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Most Americans become eligible for Medicare at age 65, but choosing how to enroll isn’t always straightforward.

That’s why a policy now under consideration could have outsized consequences. Trump administration officials say they are exploring whether to automatically enroll seniors into Medicare Advantage plans, instead of traditional Medicare, if they don’t actively choose a coverage option (1).

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Today, people who don’t make a selection are defaulted into traditional Medicare. Shifting that default to Medicare Advantage (which is run by private insurers) could quietly steer millions of beneficiaries into a different type of coverage without them realizing it.

While the proposal is still in early stages, the change could affect everything from monthly costs to which doctors you can see and how easily you can switch plans later.

Under current rules, people who sign up for Medicare but don’t actively choose a plan are automatically enrolled in traditional Medicare.

The proposal under consideration would flip that system. Instead of defaulting into traditional Medicare, seniors who don’t make a selection could be automatically enrolled in a Medicare Advantage plan — the privately run version of Medicare offered by insurance companies.

As Medicare director Chris Klomp noted at a STAT News summit in March, regulators are looking into models that would either automatically enroll beneficiaries into the private form of Medicare or accountable care organizations, including those participating in the Medicare Shared Savings Program (2).

That shift may sound technical, but defaults carry real weight. Many people don’t fully compare their options or may feel overwhelmed by the number of plans and end up sticking with whatever they’re assigned. A change in the default could move large numbers of beneficiaries into Medicare Advantage without their active consent.

While some proposals would allow people to opt out, that process isn’t always simple.

A bill introduced in Congress would not only switch the default to Medicare Advantage, but also limit a person’s ability to leave their plan for up to three years once enrolled (3). That would make it harder for seniors to switch if their coverage doesn’t meet their needs.

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Understanding the nuances of Medicare might be easier said than done, especially amid changing regulations.

But senior-focused organizations like AARP can help.

AARP members get access to guides that can help you choose the right Medicare plan, make the most of Social Security, and uncover other government benefits — potentially saving you thousands. Their Medicare Initial Enrollment navigator simplifies Medicare — allowing members to make informed decisions and receive support throughout the entire process.

Even better, members can get discounts on almost everything — from prescriptions and dental plans to travel, entertainment and insurance.

Sign up with AARP today and get 25% off your first year.

Medicare Advantage plans often attract seniors with lower monthly premiums, and in some cases, $0 premiums. But those savings can be offset by higher costs when you actually use your plan.

The biggest cost difference comes down to how care is priced and accessed. Traditional Medicare is widely accepted nationwide, but Medicare Advantage plans typically limit you to a specific network of doctors and hospitals. If you’re automatically enrolled in a plan that doesn’t include your preferred providers, you may have to switch doctors.

Those network limits can also affect where you get care. Some top hospitals or specialists may not be included in certain Medicare Advantage plans, which can force you into different networks or require you to travel farther, both of which can carry financial and logistical costs.

Instead of standardized coverage, Medicare Advantage plans typically rely on copays and coinsurance for services. That means each doctor visit, specialist appointment or procedure can come with a separate charge, and those costs can add up quickly if you need ongoing care. While plans cap annual out-of-pocket spending, that limit can still reach several thousand dollars.

Taken together, these differences mean that being defaulted into a Medicare Advantage plan could lead to higher costs depending on your doctors, your health needs and how often you use care.

The proposal to auto-enroll seniors into Medicare Advantage is still being explored by regulators and debated in Congress, but understanding how these plans work may help you avoid costly surprises when it’s time to sign up for Medicare.

After choosing a Medicare plan, it’s also worth planning for long-term care.

About 70% of Americans over 65 will eventually develop serious Long-Term Services and Supports needs, according to the Assistant Secretary for Planning and Evaluation (4).

And that price tag can add up quickly. Milliman’s 2025 Long Term Care Index estimates the average lifetime cost at roughly $171,000 for women and $98,000 for men (5).

Medicaid may help if you qualify, but it rarely covers everything. In 2023, the program paid for just 44% of long-term institutional care costs (6). That share could shrink even more, with the One Big Beautiful Act set to cut Medicaid spending by $911 billion over the next decade (7).

If you’re worried about shouldering these costs alone, you might want to consider opting for long-term care insurance.

One option is GoldenCare, which offers comprehensive long-term care insurance policies. They included hybrid life or annuity with long-term care benefits, short-term care, extended care, home health care, assisted living and traditional long-term care insurance.

But long-term care isn’t one-size-fits-all. That’s why GoldenCare offers several options that are tailored to your needs and your budget.

You can get one-on-one customer service from Goldencare Long-Term Care Specialists to help identify the best coverage options for you and your budget.

If you do end up needing long-term care and rack up significant bills, they may ultimately be settled from your estate. That could mean less money left for the same family members you hoped to support.

One way to help shield your family from that scenario is by considering term life insurance, which can provide a financial buffer if major expenses arise.

One option is to sign up for term life insurance from Ethos.

Ethos is rated “Excellent” on Trustpilot, and has an A+ rating from the Better Business Bureau (BBB). The platform offers simple and affordable coverage for a set period of time — typically between 10 and 30 years.

As a licensed third-party insurance administrator, Ethos has joined forces with some of the industry’s top insurance carriers, such as Banner Life, TruStage Financial and Ameritas Life Insurance.

Ethos gives you the flexibility to select coverage amounts ranging from $2,000 to $100,000. Premiums start at just $9.80 a month and are guaranteed throughout the term.

You can get coverage in just 10 minutes online or by phone, with no medical exams or blood tests required.

- With files from Clay Halton

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We rely only on vetted sources and credible third-party reporting. For details, see our editorial ethics and guidelines.

Center for Medicare Advocacy (1); STAT News (2); U.S. Congress (3); Assistant Secretary for Planning and Evaluation (4); Milliman (5); KFF (6); National Association of Counties (7)

This article provides information only and should not be construed as advice. It is provided without warranty of any kind.