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<td><span style="font-family:Helvetica, sans-serif; font-size:20px;font-weight:bold;">Health Tech | Fierce Healthcare</span></td>
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<td><a href="https://www.fiercehealthcare.com/ai-and-machine-learning/op-ed-empathy-meets-efficiency-how-responsible-use-ai-can-transform" style="font-family:Helvetica, sans-serif; letter-spacing:-1px;margin:0;padding:0 0 2px;font-weight: bold;font-size: 19px;line-height: 20px;color:#222;">Op-ed: How responsible AI can transform Medicare plan selection</a>
<div style="font-family:Helvetica, sans-serif; text-align:left;color:#999;font-size:11px;font-weight:bold;line-height:15px;">Mar 28th 2026, 13:44</div>
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<p><div class="col content" morss_own_score="5.661795407098121" morss_score="81.23371001959245">
<p>Imagine a future where every one of the 70 million Americans on Medicare has access to a personal AI assistant that can help them navigate the healthcare system with clarity and confidence. Instead of sorting through plan documents or decoding unfamiliar insurance terms, beneficiaries could receive personalized guidance to help them understand their options and choose the coverage that best fits their needs.</p>
<p>That future might not be far off, according to <a href="https://www.nextgov.com/artificial-intelligence/2026/03/ai-nihilism-barrier-better-health-care-cms-lead-says/412088/" title="https://url.us.m.mimecastprotect.com/s/HaanCgJNyPCw8o1KS3s2S43DVR?domain=nextgov.com/"><u>recent comments</u></a> by Mehmet Oz, M.D., administrator for the Centers for Medicare & Medicaid Services (CMS). In fact, CMS recently issued a <a href="https://sam.gov/opp/570eab65b31b4c93b556185df473266c/view">request for information</a> on how AI could be used to improve Medicare plan selection and enrollment.</p>
<p>It is a timely and necessary conversation.</p>
<p>Turning 65 and becoming eligible for Medicare is a major life milestone. Yet for millions of eligible Medicare beneficiaries, the enrollment process remains complicated. </p>
<p>Most <a href="https://news.ehealthinsurance.com/news/survey-75-of-medicare-beneficiaries-say-selecting-a-plan-is-confusing" title="https://url.us.m.mimecastprotect.com/s/qzT4CkRNgPHXgKyAU8uDSGE48U?domain=news.ehealthinsurance.com"><u>Medicare beneficiaries</u></a> (75%) say choosing coverage is confusing. New enrollees are expected to quickly understand whether their doctors are in network, how much they might pay out of pocket for medical care, and the differences between Original Medicare, Medicare Advantage, Medicare Supplement, and Medicare Part D plans. That level of complexity alone should be reason enough to modernize.</p>
<p>To make matters more complicated, in most parts of the country, beneficiaries can choose from over <a href="https://www.kff.org/medicare/medicare-advantage-2025-spotlight-a-first-look-at-plan-offerings/#:~:text=Number%20of%20Plans%20Available%20to%20Beneficiaries.,only%20available%20to%20select%20populations." title="https://url.us.m.mimecastprotect.com/s/46yyCn5jlPu3nPZgCvH5SJuRi9?domain=kff.org"><u>40 Medicare Advantage plans</u></a>, multiple Part D prescription drug plans, and various Medicare Supplement options. Each plan can differ in care provider networks, drug coverage, premiums, cost-sharing and supplemental benefits, such as dental or hearing care. Add strict enrollment windows and frequently changing rules, and the process can quickly become overwhelming, even for savvy consumers.</p>
<p>Amid all the intricacies, one fact stands out: the Medicare enrollment experience must evolve, and AI can help accelerate that progress. To understand where AI can make the greatest impact, it helps to look at how Medicare enrollment has changed.</p>
<h3>From paper to digital platform: the early evolution of Medicare enrollment </h3>
<p>Before the internet, Medicare enrollment was largely paper-based. Beneficiaries relied on government handbooks, mailed brochures, in-person seminars and lengthy phone calls with licensed insurance agents. Comparing options was a time-consuming process, with limited transparency into premiums, costs or coverage.</p>
<p>The dot-com era brought the first major shift. Consumers could compare health plans online for the first time. Digital tools replaced stacks of paperwork and introduced real-time data into the decision-making process.</p>
<p>The next phase was mobile. As smartphones became central to everyday life, beneficiaries began to expect easier access and faster answers. Research and enrollment increasingly happened from home, often with licensed insurance agents available by phone or chat to help guide individuals through their choices.</p>
<h3>The next chapter: AI</h3>
<p>We are entering the next phase of modernization. AI has the potential to address the central challenge that has persisted through every stage of Medicare enrollment: complexity.</p>
<p>Today, AI-driven tools are already being used to help beneficiaries evaluate plans based on their preferred doctors, prescriptions, chronic conditions and financial considerations. Rather than focusing only on monthly premiums, these technologies can estimate total potential out-of-pocket costs, identify network limitations and surface options that better align with an individual’s healthcare needs. For most people, conducting this level of analysis on their own would be unrealistic.</p>
<p>At the same time, Medicare plan decisions are deeply personal. When licensed insurance agents speak with beneficiaries, they often hear the same concerns. People worry about keeping access to trusted physicians, misunderstanding plan differences and facing unexpected medical costs. Many are not just looking for data—they are looking for reassurance.</p>
<p>That is where responsible use of AI becomes essential.</p>
<p>AI can reduce wait times, streamline administrative steps, gather required information, and improve plan comparisons. It can also increase transparency by explaining why certain plans are recommended. Just as important, the responsible use of AI can help close persistent health disparities by making high-quality Medicare guidance more accessible to underserved communities—bringing personalized support to beneficiaries who have historically faced the greatest barriers to navigating complex health systems.</p>
<p>But AI should not operate on its own.</p>
<p>Licensed insurance agents provide judgment, accountability and empathy. They help beneficiaries understand tradeoffs, interpret life changes and revisit coverage decisions as needs evolve. The most effective model is not one where technology replaces people, but one where technology supports professionals in delivering better guidance.</p>
<p>As CMS considers how to use AI to optimize Medicare plan selection and expand access to coverage, the focus should be on clear guardrails, transparency and meaningful human oversight alongside innovation. If implemented thoughtfully, it can make Medicare enrollment more personalized, more transparent and less intimidating.</p>
<p>The opportunity before CMS is not only technological. It is human. Used responsibly, AI can restore confidence in a system that too many beneficiaries still find confusing and ensure that innovation serves the people Medicare was created to protect.</p>
<p><em><i>Jerome Adams, M.D., is a distinguished professor at Purdue University and a former U.S. surgeon general. Derrick Duke is the CEO at eHealth, a leading private online health insurance marketplace. Adams is also a member of eHealth's public policy advisory committee.</i></em></p>
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<p><strong>Forwarded by:<br />
Michael Reeder LCPC<br />
Baltimore, MD</strong></p>
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