Open Enrollment Begins Amid Government Shutdown

Medicare’s annual open enrollment period officially began on October 15 and runs through December 7, giving millions of Americans the opportunity to adjust their health coverage for 2026. However, this year’s enrollment season comes with an unusual complication — the ongoing federal government shutdown, which started October 1 and could delay access to certain Medicare information and assistance.

Despite the shutdown, the Centers for Medicare and Medicaid Services (CMS) confirmed that all essential functions, including plan updates and enrollment processing, will continue. Still, experts like Philip Moeller, author of Get What’s Yours for Medicare: Maximize Your Coverage, Minimize Your Costs, are advising beneficiaries to wait before making final decisions.

“There’s absolutely no need to rush,” Moeller said. “Even a change made on the very last day of open enrollment takes effect on January 1. With the current situation, waiting until services are fully operational might save you from making an uninformed choice.”

Understanding How Open Enrollment Works

During the open enrollment window, beneficiaries can:

• Switch from Original Medicare (Parts A and B) to a Medicare Advantage (Part C) plan or vice versa.
• Change from one Medicare Advantage plan to another.
• Add, drop, or change Medicare Part D prescription drug coverage if enrolled in Original Medicare.

Experts warn against a “set-it-and-forget-it” approach. Juliette Cubanski, deputy director of KFF’s Program on Medicare Policy, noted that even if beneficiaries are satisfied with their current plans, changes in provider networks, drug coverage, or premiums can significantly impact out-of-pocket costs.

According to KFF’s 2022 report, Medicare beneficiaries spent an average of 39% of their Social Security income on healthcare costs. With costs rising, reevaluating your plan each year could mean substantial savings.

“It always pays to shop around,” Cubanski said. “Plans can change, and you might be leaving hundreds of dollars on the table if you don’t compare your options.”

Government Shutdown May Delay Access to Help

While the shutdown is not halting enrollment, it could slow responses from official support channels. The 1-800-Medicare hotline may experience longer wait times, and some data on the Medicare Plan Finder portal might not update as quickly as usual.

“Critical updates will continue, but there may be fewer staff available to answer complex questions,” Moeller explained. “That’s why I suggest holding off if you can.”

Even with these limitations, beneficiaries can still explore plans directly through insurance company websites, local State Health Insurance Assistance Programs (SHIPs), or licensed Medicare advisors, all of which remain operational.

Original Medicare vs. Medicare Advantage: Key Considerations

Choosing between Original Medicare and Medicare Advantage remains one of the most significant decisions for beneficiaries. Each option has unique pros and cons that depend on health needs, provider preferences, and budget.

• Medicare Advantage (MA) Plans: These private plans often charge no additional premium beyond Part B and offer extra benefits like dental, vision, and hearing. However, MA plans typically restrict provider networks and require prior authorizations for some treatments.
• Original Medicare: Offers freedom to visit any doctor or hospital nationwide that accepts Medicare, but lacks a cap on out-of-pocket costs. Many beneficiaries pair it with Medigap supplemental insurance to reduce financial exposure.

Cubanski emphasized the importance of reading the fine print: “Just because a plan offers dental coverage doesn’t mean it’s comprehensive — it could mean one cleaning per year rather than full coverage for dentures or multiple cleanings.”

New Transparency in Medicare Advantage Plans

This year, Medicare’s online Plan Finder tool includes more details about supplemental benefits offered by Advantage plans, including vision, hearing, and dental coverage. Beneficiaries can now also view provider networks and hospital affiliations directly through insurance websites, providing a clearer comparison before enrolling.

While this added transparency is a step forward, Moeller warns there may be “some data hiccups.” If beneficiaries realize they’ve made a mistake, they will still have a second chance to make changes during the Medicare Advantage Open Enrollment Period, which runs from January 1 to March 31.

Prescription Coverage: Reviewing Medicare Part D Plans

For those with Original Medicare, Part D coverage helps pay for prescription medications. Medicare Advantage enrollees often have drug coverage bundled into their plans.

Moeller stresses the importance of ensuring that your medications remain covered next year. “If a plan doesn’t include all of your prescriptions, it’s not the right fit,” he said.

While there are more zero-premium Part D plans available in 2025, beneficiaries should watch for rising annual deductibles and copay tier shifts. “Your total yearly costs, not just the premium, should guide your decision,” Moeller added.

Notably, the Part D annual out-of-pocket maximum will rise to $2,100 in 2026, up from $2,000 in 2025. However, this cap only applies to covered prescriptions — any drug paid for outside your plan won’t count toward that limit.