The Medicare Open Enrollment Period (OEP) started January 1st, 2023, and ends March 31st, 2023. Make sure you have all the information you need to help beneficiaries.
Medicare OEP Critical Points:
- Enrollment Dates: January 1st – March 31st
- Who is eligible to participate: Those enrolled in a Medicare Advantage plan
- What changes can a beneficiary make:
- Change to a Medicare Advantage plan
- Change to Original Medicare, add a Medicare Part D plan if needed
- How many changes can a beneficiary make during this period: Beneficiaries can only make one plan election during this period.
- When does coverage begin after the change is made: the first month following the receipt of the enrollment request.
Key Differences Between AEP & OEP:
- AEP occurs during the fall (Nov. 7 – Dec 15) for coverage beginning Jan. 1.
- Anyone who is eligible for Medicare can participate in AEP.
- Beneficiaries can make as many changes to their plan as needed during AEP.
What Changes Can Beneficiaries Make During OEP?
- Can Change:
- Beneficiaries enrolled in an MAPD plan can enroll in a different MAPD plan, MA plan, or Original Medicare plan, with or without a prescription drug plan.
- Beneficiaries enrolled in a MA plan can switch to a different MA plan, MAPD plan, or Original Medicare, with or without a prescription drug plan.
- Can’t Change:
- Beneficiaries enrolled in an Original Medicare plan cannot use the OEP to change to a MA or MAPD plan, or add or change their prescription drug plan.
CMS Rules and Regulations for OEP:
CMS guidelines prohibit producers and state plan sponsors from knowingly targeting or sending unsolicited marketing materials to a MA or MAPD enrollee during the OEP. The term “knowingly” considers who the intended recipient was and the overall content of the message. Examples of “knowingly targeting” include:
- Sending messaging specifically calling out the OEP.
- Sending unsolicited marketing materials to an individual that had already made an AEP enrollment decision, even if the OEP was not mentioned.
For more details, review Chapter 42 of the Code of Federal Regulations, Part 422 Subpart V – Medicare Advantage Communication Requirements, § 422.2263 General marketing requirements.
If you are looking for more resources to stay compliant during the Medicare Open Enrollment Period or have further questions, our team at Carolina Senior Marketing is here to help.
_________________________________
As your North Carolina Medicare FMO, Carolina Senior Marketing is committed to serving you, the Independent Insurance Agent. If you’re not an agent with us, we’re still glad to meet a new face and answer any of your questions you may have. Please email us at info@carolinaseniormarketing.com to reach out.
