Medicare Advantage Open Enrollment Tips for Success by Plans for Life

It’s January, and some of your clients in new Medicare Advantage plans may be reaching out with concerns. Changing health plans can be uncertain, and the transition from the known to the unknown can raise questions. What happens if someone tries out a Medicare Advantage plan for the first time or switches plans and finds that their new coverage isn’t the right fit?

The good news is, they’re not stuck with their new coverage. Right after the Annual Enrollment Period (AEP), beneficiaries in Medicare Advantage plans have the option to reconsider their plan selection during the Medicare Advantage Open Enrollment Period (MA OEP). Here’s what you need to know about MA OEP do’s and don’ts to stay compliant.

Medicare Advantage OEP Qualifications: According to the Centers for Medicare & Medicaid Services (CMS), the MA OEP applies to clients who:

1. Are new to Medicare and enrolled in an MA plan during their Initial Coverage Election Period (ICEP).
2. Enrolled in MA plans as of January 1.

MA OEP Enrollment Can’s & Can’ts: Here are the key enrollment guidelines to keep in mind:

Can…

• Switch a client from one MA plan to another
• Drop a client’s MA plan to return to Original Medicare
• Enroll clients in a prescription drug plan if they go back to Original Medicare

Can’t…

• Drop a client’s Medicare Medical Savings Account plan
• Disenroll clients with Original Medicare from any accompanying prescription drug plans
• Try to change a client’s plan more than once
• Try to enroll a client with Original Medicare in an MA plan

Remember, the MA OEP is designed for those already in MA plans, and clients in Original Medicare or Med Supps can’t use the OEP to enroll in an MA plan.

Marketing Do’s & Don’ts During MA OEP: During the MA OEP (January 1 to March 31), there are restrictions on marketing. Here are the do’s and don’ts:

Do’s:

• Host marketing events focusing on plans other than MA or Part D.
• Send marketing materials to a beneficiary who makes a proactive request.

Don’ts:

• Send unsolicited communications about the ability to make additional changes or reference the MA OEP.
• Target beneficiaries in the MA OEP through purchased mailing lists or any other means.
• Advertise any agent/broker activities that address the MA OEP as a means of making more sales.
• Contact former enrollees who chose a new plan during AEP.

Effective Date of Coverage and Beyond: Coverage on a plan chosen during the MA OEP begins the first day of the month following the month an MA company receives the enrollment request. However, companies can decide whether they’re open to enrollments during MA OEP, so clients are not guaranteed a plan during this period.

Before the MA OEP begins, reach out to your clients to ensure they understand their plans and are happy with them. Let them know you’re available for any questions or assistance. By doing so, you’ll provide your clients with a sense of security, making them more likely to refer others to you.

Call to Action: For any questions or assistance during Medicare Advantage Open Enrollment, call Plans for Life at 915-591-1957. We’re here to help both clients and agents navigate the process and ensure the right coverage.

Don’t let the opportunity slip away. Contact your clients throughout the year to maintain their trust and secure your business. A client with questions or confusion is more susceptible to other agents. Protect your business and ensure your hard work during AEP pays off.