With the new Medicare Communications and Marketing Guidelines (MCMG) comes a new Open Enrollment Period (OEP) to help any of your clients manage their buyer’s remorse.

Changing health plans can feel uncertain for those over 65 as they transition from the known to the unknown on a fixed income. What happens if they make the move to try out a Medicare Advantage plan for the first time, or switch health plans, and then feel like their new coverage is not the right fit?

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Luckily for them, they’re not stuck with their new coverage. Almost immediately after the Annual Enrollment Period (AEP), seniors in Medicare Advantage plans have an option to reconsider their plan selection.

Here’s what you need to know about the Medicare Advantage Open Enrollment Period (MA OEP).

Open Enrollment Qualifications

According to the Centers for Medicare & Medicaid Services (CMS)’ Medicare Advantage Enrollment and Disenrollment Guidance, the Open Enrollment Period that most accurately applies to your clients hoping to switch plans after AEP is the MA OEP, as long as they qualify.

The MA OEP is specifically for:

  • Clients new to Medicare who enrolled in an MA plan during their Initial Coverage Election Period (ICEP). These beneficiaries have a three-month OEP that starts with the month they are entitled to Part A and B.
  • Those who enrolled in MA plans as of January 1. For these clients, OEP is from January 1 to March 31.

Note: MA OEP does not allow those enrolled in Original Medicare to join an MA plan. However, MA enrollees can switch back to Original Medicare during OEP and add a stand-alone Part D plan.

Marketing During Medicare Advantage Open Enrollment

A big difference in the new MCMG is the definition and prohibition of marketing during the MA OEP.

What Qualifies as Marketing?

Agents cannot knowingly target or send unsolicited marketing materials to MA or Part D enrollees during OEP (January 1 – March 31).

It’s important to note that “‘knowingly’ takes into account the intended recipient as well as the content of the message.”

What Does That Mean?

Basically, it means there are rules as to how agents can communicate with beneficiaries during this time.

Do:

  • Host marketing events focusing on plans other than MA or Part D, such as:
    • Appealing to age-ins who have not enrolled in a plan yet
    • Marketing based on the continuous Special Enrollment Period (SEP) beneficiaries have to enroll in a 5-star plan
    • Reaching out to dual-eligible and Low Income Subsidiary (LIS) beneficiaries, since they can generally change plans once each quarter during the first nine months of the calendar year
  • Send marketing materials to a beneficiary who makes a proactive request
  • Hold one-on-one meetings with beneficiaries who request them
  • Give out OEP information if a beneficiary asks for it

Note: If a beneficiary who has already made an enrollment decision unintentionally receives marketing information, it’s not considered “knowingly targeted.”

Don’t:

  • Send beneficiaries unsolicited communications about the ability to make any additional changes or reference OEP
  • Target, by way of purchased mailing list or any other means, any beneficiary who’s in OEP because they made a decision during AEP
  • Participate in or advertise any agent/broker activities that address 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 OEP begins the first day of the month following the month an MA company gets the enrollment request. But note that the company in question can decide whether or not they’re open to enrollments during MA OEP, which means your clients are not guaranteed a plan during this period.

That doesn’t mean they’re stuck if this is the case. Your client may be eligible for multiple enrollment periods occurring within this one. For instance, they may qualify for an SEP, so it’s possible their request for coverage will be accepted, but under a different enrollment period and with a different coverage start date.

Something to Think About

Going into this new year, reach out to your clients to make sure they understand their plans, and that they are happy with them. Let them know you’re available if they have any questions or need further assistance. By doing so, you’ll provide your clients with a feeling of security, and as a result, they’ll be far more likely to refer their family and friends to you.

Remember, if you’re not contacting your clients throughout the year, another agent may seize the opportunity to gain their trust. A client who has questions or is confused with their plan is far more susceptible to let another agent write them into an MA plan next time around. Protect your business; don’t let the hard work you put into AEP go to waste.

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It’s important to keep up with your clients after AEP to discuss any change of heart, their qualifications, and the options available to them, so that they may take advantage of the new OEP.