Medicare Advantage Open Enrollment Period: What Agents Need to Know


The Centers for Medicare & Medicaid Services (CMS) is reinstating the Medicare Advantage Open Enrollment Period (MA OEP) in 2019. The MA OEP gives your clients more time to make changes to their coverage. But how will this affect your marketing activities? Excelsior explains what options your clients have during the MA OEP and how agents’ marketing activities are impacted.

When Is the Medicare Advantage Open Enrollment Period?

Beginning in 2019, the Medicare Advantage Open Enrollment Period (MA OEP) will take place from January 1 to March 31 every year. The Centers for Medicare & Medicaid Services (CMS) is restoring the MA OEP in January 2019 to replace the current Medicare Advantage Disenrollment Period, which previously ran from January 1 to February 14.

Who Can Use the Medicare Advantage OEP?

The Medicare Advantage Open Enrollment Period (MA OEP) applies to:

  1. Beneficiaries who are enrolled in an MA plan as of January 1. These enrollees can use the January 1 to March 31 MA OEP to enroll in another MA plan or disenroll from their MA plan to return to Original Medicare.
  2. New Medicare beneficiaries who enrolled in an MA plan during their . These enrollees get an MA OEP starting the first month of entitlement to Medicare Parts A and B and ending the last day of the third month of entitlement. For example, if your client becomes eligible for Medicare in February, their MA OEP will start February 1 and end April 30. The January 1-March 31 timeline would not apply to them, because their Medicare eligibility is not valid until February.

What Does Medicare Advantage Open Enrollment Mean for Your Clients?

Medicare Advantage Open Enrollment gives beneficiaries who are currently enrolled in an MA plan a few options. They can switch to a different MA plan or drop their plan and return to Original Medicare with or without Part D drug coverage. Enrollees get a one-time election to make any of the following changes through the MA OEP:

  • Switch from a Medicare Advantage Prescription Drug Plan (MA-PD) to a different MA-PD
  • Switch from an MA-PD to an MA-only plan
  • Switch from an MA-only to an MA-PD
  • Switch from an MA-only plan to a different MA-only plan
  • Drop MA-PD coverage and return to Original Medicare (with or without Part D)
  • Drop MA-only coverage and return to Original Medicare (with or without Part D)

However, there are stipulations for beneficiaries enrolled in Original Medicare.

  • If an enrollee has Original Medicare, they cannot use the MA OEP to switch to an MA plan.
  • The MA OEP does not apply to beneficiaries who have a Medicare Savings Account (MSA) or another type of Medicare health plan, such as a Medicare Cost Plan. Medicare Supplements are also exempt, as they are connected to Original Medicare, which does not apply to the MA OEP.
  • Enrollees of standalone Part D prescription drug plans (including those who have Original Medicare) cannot use the MA OEP to make changes to their drug coverage.

What Agent Marketing Activities Are Prohibited During the MA OEP?

CMS prohibits agents and brokers from intentionally targeting or sending unsolicited marketing materials to MA and Part D enrollees during the Medicare Advantage Open Enrollment.

During the MA OEP, brokers and agents cannot:

  • Engage in activities that use the MA OEP as an opportunity for additional sales.
  • Call or contact enrollees who have made a new plan selection during the Annual Enrollment Period (AEP).
  • Purchase mailing lists or other identifiable information in an attempt to directly target beneficiaries during the MA OEP because they made a selection during the AEP.
  • Send unsolicited marketing materials referencing the MA OEP or the opportunity to make an additional enrollment change.

What Marketing Activities Can Agents Perform During the MA OEP?

Agents and brokers are limited in marketing activities during the Medicare Advantage Open Enrollment Period (MA OEP) however, are able to:

  • Conduct marketing activities that focus on other enrollment opportunities, including but not limited to:.
    • Send marketing materials only when a beneficiary makes a proactive request.
    • Set up a one-on-one meeting only at a beneficiary’s request.
    • Marketing 5-star plans by regarding their continuous enrollment SEP
    • Marketing to age-ins (who have not yet made an enrollment decision)

Where Can I Get Help With Navigating the Medicare Advantage OEP?

Excelsior’s senior market experts can help you compliantly conduct marketing activities during the Medicare Advantage Open Enrollment Period (MA OEP). Our regional sales directors have decades of field marketing experience to help you navigate various scenarios that may arise during the MA OEP. We’re here to help guide you, whether it’s for the upcoming MA OEP or AEP. Get connected with Excelsior to learn about our product solutions, innovative quoting technology, insurance training events, and senior market lead programs.


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References
https://www.cms.gov/newsroom/fact-sheets/cms-finalizes-policy-changes-and-updates-medicare-advantage-and-prescription-drug-benefit-program
https://www.cms.gov/Medicare/Eligibility-and-Enrollment/MedicareMangCareEligEnrol/Downloads/CY_2019_MA_Enrollment_and_Disenrollment_Guidance.pdf
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/CY2019_Medicare_Communications_and_Marketing_Guidelines.pdf
https://www.gormanhealthgroup.com/blog/webinar-recap-2019-mcmg-highlights/

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