Navigating Medicare Changes under DOGE: What You Need to Know

Why This Matters to You

If you're someone who relies on Medicare—or if you have loved ones who do—you've probably heard rumblings about potential changes under the Department of Government Efficiency (DOGE). Some people say it's about cutting waste, while others worry it's just another way to privatize healthcare and put profits over people. So, what’s really happening, and how could it affect you?

As someone who has personally experienced both Medicaid and commercial insurance, I know firsthand how confusing and frustrating our healthcare system can be. It feels broken at times—too much bureaucracy, too little transparency, and too many hoops to jump through just to get the care you need. Now, with DOGE spearheading Medicare reforms, we need to pay close attention because these changes could impact millions of elderly Americans.

Let’s break it all down: what DOGE is proposing, what it means for you, and what steps you can take to protect yourself and your healthcare.

What Is DOGE Trying to Change About Medicare?

The biggest shift being discussed is moving Medicare toward privatization. This means Medicare Advantage (which is run by private insurance companies) would become the default option instead of traditional Medicare.

Now, Medicare Advantage has its pros—it often covers things like vision, dental, and wellness programs. But here’s the catch:

Restricted Networks – You may be forced to switch doctors if they’re not in-network.
Prior Authorizations – Insurance companies decide whether you really "need" that treatment.
Coverage Denials – Private companies have a history of rejecting claims to cut costs.

In contrast, traditional Medicare gives you more freedom in choosing providers, but it often lacks those extra benefits unless you buy supplemental coverage.

The concern? If everyone is pushed into Medicare Advantage by default, will people still have a choice? And what happens when private insurers prioritize profits over patient care?

Who Could Be Affected the Most?

These reforms don’t just exist in a vacuum. Here’s who could really feel the impact:

1. Seniors Who Need Specialized Care

If you or someone you love has a chronic illness (think cancer, Parkinson’s, or severe diabetes), switching doctors or waiting for insurance approval could literally be life-threatening. Medicare Advantage is notorious for limiting networks and requiring pre-approvals.

2. Low-Income Seniors

Many seniors rely on Medicare + Medicaid (also called “dual eligibility”) to cover their costs. If more services move to privatized plans, the cost structure could change, leaving the most vulnerable at risk.

3. People Trying to Switch Back to Traditional Medicare

Here’s a dirty little secret: Once you choose Medicare Advantage, it’s really hard to switch back. You might not qualify for Medigap plans (which help cover out-of-pocket costs in traditional Medicare), meaning you’re stuck with fewer coverage options.

The Financial Angle: Will This Really Save Money?

The whole point of DOGE is to “cut government waste,” but is Medicare Advantage actually cheaper for taxpayers?

Not really. Studies have shown that the government pays private insurers MORE per Medicare Advantage patient than it would under traditional Medicare. So where’s the savings? A lot of that extra money goes into the pockets of insurance companies, not into better care for seniors.

And let’s be honest—how often do corporate-run healthcare plans prioritize patient well-being over profit margins?

What Can You Do?

Even though Medicare changes might feel out of your control, you do have some power in this situation. Here’s what you can do:

1. Stay Informed

Read about Medicare policy updates from non-partisan sources like the Kaiser Family Foundation or AARP. Don’t just rely on politicians' soundbites—dig into the facts.

2. Check Your Plan Options

If you or your family members are approaching Medicare enrollment, take time to compare Medicare Advantage vs. traditional Medicare options carefully. Call providers, ask about networks, and don’t just assume one option is better than another.

3. Advocate for Change

If you’re concerned about these policy shifts, speak up. Contact your representatives, sign petitions, and support organizations that fight for healthcare transparency and affordability. If enough people push back, policy decisions can shift.

Final Thoughts

We all want a healthcare system that works—one that gives people affordable, accessible care without unnecessary bureaucratic roadblocks. But the proposed Medicare changes under DOGE could make things harder for seniors, particularly those with chronic conditions or limited financial resources.

Instead of rushing into privatization under the guise of “efficiency,” policymakers should focus on reducing healthcare costs without reducing care.

At the end of the day, this issue isn’t just about politics—it’s about real people’s lives and well-being. If these reforms move forward, we need to make sure they actually improve Medicare rather than making it more complicated and profit-driven.

So, stay informed, advocate for transparency, and don’t let the future of your healthcare be decided without your voice being heard.

By - Brendan Araujo

Sources & Further Reading:

Abelson, R. (2025). "UnitedHealth Lawsuit Highlights Medicare Advantage Coverage Denials." The Guardian.
Kaiser Family Foundation (2025). "Medicare Advantage vs. Traditional Medicare: A Financial Analysis."
Centers for Medicare & Medicaid Services (2025). "Medicare and You Handbook 2025."
American Progress Report (2025). "Privatization of Medicare: Risks and Costs."

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