The question of whether Medicare is affected by a government shutdown has been on many Americans’ minds. As of today, October 25, 2025, here is the up-to-date verified status:
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Current Status of Medicare During the Shutdown
- The federal government entered a shutdown on October 1, 2025, after Congress failed to pass appropriations bills.
- The Centers for Medicare & Medicaid Services (CMS) has confirmed that the Medicare program will continue during the lapse in appropriations because it is a non-discretionary program.
- CMS issued updated guidance indicating that most Medicare claims payment holds tied to the shutdown have been lifted, meaning payments for many services will resume.
- While coverage and core benefits remain unaffected, some administrative and oversight functions may face delays or disruption.
What Exactly Is Covered and What Might Be Affected
Covered / unaffected:
- Beneficiaries under Medicare continue to receive coverage and benefits as usual. The mandatory nature of the program means funding for core operations remains intact.
- CMS instructed Medicare Administrative Contractors (MACs) to process claims with dates of service on or after October 1, 2025, that had been previously held.
Potentially impacted administrative areas:
- Overseeing contractors, processing non-urgent enrolment requests, and education/outreach functions may slow down due to staffing adjustments.
- Some special programs tied to Medicare, or expanded services such as telehealth flexibilities, may face delays. For example, CMS guidance noted telehealth claims will remain on hold in certain cases.
Why Medicare Is Not Fully Disrupted
- Medicare is classified as a mandatory entitlement program. It does not rely solely on annual discretionary appropriations in the same way many other federal programs do.
- The CMS contingency plan ensures that “excepted functions”—those essential to life, health, and safety—continue operating during a funding lapse.
- The swift lifting of most payment holds and the resumption of claims processing underscores that CMS prioritized maintaining key Medicare operations.
What Should Beneficiaries Do?
- If you are a Medicare beneficiary, continue to use your benefits as usual—doctor visits, hospital services, claims should go through.
- If you experience a delay beyond what you normally expect (for example, claims taking much longer), it may be related to administrative slowdowns. Contact your provider or MAC if necessary.
- Stay alert for communications from CMS or your plan provider, particularly if you are enrolling or changing plans during the annual open-enrollment period.
- Keep good records of your claims and communications, just in case there are minor hiccups or delays due to the shutdown.
Key Facts at a Glance
| Issue | Status |
|---|---|
| Medicare benefits paid | Yes — core Medicare benefits continue |
| Claims processing (Oct 1 onward) | Instructions issued to MACs to resume processing these claims |
| Staff and operations | Some CMS operations continue with limited staffing; oversight and outreach may slow |
| Special/innovation programs | Some flexibility programs (e.g., telehealth) may face holds or delays |
| Overall Medicare coverage | Unaffected in terms of core benefit delivery |
Why It Matters for U.S. Adults
Millions of Americans rely on Medicare for hospital care, physician visits, prescription drugs, and more. Knowing that Medicare continues operating provides important reassurance to beneficiaries. At the same time, potential delays in administrative services, slower responses, and impacted innovations can still affect people’s experience.
The key phrase “is Medicare affected by government shutdown” is central to understanding how this shutdown specifically intersects with one of the largest federal programs. The answer: while Medicare is not halted by the shutdown, there are some ripple effects to be aware of.
We encourage you to share your experiences—have you noticed any delays or issues with Medicare during the shutdown? Let us know in the comments and stay tuned for further updates.