How Does Medicare OEP Work?

January 6, 2021

The Medicare Open Enrollment period (OEP) occurs each year between January 1st and March 31st.  A client must be on a Medicare Advantage plan to take advantage of the OEP opportunity.  If your client is currently on a Medicare Advantage plan, they can either make a one-time switch to; a different Medicare Advantage Plan or go back to Original Medicare and enroll in a stand-alone Prescription Drug Plan.  The new plan would be effective the first of the month following submission of the enrollment.

Medicare OEP “Do’s and Dont’s”?

CMS has specific marketing guidelines that must be followed during OEP.  Agents may not knowingly target or send unsolicited marketing materials to any MA or Part D for the purpose of using their OEP option to change plans. “Knowingly” take into account the intended recipient as well as the content of the message.

Do Not

  • 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 Annual Enrollment Period (AEP) by the 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; or
  • Call or otherwise contact former enrollees who have selected a new plan during the AEP.
  • Market to age-ins (who have not yet made an enrollment decision);
  • Marketing by 5-star plans regarding their continuous enrollment SEP;
  • Marketing to dual-eligible and LIS beneficiaries who, in general, may make changes once per calendar quarter during the first nine months of the year;
  • Send marketing materials when a beneficiary makes a proactive request;
  • At the beneficiary’s request, have one-on-one meetings with a sales agent; and
  • At the beneficiary’s request, provide information on the OEP through the call center

Medicare OEP Training

We hold webinars multiples times throughout the week covering a variety of topics, including Medicare OEP and other marketing opportunities. Be sure to always check the Enrollment Period Guide if you have questions on eligibility.  Reach out to our support team for training calendars from each carrier in your area.

For more information, contact a Pinnacle Financial Services representative today

1 (800) 772-6881 x7731 | sales@pfsinsurance.com

Jeff Palo

Jeff Palo

Senior Sales Director - Health

x7716 | jpalo@pfsinsurance.com

Contact a Pinnacle Representative if you have any questions.

1 (800) 772-6881


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