December 29

Open Enrollment Period — Things to remember during OEP

What is the Medicare Open Enrollment Period?

OEP stands for Open Enrollment Period and is when clients are allowed to make a one time change if they are unhappy with their current plan. The Medicare Open Enrollment Period follows AEP or Annual Enrollment Period where the majority of apps are written. 

When is the Medicare Open Enrollment Period?

The new OEP is effective from January 1 to March 31 each year, and began in 2019. The effective date for an MA OEP election is the first of the month following receipt of the enrollment request. 

Possible changes include:

  • Switch from one Medicare Advantage plan to another Medicare Advantage plan
  • Disenroll from a Medicare Advantage plan and return to Original Medicare, with or without a Part D drug plan

Take note that it is important to know that you may not enroll into a Medicare supplement plan at this time through the same process. It is required that you apply, answer health questions, and go through underwriting. Also, acceptance is not guaranteed. In addition to, it depends on your health history and how much risk is associated.

How does OEP, AEP and SEP compare?

Open Enrollment Period allows Seniors to make single changes and adjust plans accordingly.  During the Annual Election Period,  Seniors with Original Medicare make changes to their Medicare coverage during this time. Also in AEP compared to OEP, clients can't switch from Original Medicare to a Medicare Advantage plan.

However, in Special Enrollment Period, this is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. Enrollment happens in Medicaid or the Children’s Health Insurance Program (CHIP) any time.

How does this benefit the agent?

How can you benefit from OEP as an agent? If someone approaches you and expresses dissatisfaction with their MA plan during the first quarter, discussing OEP options takes place with them and you can help them find a plan more appropriate to their needs.

It is vital to remember that you can and should be marketing all year long for age-ins, dual eligibles, and those who receive extra help with their drug cost. This is done during the first quarter and, if written, the agent should use the appropriate SEP code (not OEP).

Why might beneficiaries want to change their plan?

Medicare Open Enrollment appointment

Medicare beneficiaries are sometimes confused and don't fully understand their plans. They may not have been fully informed of their benefits, and therefore are not covered as much as they wanted. This is why it is crucial to be transparent with your clients during your appointments.

You don't want to enroll them in something they don't need just to make a sale. This will come back to bite you during OEP when they change plans or decide to work with another agent. You lose money and an important client in your book of business. Another reason people may change is drugs may not have been looked up and are not covered on current plan.

As an agent it is important to check on a number of things your client may not know to check themselves. This includes making sure that their doctors support the plan that they enroll in. Make sure they aren't focusing on the premium alone.

While a low premium might be attractive, the rest of the plan's benefits are important as well. It is important to cover your client based on their health needs as well as cost. In addition, even if the plan has a low premium, don't forget about copays. 

Do's and Don'ts of Open Enrollment Period (OEP)

Do

  • Market to age-ins (who have not yet made an enrollment decision)
  • Market to dual-eligible and low-income subsidy (LIS) beneficiaries who, in general, may make changes once per calendar quarter during the first nine months of the year
  • At a beneficiary’s proactive request, send marketing materials, have one-on-one meetings, and provide information on the OEP
  • Include general information on your website about enrollment periods, including OEP

Don't

  • Send unsolicited materials advertising the ability/ opportunity to make an additional enrollment change or referencing the OEP
  • Specifically target beneficiaries who are in the OEP because they made a choice during AEP, by purchase of mailing lists or other means of identification
  • Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
  • Call or otherwise contact former enrollees who have selected a new plan during the AEP

As an agent, you are not permitted to directly and actively market OEP. A client must come to you with concerns and a desire to change their current plan. One can then discuss the OEP election period with them.  

OEP comes with many decisions to be made, which makes it stressful for both customers and agents. Don't miss out on an opportunity to cross-sell. You could bring up hospital indemnity or home health plans to add on at this time if your clients feels as though they don't have enough coverage. 

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.

Here you can see and check out this blog post and video on the variety of special election periods, or this recorded TMG agent conference call regarding special election periods to learn more. We wish you the best in your business and personal lives. 

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