10/06/2025
Government Shutdown Explained: Top FAQs Answered
The United States government shut down on October 1, 2025, leaving many clients to question their healthcare coverage and agents to wonder what this means for AEP. Here’s what you need to know regarding the shutdown.
During a federal government shutdown, several key aspects of Medicare and related services continue to function without interruption. Here’s a breakdown of what doesn’t stop during a shutdown:
1. Medicare Benefits
• Coverage Remains Intact: Medicare beneficiaries will continue to receive their healthcare coverage, including hospital and medical services, preventive services, and prescription drug coverage.
2. Claims Processing
• Continuity in Claims: Medicare continues to process claims and make payments to healthcare providers. Beneficiaries can seek medical care without worrying about interruptions in their claims being processed.
3. Customer Service
• Call Centers Available: Most Medicare call centers remain operational. Beneficiaries can still reach out for assistance with questions regarding their benefits, claims, or enrollment.
4. Enrollment Periods
• Insurance Enrollment Unaffected: The Medicare Annual Election Period (AEP), which typically runs from October 15 to December 7, remains unaffected. Beneficiaries can enroll in or change their plans as scheduled.
5. Preventive Services
• Access to Services: Beneficiaries can still access preventive services without any delays, including annual wellness visits and screenings.
6. Coverage for Critical Services
• Emergency Services: Access to emergency services and urgent care continues, ensuring that beneficiaries can receive necessary medical attention.
7. Medicare Advantage Plans
• Plans Function as Usual: Medicare Advantage plans are also unaffected, allowing beneficiaries to maintain their coverage and care through these private plans.
8. Oversight and Funding
• Funding for Medicare: Medicare is typically funded by mandatory spending, which doesn't require annual appropriations from Congress, ensuring its operation even during shutdowns.
9. Social Security remains funded
• 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).
10. Telehealth Appointments
• 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.
11. Medicaid or other entitlements
• Medicaid, CHIP, SNAP, and other entitlement programs still have funding through CMS.
In conclusion, while a government shutdown may create uncertainty in many areas, Medicare beneficiaries can rest assured that their health coverage, services, and supports will continue as normal. Agents and clients must stay informed, especially during the lead-up to AEP, to make the most of their options.
Have questions? Feel free to reach out to us.
