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Medicare may not seem like a pressing issue for most Americans under the age of 65, but according to a new NerdWallet survey, 65% of Americans have interacted with the Medicare system in some way — whether that means being an enrollee, helping someone else figure out their coverage or needing to understand the system as part of job responsibilities.

The survey of over 2,000 U.S. adults — among whom 779 are enrolled in Medicare — commissioned by NerdWallet and conducted online in July 2024 by The Harris Poll, asked Medicare enrollees about their satisfaction with their health plan and whether they have concerns about Medicare benefits being reduced in their lifetime.

This survey is particularly timely in light of this year’s Social Security and Medicare Trustees reports that estimate the Medicare trust fund will be depleted by the year 2036 and the Social Security fund by 2035. Perhaps unsurprisingly, our survey found that some younger Americans aren’t confident Medicare benefits will still be available when they turn 65.

• Medicare satisfaction is high, but some still question their choice: Most Americans enrolled in Medicare (86%) are satisfied with their coverage. Still, 35% of Medicare enrollees aren’t sure if they chose the right Medicare coverage for them.

• Many are concerned about Medicare’s longevity: Nearly three-quarters of Americans enrolled in Medicare (74%) say they are concerned about Medicare benefits being reduced in their lifetime. And 35% of Americans under age 65 don’t believe Medicare benefits will still be available when they turn 65.

• Some are relying on Social Security for their retirement plans: The survey finds that 30% of Americans believe Social Security alone will provide enough income for them to live comfortably throughout their retirement. Around the same proportion (31%) say they don’t/won’t have a retirement account to draw from when they leave the workforce.

“Having adequate health insurance coverage is essential, especially during retirement when your income is likely to change,” says Elizabeth Ayoola, personal finance writer at NerdWallet. “Medicare Advantage and Medicare Part D plans aren’t static and can change each year. It’s important to shop around during open enrollment and make sure your doctors and prescriptions will be covered.”

According to our survey, 88% of Americans ages 65 and older say they have Medicare coverage. Nearly half of this age group have Original Medicare (49%), while 32% have Medicare Advantage, 25% have Medicare Part D and 24% have Medigap coverage.

Medicare is a health insurance program for Americans age 65 and up, as well as some younger Americans who have certain disabilities or health conditions. Original Medicare, also known as Medicare Parts A and B, is managed by the federal government. Medicare Advantage, or Medicare Part C, is offered by private insurance companies but has the benefits of Original Medicare as well as Medicare Part D — prescription drug coverage — in some cases.

There’s also Medicare Supplement Insurance, or Medigap, which is supplemental coverage to Original Medicare. It covers the “gaps,” hence the name, in Medicare Parts A and B. It’s not an option for those with Medicare Advantage.

Overall, most Medicare enrollees (86%) say they’re satisfied with their current Medicare coverage, and nearly as many (82%) are confident they’re getting the most out of the Medicare benefits. Still, more than a third of Americans enrolled in Medicare (35%) are unsure if they chose the right Medicare coverage for them.

If you’re part of the 35% of those enrolled in Medicare who aren’t sure if they chose the right Medicare coverage, check out the other coverage options to see if they fit your health needs and preferences better. If you decide to make a change in your Medicare coverage, open enrollment goes from Oct. 15 to Dec. 7 each year.

Original Medicare might be a good option for those who need nationwide coverage — like if you travel frequently — as well as those who want to be able to choose their providers without many limitations. It also often allows you to go to specialists without referrals, which may be useful for those with more complex health issues who might seek out second opinions. However, if you opt for Original Medicare, you’ll want to purchase a Medigap plan to cover certain out-of-pocket expenses like deductibles, copays and coinsurance, and a Medicare Part D plan to cover prescription drugs.

Medicare Advantage could be the ideal plan for healthy individuals who don’t need frequent access to specialists or nationwide coverage. Medicare Advantage plans often have some vision, dental and hearing coverage, prescription drug coverage and extra benefits, like gym memberships. It’s a bundled alternative to Original Medicare often with low premiums, but you’re limited to a network of providers.

“When weighing your options, think about factors like your current health status, lifestyle, potential risk factors to your health and how much you can afford to spend on health care,” Ayoola says. “These factors can give you insight into which Medicare options are most suitable for you and potentially minimize out-of-pocket costs.”

Whether you currently have Medicare coverage, or hope to in the future, you may have questions about the longevity of the program. Nearly three-quarters of Medicare enrollees (74%) say they’re concerned about Medicare benefits being reduced in their lifetime. And more than a third of Americans under age 65 (35%) don’t believe Medicare benefits will still be available when they turn 65.

The concern isn’t unwarranted. According to the 2024 annual report from the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, it’s projected that funds in the Medicare Part A trust will be depleted in 2036, which would result in an inability to pay full benefits. Further, funds in the Social Security trust are estimated to run out the year prior, again resulting in an inability to pay out full benefits. Neither of these dates are set in stone; they’re updated annually based on projections of a variety of things including prices and healthcare needs.

Social Security provides retirement benefits for Americans as young as 62 — as well as some disabled Americans and survivors of beneficiaries — so they continue to receive a regular income after leaving the workforce. The average monthly Social Security retirement benefit is $1,907, according to the Social Security Administration. This equates to an annual income of less than $23,000.

According to our survey, 3 in 10 Americans (30%) think Social Security alone will provide enough income for them to live comfortably throughout their retirement, including 46% of Generation Z (ages 18-27) and 44% of millennials (ages 28-43). Furthermore, less than 7 in 10 Americans (69%) say they do or will have at least one retirement account to draw from in retirement. Not having at least one other retirement account is a risky position, especially because Social Security and Medicare benefits — particularly at their current level — aren’t a guarantee long-term.

The good news is that Medicare and Social Security are popular programs across the political spectrum, and are unlikely to be done away with entirely. However, in the event that these benefits are reduced in your lifetime, it’s a good idea to shore up your personal finances to put yourself in a better position for an uncertain future.

Start by putting something away for retirement, regardless of your age or even whether or not you plan to retire. You can use a retirement calculator to figure out how much you should aim to save, but keep in mind that falling short of your target retirement savings is better than not saving anything at all. Also, while it’s often referred to as “retirement savings,” this money can be invested in order to supercharge your retirement funds.

In addition to saving for retirement, it’s a good idea to get the rest of your financial house in order. Take steps to pay off your consumer debt, and save up an emergency fund. It’s OK if this takes years, the goal is to reduce your financial stress and commitments as you approach retirement age, or well in advance of it.

“Diversifying your options when it comes to paying for health care expenses in retirement can help hedge against any unforeseen turn of events like changes in Medicare or Social Security,” Ayoola adds. “Funding health savings accounts, saving extra money for health care costs in retirement accounts or investing in long-term care insurance are a few options to consider.”