The possibility of a government shutdown can be concerning, and we want to assure you about the status of your essential benefits. For the vast majority of beneficiaries, a government shutdown is expected to have minimal to no impact on benefit payments and essential medical coverage.

Here is a breakdown of what you should know about Medicare and Social Security during a shutdown:

Essential Benefits Will Continue Uninterrupted

• Social Security Payments and Medicare Claims Processing will continue.
  • The reason: Social Security, Medicare, and Medicaid are classified as mandatory spending programs. They are permanently funded through dedicated sources (like payroll taxes) and existing law, rather than needing annual appropriation (spending) bills from Congress.
  • This means regular benefit checks will still be paid, and medical claims will continue to be processed so you can keep seeing your doctors and using your current plan benefits as normal. This was the case during the 2018-2019 government shutdown.
• Your Medicare Advantage or Medicare Supplement coverage remains active.
  • You can continue to use your current plan, and the upcoming Annual Enrollment Period is a statutory period that will not be affected by a shutdown.

Expect Delays and Limited Services

While payments and coverage continue, the operational staff at the Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) are reduced. This can lead to delays in administrative services:

• Customer Service Delays: If you need to call the SSA or the CMS call center, you will likely experience longer wait times and reduced capacity as offices won’t be fully staffed.
• Processing Delays: Any requests that require in-person staff or extensive administrative processing will likely be delayed. This includes:
  • Mailing of new or replacement Medicare cards.
  • Processing new applications for Medicare and Social Security benefits.
  • Benefit verification requests.
• How to Get a Replacement Medicare Card: You don’t have to wait for the mail! You can print an official copy of your Medicare card instantly from your online MyMedicare.gov account.

Potential Impact on Telehealth Services (Important Distinction)

While core benefits are protected, some temporary services extended by Congress may be affected:

• Traditional Medicare Telehealth: Some temporary telehealth flexibilities (like the ability to receive certain services in any geographic area, including your home) that were put in place during the COVID-19 Public Health Emergency may expire without specific Congressional action.
• Medicare Advantage Telehealth: This potential lapse is generally less of a concern for Medicare Advantage (MA) beneficiaries because MA plans can choose to maintain these flexible telehealth policies even if the temporary rules for Original Medicare expire.

We are here to help. We will continue to closely monitor the situation and provide updates. If you have any concerns about your coverage or need assistance navigating administrative issues with Medicare or Social Security, please don’t hesitate to give us a call.

FAQs on Government Shutdown and Your Medicare/Social Security