How do Medicare Advantage and Part D plan payments differ during a federal shutdown?
Executive summary
During the 2025 federal shutdown, mandatory programs including Medicare continued to pay benefits, but CMS rulemaking, certain customer services and some HHS staff were reduced — creating potential delays and uncertainty for Medicare Advantage (MA) rule releases and enrollment support [1] [2] [3]. CMS and advocates report that claims and core benefits largely continue, while non‑essential CMS work such as proposed MA/Part D rules or staff technical assistance may be paused or delayed by furloughs [2] [3].
1. Shutdown basics: mandatory payments continue, but operations are trimmed
The federal government treats Medicare as a mandatory program, so benefit payments to beneficiaries continue even during a lapse in appropriations; HHS said core, direct‑service activities supporting Medicare and Medicaid would be retained while about 45% of HHS staff face furloughs, meaning some administrative activities slow or stop [1]. The Center for Medicare Advocacy summarized that Medicare and Medicaid “continue, but some services and supports may be limited” — emphasizing continuity of payment but interruptions to ancillary functions [2].
2. What happens to Medicare Advantage and Part D plan payments specifically
Available sources state the program’s funded activities — including the timely payment of Medicare benefits — continue during the shutdown, and CMS has been able to release 2026 plan information and enrollments tools prior to the shutdown [1] [2] [4]. Sources do not claim MA or Part D insurers will stop receiving their routine payments; rather, the worry centers on regulatory work and communications rather than the flow of premium or claim payments [2] [3]. If you expect a specific cut or suspension of MA/Part D plan payments during the shutdown, that claim is not found in the current reporting.
3. Delays in rulemaking and future payment notices: where the risk lies
Private‑sector analysis and trade commentary warn the shutdown can delay non‑essential CMS rulemaking — including proposed MA and Part D rules and related notices that set future payment rates and bid guidance — because CMS and OMB staff working on voluntary projects may be furloughed, slowing releases of proposed rules and notices that inform insurers’ bids [3]. McDermott+ argued that the proposed rule for 2027 MA/Part D could be delayed and that release timing for regulatory documents expected in November/December 2025 was at risk without full CMS staffing [3].
4. Practical effects for beneficiaries during enrollment and appeals
CMS updated plan‑finder and released 2026 premiums and plan counts before the shutdown, which helped preserve the Annual Enrollment Period (AEP) decision tools [4] [2]. Nonetheless, consumer groups and reporters warned that processing times for applications, card replacements, SHIP technical assistance and customer service could be slowed — Social Security said it would continue timely benefit payments but pause some services such as replacing Medicare cards [1] [5]. The net effect: coverage and claims generally work, but beneficiaries may face more friction when calling for help or replacing documents [1] [5].
5. Industry and advocacy perspectives: competing narratives
Insurers and brokers told reporters they did not expect plan payments or claims processing to stop and emphasized that MA operations are “essential,” but they also warned of administrative delays in processing enrollments [6]. Advocacy groups like the Center for Medicare Advocacy highlighted that while core Medicare functions continue, shutdown effects on communications, technical assistance to SHIPs and long‑range policymaking remain concerning [2]. These perspectives agree on continuity of benefits but diverge on how disruptive the staffing gaps will be to enrollment and rule timelines [6] [2] [3].
6. What isn’t in the reporting — and what to watch for
Available sources do not report any suspension of MA or Part D insurer payments or an interruption to beneficiary claims payments; they focus on delays to regulatory notices, customer service and non‑essential CMS work [2] [3] [1]. Watch CMS announcements for updates on proposed rule schedules and for notices about administrative backlogs; stakeholders singled out upcoming rule releases (e.g., Contract Year/2027 proposals) as the clearest area of vulnerability to furlough‑related delay [3] [7].
7. Practical guidance for beneficiaries and plan sponsors
Because CMS released 2026 plan information before the shutdown, beneficiaries can still compare MA and Part D options for 2026 using Plan Finder and AEP channels, but expect slower phone responses, paused card replacements and limited HHS/CMS technical assistance for SHIPs [4] [1] [2]. Plan sponsors should expect potential delays in receiving finalized guidance for future payment rules and build contingency timelines for bid preparation if CMS rule releases are deferred [3] [7].
Limitations: reporting used here focuses on October–November 2025 coverage of the shutdown and CMS actions; sources do not provide a day‑by‑day accounting of actual payments to insurers during the entire shutdown, and they do not claim any permanent changes to benefit payments [2] [3] [1].