With the new open enrollment program (OEP) introduced in 2019, there are several changes and adjustments of which agents need to be aware.
What is the new open enrollment period in 2019?
The new OEP will be effective from January 1 to March 31 each year. The new OEP allows Medicare beneficiaries to make a one-time switch to another Medicare Advantage (MA) plan, to disenroll from a Medicare Advantage plan, or to add or drop Prescription Drug (PDP) coverage.
For example, an individual enrolled in an MAPD plan may use the OEP to switch to: (1) another MAPD plan; (2) an MA-only plan; or (3) Original Medicare with or without a PDP.
As another example, the OEP will also allow an individual enrolled in an MA-only plan to switch to: (1) another MA-only plan; (2) an MAPD plan; or (3) Original Medicare with or without a PDP.
It is important to note that clients who only have traditional Medicare cannot pick up a Medicare Advantage plan unless they qualify for a special enrollment period.
Here are the possible switches:
MAPD to MAPD
MAPD to Original Medicare and a Part D
Original Medicare and a Part D to MAPD
MA only plan to MA only plan
MA only plan to Original Medicare
Your clients can only enroll in new Part D plans if they have disenrolled from an MAPD plan. The enrollment period does not allow for Part D changes for individuals who are enrolled in Original Medicare, including those with enrollment in stand-alone PDPs.
Furthermore, those individuals with enrollment in Original Medicare or other Medicare health plan types, such as cost plans, are not able to use the OEP to enroll in a Medicare Advantage plan, regardless of whether they have Part D.
Enrollments made using the OEP are effective the first of the month following the month in which the enrollment is made. There is an extra three-month opportunity to sell Medicare Advantage plans beyond the 54 day enrollment period.
What does this mean for agents?
OEP can be a stressful time for agents, so it’s important to remember to follow up with members to see if they are happy with the plan selections that were made or kept during AEP.
This is also a great time to cross-sell hospital indemnity plans or home health plans to provide further protections for 2019. It’s also a good time to focus on clients who are turning 65.
Things to Remember
Keep in mind that agents cannot actively advertise or market OEP. If a client calls you to let you know that they aren’t happy with their current plan, this is the time that you can let them know about the OEP election period.
If your client has Medicare and Medicaid, or if they qualify for the low-income subsidy, they can make one change per quarter for the first nine months of 2019.
Do you have any questions regarding OEP, or anything else? Don’t hesitate to give us a call at 888-622-9122 and our expert agent support specialists will be happy to speak with you. To learn more about which MAPD plans we have to offer, check out our carrier index page.