AEP is ending, but the Medicare Advantage Open Enrollment Period is right around the corner. To help you prepare, here’s a reminder of what you as an agent can do during OEP, as well as what your clients can do.

For Clients – Enrollment Options

The Medicare Advantage OEP runs from January 1 to March 31. During this time, people who are enrolled in a Medicare Advantage plan for the current year can switch their plan. Enrollees can either switch to a different Medicare Advantage plan or switch back to Original Medicare. If they switch to Original Medicare, they can also enroll in a Medicare prescription drug plan.

This is a good opportunity for any Medicare Advantage beneficiary who is unhappy with their plan selection. However, there are some important restrictions that you and your clients should keep in mind.

  • Only Medicare Advantage enrollees can take advantage of OEP. Medicare beneficiaries who are enrolled in Original Medicare cannot use OEP to switch to Medicare Advantage or to enroll in a new prescription drug plan.
  • Only one switch is allowed. Consider OEP a second chance to pick the most suitable coverage for the year. Barring eligibility for a special enrollment period, your clients won’t get a third chance.

For Agents – Marketing Rules

CMS issues the Medicare Communications and Marketing Guidelines (MCMG). Agents should review these guidelines, as well as a memo that CMS issued in August regarding updates. Both documents can be found at the CMS website. Here are a few key takeaways regarding the marketing rules that exist during OEP.

  • You CANNOT knowingly target Medicare Advantage or Part D enrollees during OEP.
  • You CANNOT send unsolicited marketing materials advertising OEP.
  • You CANNOT target OEP as an opportunity to make further sales.
  • You CANNOT contact former enrollees who selected a new plan during AEP.
  • You CAN send marketing materials if a beneficiary makes a proactive request.
  • You CAN market to age-ins, by five-star plans, and to dual-eligible and LIS beneficiaries.

It’s important to follow these guidelines. However, you do not need to worry too much about unintentionally sending marketing materials to a beneficiary who enrolled in a plan during AEP, as long as your focus is on one of the permitted marketing activities. For example, according to the MCMG, “if a Plan sends mailers to a list of age-ins discussing the Initial Coverage Election Period (ICEP), it is possible that some recipients may have already made an enrollment decision; however, the content of the message to the intended audience of age-ins is not prohibited OEP marketing.”

Need guidance? PTT Financial is here to help. Contact us with any questions.