What Is the Medicare OEP?

The Medicare OEP runs annually from January 1 through March 31. During this period, individuals already enrolled in a Medicare Advantage plan may make one of the following changes:

• Switch from one Medicare Advantage plan to another.
• Disenroll from Medicare Advantage and return to Original Medicare, with the option to add a standalone Medicare Part D prescription drug plan.

Key CMS Rules for Agents During OEP

CMS closely regulates agent activity during OEP to protect beneficiaries from inappropriate marketing practices. Agents must stay within the following boundaries:

Prohibited Activities

Agents may not:

• Send unsolicited marketing materials promoting OEP plan changes.
• Target beneficiaries based on elections made during AEP.
• Use purchased lead lists or data sources specifically identifying OEP-eligible individuals.
• Proactively contact former clients who changed plans during AEP. 

Permissible Activities

Agents may:

• Market to individuals aging into Medicare who have not yet enrolled.
• Assist dual-eligible and Low-Income Subsidy (LIS) beneficiaries who may qualify for additional enrollment opportunities.
• Respond to inbound requests from beneficiaries seeking information or assistance.
• Conduct one-on-one meetings or provide plan information through call centers at the beneficiary’s request.

Other Enrollment Opportunities That May Apply

While OEP is limited to Medicare Advantage enrollees, some clients may qualify for Special Enrollment Periods (SEPs), including:

• Contract Non-Renewal SEP: Beneficiaries affected by a plan non-renewal may select new coverage through the end of February.
• Integrated Care SEP: Full-benefit dual-eligible beneficiaries may have monthly enrollment opportunities into qualifying integrated plans.
• C-SNP SEP- Individuals who can qualify for a CSNP plan such as diabetic or heart related option have a year round SEP.

Final Takeaway for Agents

OEP is an important but highly regulated window. Agents who understand the boundaries, and know when SEPs may apply, are better positioned to support clients compliantly while uncovering legitimate enrollment opportunities.

For questions or agent support, contact a Pinnacle Financial Services Team Member at

📞 800-772-6881 | 📧 healthsales@pfsinsurance.com