & VA

Answered by Josh Vojtush Medicare Insurance Agent

Lenora Sikkenga · Answer

Medicare should have always provided dental, hearing aid etc for seniors . These are things seniors need. That's where the Medicare advantage plans come in. The reasoning behind Medicare advantage plans is that it takes the risk away from Medicare and puts it in the hands of insurance companies. Also the incentive behind the health club membership in the Medicare advantage plans is that they have to pay out less if their client base is healthier. Whether Medicare can provided these same services is questionable.

Answered by Lenora Sikkenga on April 30, 2025

Broker Licensed in NV

Answered by Lenora Sikkenga Medicare Insurance Agent

Debra Hartman · Answer

Yes, many experts and advocates believe it is time for Medicare to undergo a significant overhaul in how it approaches senior care. While Medicare has been a lifeline for millions of older Americans, several critical issues point to the need for reform.

Fragmentation of Care

Medicare often treats conditions and services in silos—hospital care, physician services, home care, etc.—with poor coordination between them. Seniors with chronic or multiple conditions can experience disjointed care and repetitive services.

Solution: Move toward integrated, value-based care models like Medicare Advantage (MA) plans or Accountable Care Organizations (ACOs), but with stronger oversight and transparenc

Inadequate Long-Term Care Coverage

Medicare does not cover most long-term care services, such as help with bathing, dressing, or eating—support that’s vital for many seniors.


Result: Seniors often deplete their savings and turn to Medicaid for long-term care, creating both personal and systemic financial strain.
Solution: Incorporate long-term support services into Medicare—either through new benefits or a hybrid public-private solution.

Underinvestment in Preventive and Home-Based Care


While preventive services are covered, Medicare still leans heavily toward reactive, acute care. Seniors would benefit from stronger support for preventive, home-based, and palliative care.

Solution: Expand coverage and reimbursement for home-based primary care, telehealth, and geriatric care teams.

Mental Health & Social Isolation

Medicare has limited mental health coverage, and many seniors suffer from depression, dementia, and loneliness, which can worsen physical health.
Solution: Increase access to mental health professionals, community-based support, and addrss social determinants of health

Medicare Advantage Oversight

MA plans are growing fast, but some prioritize profi

Gus Kinnie · Answer

Medicare is a complex system with many moving parts. There's constant updates and changes to make it more efficient, user friendly and better for everyone on Medicare.

Isn't it time for Medicare to completely overhaul how it approaches senior care?

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Isn't it time for Medicare to completely overhaul how it approaches senior care?

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