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Medicare Blog | Medicare News | Medicare Information

Essential MA OEP Reminders

Posted by www.psmbrokerage.com Admin on Thu, Dec 07, 2023 @ 12:18 PM


In January, some clients who recently enrolled in new Medicare Advantage plans may contact you, expressing uncertainty about their decision. Moving from a familiar plan to an unfamiliar one can be daunting. Fortunately for your client, they're not locked into their new coverage. Shortly after the Annual Enrollment Period (AEP), beneficiaries in Medicare Advantage plans have the option to reconsider their plan choice.

Today we'll look into what options beneficiaries have, as well as a few points to consider as it relates to restrictions on marketing during this time.

As you might be aware, the Medicare Advantage Open Enrollment Period (MA OEP) is designed for two specific groups:

  • Clients who are new to Medicare and have chosen to enroll in a Medicare Advantage (MA) plan during their Initial Coverage Election Period (ICEP). These beneficiaries are granted a three-month OEP, which initiates in the same month they become eligible for both Part A and B of Medicare.
  • Clients who have already enrolled in MA plans starting on January ,. For these clients, an OEP is available from January 1 to March 31.

This means that clients who contact you in January, expressing dissatisfaction with their new plan, have the opportunity to make a one-time switch in their coverage. So, what alternatives do they have?

Keep in mind that Part D changes during the MA 0EP are tied to MA plan changes. Clients can modify their drug coverage by switching to a different MAPD plan, transitioning from MA to MAPD, or returning to Original Medicare with a standalone Part D plan. However, if someone has Original Medicare with a Part D plan, they cannot switch to a different drug plan during the MA 0EP; they must wait for a Special Enrollment Period (SEP) or the next Annual Enrollment Period (AEP).

Restrictions on Marketing

One major point to consider is the restriction on marketing during the MA OEP window. 

Agents cannot knowingly target or send unsolicited marketing materials to MA or Part D enrollees during the MA OEP 0anuary 1 to March 31). It's important to note that "knowingly" takes into account the intended recipient as well as the content of the message.

SureBridge Dental PlansUnderstanding these rules is crucial for anyone working with Medicare beneficiaries, especially insurance agents and healthcare advisors, to ensure compliance and provide accurate guidance.

After the Annual Enrollment Period (AEP), there are several effective sales strategies you can employ to maintain momentum and continue growing your business.

Check out a summary of ideas here.

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Tags: Medicare Advantage plans, OEP, Compliance

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