The Government Shutdown and Medicare: What to Know

(Illustration by Barron’s; Dreamstime (3))

A battle over Obamacare is at the center of the government shutdown but the ripple effects are reaching other services, including Medicare.

The shutdown won’t derail Medicare’s core services or the open-enrollment period, which begins Oct. 15. But if you’re thinking of making a switch, it may be better to wait until the situation stabilizes.

From Oct. 15 to Dec. 7, Medicare recipients can change their coverage for 2026. That could mean switching from traditional Medicare to Medicare Advantage or the reverse, or switching to a new Part D drug plan or a new Medicare Advantage plan. Medigap supplement plans aren’t part of open enrollment, as you can apply for a new Medigap plan anytime, but coverage may be subject to constraints.

While open enrollment is set to proceed even if the government shutdown continues, there could be some snags. The official Medicare.gov website says, “Due to the government shutdown, updates to information on this website may be limited or delayed.”

You can preview 2026 plan options now on Medicare.gov. But it’s best to wait until later in the season before making a final decision, says Mary Johnson, an independent Medicare and Social Security policy analyst. Even in a normal year, drug plan details on Medicare.gov often get updated at the beginning of open enrollment, and the government shutdown may make that process slower this year. (That said, don’t wait until the very last minute, because the process can take some time.)

For now, beneficiaries can prepare by reviewing their annual notice of change—an important letter from your health insurer outlining any changes to your coverage for 2026. This notice can come in the mail or by email.

If you want unbiased help navigating your choices, sign up now for an appointment with your local State Health Insurance Assistance Program, or SHIP, whose counselors are likely to be in high demand.

Here are some changes to keep in mind for 2026.

Part D

Many traditional Medicare members pick a stand-alone Part D drug plan from a private insurer to cover their medications. Choosing the wrong drug plan can cost beneficiaries hundreds of dollars a year, studies have shown. Monthly premiums get the most attention, but they’re only part of what you’ll pay.

The average stand-alone Part D plan total premium is projected to decrease to $34.50 in 2026 from $38.31 in 2025, according to the Centers for Medicare and Medicaid Services.

But some Part D recipients are paying far more, up to a maximum allowed increase of $50 a month for next year. Johnson’s premium is set to rise by this full amount, to $78.20 a month from $28.20.

Review how your plan covers your medications. You can find your drugs on the plan’s formulary—the list of covered drugs—and compare that against the costs outlined for each coverage tier in your annual notice of change.

While Johnson’s monthly premiums are set to spike, her plan is lowering the cost of medications in most coverage tiers, including reducing costs in Tier 1 to $0 from $5 for a month’s supply. Also, pay attention to your pharmacy choices, since costs can be lower if you use your plan’s preferred pharmacy.

Next year, the cap on beneficiaries’ out-of-pocket drug costs rises to $2,100 from $2,000 this year.

Medicare Advantage

Unlike traditional Medicare, which is run by the federal government, Medicare Advantage is run by private insurers that contract with the government to provide Part A hospital coverage, Part B outpatient coverage, and often Part D drug coverage. About half of all beneficiaries have chosen Medicare Advantage, also known as Part C.

The average premium across all MA plans is estimated to fall to $14 a month in 2026 from $16.40 this year, according to the CMS. Many Medicare Advantage plans have $0 premiums and include drug coverage and supplemental benefits not covered by traditional Medicare, such as limited vision, hearing, and even gym benefits.

On its face, this seems like a great deal, but costs in Medicare Advantage can mount with patients’ needs. Advantage plans tend to charge more at the point of care than traditional Medicare plus Medigap. If you wind up in the hospital, it isn’t clear that you’ll save money on Advantage.

Rather than focus on supplemental benefits that are subject to change from year to year, make sure your doctors participate in your Medicare Advantage plan. Many Advantage plans are HMOs with limited networks of participating doctors that restrict patients’ choices and require referrals to see specialists.

You can switch from Medicare Advantage to traditional Medicare any year, but you aren’t guaranteed the ability to buy a Medigap supplement plan outside of the six-month window when you first enroll in Medicare, with limited exceptions. A handful of states have other rules, too.

Barring these exceptions, Medigap policies are medically underwritten, and you can be charged more or denied coverage based on your health status. Without Medigap, you will be responsible for about 20% of covered costs in traditional Medicare, with no out-of-pocket cap.

Write to Elizabeth O’Brien at elizabeth.obrien@barrons.com