How Can You Market During the Open Enrollment Period?

Every year from January 1 – March 31, a new Medicare Advantage Open Enrollment Period (OEP) runs. OEP is a bit different than AEP (Annual Enrollment Period from October 15 – December 7) in terms of what your client can do, and what you can do as an agent too. Wonder what this means for your client, and for yourself as an agent? We are breaking it down for you here:

If you have clients who have enrolled into a Medicare Advantage plan as of January 1st, they have a one-time opportunity to:

  • Switch to a different MAPD or MA Only Plan
  • Drop their Medicare Advantage plan and return to Original Medicare, Part A, and Part B
  • Switch a Medicare Supplement plan to another Medicare Supplement plan (will have to go through underwriting again)
  • Sign up for a stand-alone Medicare Part D Prescription Drug Plan if they return to Original Medicare

What can agents do during Open Enrollment Period?

According to the 2019 Medicare Communications and Marketing Guidelines (MCMG), you are prohibited from knowingly targeting or sending unsolicited marketing materials to any MA enrollee or Part D enrollee during the continuous Open Enrollment Period, Jan 1 – March 31. ‘Knowingly takes into account the intended recipient as well as the content of the message.’

But, what does this really mean? Basically, you can’t use OEP as a marketing opportunity:

  • Don’t send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP.
  • Don’t specifically target beneficiaries who are in the OEP because they made a choice during AEP by the purchase of mailing lists or other means of identification.
  • Don’t engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales.
  • Don’t call or otherwise contact former enrollees who have selected a new plan during AEP.

There are some plan changes you are not allowed to make during OEP:

  • OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan.
  • OEP does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans.
  • OEP is not available for those enrolled in Medicare Savings Accounts or other Medicare health plan types (such as cost plans or PACE).

You do want to stay busy during OEP right? Well, there are some things you can do during this period to keep you CMS compliant.

  • Conduct marketing activities that focus on other enrollment opportunities, including but not limited to:
  • Marketing to age-ins (who have not yet made an enrollment decision),
  • 5-star plans marketing the continuous enrollment SEP, and
  • Marketing to dual-eligible and LIS beneficiaries who, in general, may make changes once per calendar year during the first nine months of the year.
  • Send marketing materials when a beneficiary makes a proactive request.
  • At the beneficiary’s request, provide information on the OEP through a call center
  • Individuals may add or drop Part D coverage during the MA OEP. Individuals enrolled in either MAPD or MA-Only plans can switch to:
    • Medicare Advantage – Prescription Drug
    • Medicare Advantage – Only
    • Original Medicare (with or without a stand-alone Part D Plan)

Another thing to keep in mind is, a Medicare Advantage organization has the option to voluntarily close one or more of its MA plans to OEP and OEPI enrollment requests. If an MA plan is closed for OEP and PEPI enrollments, then it is closed to all individuals who are making OEP or OEPI enrollment requests for that plan. All MA plans must accept OEP and OEPI dis-enrollment requests, regardless of if it is for open enrollment or not.

We can help you navigate through the Medicare Communications and Marketing Guidelines issued by CMS any time you have questions. We know them. We live them. That’s what we do for you, give us a call at (800) 878-1058, ext. 1380, or email us at [email protected]

For the most up-to-date information on Marketing and Communications Guidelines, please refer to this link.