16 Fev, 2021

Understanding Medicare OEP

In 2019 CMS replaced the annual Medicare Advantage (MA) disenrollment period with an MA Open Enrollment Period (OEP).

OEP runs from 1 de janeiro – 31 de março each year and provides beneficiaries who are enrolled in an MA plan with a one-time opportunity to:

  • Switch to a different MA plan
  • Drop their MA plan and return to Original Medicare, Part A and Part B
  • Sign up for a stand-alone Medicare Part D Prescription Drug plan (if they return to Original Medicare)

The MA OEP does NOT allow individuals to:

  • Join an MA plan if they were enrolled in Original Medicare
  • Enroll in Original Medicare to make Part D changes
  • Make changes if they are enrolled in stand-alone Part D

The MA OEP is not available for those enrolled in Medicare savings accounts or other Medicare health plan types, such as cost plans or PACE. The effective date for an MA OEP election is the first of the month following receipt of the enrollment request.

During OEP, Individual Medicare agents can:

  • Conduct marketing activities that focus on enrollment opportunities for individuals, such as age-ins, dual eligible, and LIS beneficiaries
  • Send marketing materials to beneficiaries who have made a proactive request

During OEP, Individual Medicare agents cannot:

  • Conduct sales activities that promote or target the OEP as an opportunity to make sales
  • Solicit or target individuals with materials advertising the ability to make a plan change due to OEP
  • Target individuals who are in the OEP because they made a specific choice during the Annual Enrollment Period (AEP)
  • Call or otherwise contact former enrollees who have selected a new plan during the AEP

Please refer to Chapters 2 and 3 of the Medicare Managed Care Manual for additional details.