Medicare has made an enormous difference in the health and lives of older Americans, but, as with every big program, there's room for improvement. We asked experts for specifics. The suggestions listed below vary in cost and savings and are not universally supported. But all seek to make Medicare more patient-friendly and financially stable as it enters its sixth decade of service to the nation.
1. Notify everyone by mail about Medicare options as their 65th birthday approaches.
You're largely on your own figuring out the tangle of rules, rates and deadlines that govern Medicare enrollment. Pestering older friends, searching websites, you may get basic things wrong and do major harm to your finances, not to mention your health. "We believe that all Americans should get a letter several months before their 65th birthday giving them straightforward information on how and when to enroll in Medicare, and a special number to call to discuss their own situation," says Joe Baker, president of the Medicare Rights Center, a consumer group. At present, such letters go only to people who are already receiving Social Security benefits.
2. Let latecomers get coverage right away.
If you're late signing up for Medicare, you may be hit with late penalties that permanently raise your premiums. A lesser-known penalty for lateness is that you can sign up only during an annual general enrollment period, Jan. 1 to March 31, and your coverage won't begin until July 1 of the same year. That can mean months with no insurance protection, potentially leading to a drained bank account or unattended illness. AARP is among advocacy groups arguing that this is financially unfair and detrimental to good health.