What Impact Could the Government Shutdown Have?

Those looking to sign up for or change their Medicare health and drug plans will get a chance soon.

Medicare open enrollment begins Oct. 15 and runs through Dec. 7. During this time, enrollees can switch their coverage plan that will start Jan. 1. Some beneficiaries are concerned that the government shutdown will affect their ability to change their coverage.

The government is shut down because Democrats and Republicans have yet to resolve a budget dispute. This has led to hundreds of thousands of federal workers being furloughed, and some federal operations halting until a government budget agreement can be reached.

While the government could reopen before the Medicare open enrollment period, the clock is ticking. Here is what you should know if the shut down stretches on.

How The Government Shutdown Will Affect Open Enrollment

The government shutdown should not affect Medicare enrollment because the program is covered under mandatory government spending and has its own dedicated revenue stream. Money paid into Medicare from payroll taxes is separate from the government’s general fund.

However, there are other ways beneficiaries could be impacted, according to Anne Montgomery, senior health expert at the National Committee to Preserve Social Security and Medicare. 

“Medicare beneficiaries and those aging into Medicare could encounter significant delays and have a hard time getting timely information,” Montgomery said.

That is because the Centers for Medicare and Medicaid Services has furloughed about half its employees during the shutdown. If people have specific situational questions, they will likely have to wait longer than during previous open enrollment periods to get them answered.

The official Medicare website now includes a banner at the top of the homepage saying updated information may be limited or delayed due to the government shutdown.

“Medicare beneficiaries and those entering the program are often in need of good orientation and grounding, and whether they’re going to be able to get that from the system that’s always been there to serve [beneficiaries in the past] is uncertain,” Montgomery said.

What You Can Do During Open Enrollment

If you’re making changes or enrolling for the first time, here are some basics you need to know.

Costs, coverage, and the in-network status of providers and pharmacies can change annually, so beneficiaries should review these details to make any necessary adjustments during open enrollment. 

During open enrollment, beneficiaries can enroll in a Part D prescription drug plan, switch to a different Part D plan, or switch to a different Medicare Advantage plan. Beneficiaries can also switch between Original Medicare (Parts A and B) and Medicare Advantage (Part C) plans.

Original Medicare vs. Medicare Advantage

The government provides Original Medicare plans, which include basic medical and hospital services by any provider that accepts Medicare. 

Medicare Advantage plans provide benefits through a Medicare-approved private insurance plan, like Preferred Provider Organizations or Health Maintenance Organizations. These plans cover everything in Part A and B, and often also include Part D prescription drug coverage. Other benefits, like dental and vision, can also be included in these plans. However, beneficiaries with Medicare Advantage coverage typically need to visit in-network providers.

Do You Have To Make Changes in Open Enrollment?

Not everyone will need to make changes during open enrollment, but if you have a change you’d like or need to make, it must be done during that time (unless you qualify for a Special Enrollment Period, such as losing employer health coverage or moving out of the coverage area).

If beneficiaries are satisfied with their current plans and the plan is still being offered to them, they do not need to do anything during open enrollment.

However, Medicare beneficiaries should always review correspondence from their plans, as they may send an Annual Notice of Change (ANOC) that could impact their coverage. This could include adjustments to coverage, provider networks, premiums, deductibles, copays, or other changes. An ANOC will show how costs and coverage could be different next year, and if that will no longer work for your situation, it’s important to make a change during open enrollment.