As of October 1st, the United States Government has shut down because Congress could not pass necessary funding bills to keep federal agencies running. Government shut downs have unfortunately occurred several times over the past few decades – but even still, many Medicare beneficiaries and agents are wondering what this means for health coverage, especially as we approach AEP.
The good news: Medicare coverage continues, no matter what goes on in Washington. Here’s some important things to understand about the shutdown and how it can affect your clients.
What doesn’t stop during a shutdown?
Your clients can rest easy because:
- Medicare benefits continue
- Claims and payments go on
- AEP Continues
- Social Security remains funded
Let’s take a deeper dive into some commonly asked questions.
Government Shutdown & Medicare FAQs
❓Will Medicare coverage stop during the shut down?
No, Medicare benefits are considered mandatory spending and will continue regardless of the shut down. Your clients coverage, claims, and payments to providers remain the same.
❓Will Social Security checks still be processed?
Yes, clients will still get their Social Security benefits, aka their checks. However other Social Security operations like appeals and updating earnings will be suspended (due to limited staff).
❓Will Medicare customer service still be available?
Yes, but call centers like 1-800-MEDICARE will have longer wait times due to limited staff.
❓Are Medicare-covered telehealth appointments impacted by the shutdown?
Yes, Congress could not come to a funding agreement and so telehealth services under Medicare expired on October 1, 2025. Telehealth services will no longer be billable, unless Medicare and Congress agree on claims and expansion. However, beneficiaries in rural areas will still be covered for telehealth appointments.
❓Is Medicaid or other entitlements impacted by the shutdown?
No, Medicaid, CHIP, SNAP, and other entitlement programs still have funding through CMS.
❓Will the Medicare Annual Enrollment Period still occur?
Yes, the Annual Enrollment Period continues as scheduled, and private insurance carriers are not impacted by the shutdown. Agents could experience delays in processing times due to limited staff depending on how long the shutdown lasts, but we have no way in knowing if it will remain closed until AEP begins on October 15th.
What can you do for your clients?
As an agent, you can provide reassurance that their coverage is safe, they can still enroll or make changes during the upcoming AEP, and you are there to guide them through this season and answer their questions.
Tidewater is here for you
A government shutdown can slow down processes, but it does not stop Medicare or AEP. Agents can still serve clients, and clients can rest knowing their coverage continues. If you as an agent need anything during this time, please give us a call. You are there for your clients, and the Tidewater team is here for you.
*We will continue to update you with any information we receive regarding the shutdown. This information is subject to change.*
