Medicare eligibility translates into meaningful gains in health equity. But the COVID-19 pandemic in particular has demonstrated that racial, ethnic, gender, LGBTQ+ status, disability status, and income disparities in health outcomes and access to care remain. For example, Medicare beneficiaries most likely to report difficulty getting vision, dental, or hearing care include individuals with low incomes, those in fair or poor health, and Black and Hispanic enrollees. Many LGBTQ+ individuals have significant challenges finding able and willing providers, and those over age 50 in particular experience pronounced health disparities. In our experience, transgender people in particular may struggle to access appropriate care, including gender affirming care, in Medicare. This lack of access can magnify inequities, put beneficiary health at risk, and lead to more costly and invasive treatments later.