by Nicola Godman | Jan 8, 2024 |
Devoted Health Member Retention Strategy and OEP Review
A retention strategy is crucial to agents to maintain customer loyalty and prevent rapid dis-enrollments. After investing time and energy to enroll them in their Devoted Health plan you want to ensure your clients remain happy with their plan going forward. Join us to learn more about Devoted Health’s retention strategy and how you can create a year-long winning strategy to retain your clients. Additionally, we will get you ready, set, and sell for OEP.
This training session will be available during the below dates and times:
Click here to register.
- January 10th (Wednesday) at 3:00 PM Eastern
- January 11th (Thursday) at 9:00 AM Eastern
- January 12th (Friday) at 12:00 PM Eastern
by Bob Brzyski | Jan 5, 2024 | Blog, Medicare |
Medicare’s Open Enrollment Period (OEP) is a time for individuals to review and adjust their Medicare coverage. Understanding the intricacies of Medicare OEP is essential for making informed decisions about healthcare plans. Below, we discuss the rules and opportunities with the Medicare OEP, which has replaced the previous Medicare Disenrollment Period.
Introduction to Medicare Open Enrollment Period (OEP)
The Medicare Open Enrollment Period, occurring annually from January 1st to March 31st, is pivotal for beneficiaries. It’s designed to offer flexibility and a chance to reassess one’s current Medicare coverage. This period is particularly significant as it replaces the former Medicare Disenrollment Period, which was limited to January 1st to February 14th each year.
Key Changes in OEP
One of the most notable changes in the OEP is its extended duration. Now, running for three months provides ample time for clients to consider their options without feeling rushed. During this period, beneficiaries have a one-time opportunity to change their existing plans. This flexibility is crucial for adapting to new healthcare needs or financial considerations that may have arisen since the initial enrollment.
Understanding “Like Plan” Changes
The OEP allows for changes to a “like plan.” Understanding what this means is crucial for making the right decision. The term “like plan” refers to a specific set of allowable changes. These include:
- MAPD to MAPD: Beneficiaries can switch from one Medicare Advantage Prescription Drug plan (MAPD) to another. This option is ideal for those who wish to find a plan with different coverage details, network providers, or drug formularies.
- MAPD to Original Medicare (and a Part D plan): For those who wish to return to Original Medicare, this option allows beneficiaries to switch from their MAPD plan. Additionally, they can enroll in a Part D plan for prescription drug coverage, ensuring they don’t lose prescription benefits.
- MA Only plan to an MA Only plan: This change enables beneficiaries to switch from one Medicare Advantage (MA) plan to another. It’s an essential option for those satisfied with having their health and medical services under Medicare Advantage but seeking different coverage specifics.
- MA Only plan to Original Medicare: This choice is for beneficiaries who prefer the flexibility and broad network of providers that Original Medicare offers, allowing them to move away from a Medicare Advantage plan.
Importance of Personalized Advice
While the OEP provides an opportunity to make changes, switching should be based on individual healthcare needs. It is advisable to consult with a healthcare advisor or use Medicare’s resources to understand the implications of each option. Personalized advice can help beneficiaries navigate the complexities of Medicare and make choices that align with their healthcare needs.
| During the OEP, you may not: |
During the OEP, you may: |
| Send unsolicited materials advertising the ability/opportunity to make an additional enrollment change or referencing the OEP |
Market to age-ins (who have not yet made an enrollment decision)
|
| Specifically, target beneficiaries who are in the OEP because they chose AEP by purchasing mailing lists or other means of identification |
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
|
| Engage in or promote agent/broker activities that intend to target the OEP as an opportunity to make further sales
|
At a beneficiary’s proactive request, send marketing materials have one-on-one meetings, and provide information on the OEP
|
| Call or otherwise contact former enrollees who have selected a new plan during the AEP
|
Include general information on your website about enrollment periods, including OEP. |
Medicare’s Open Enrollment Period allows beneficiaries to reassess and adjust their healthcare plans. By understanding the rules and options available, such as the ability to switch to a “like plan,” beneficiaries can make decisions that better suit their evolving healthcare needs. It’s a time for careful consideration and consultation with Medicare experts to ensure the choices are in the best interest of one’s health and well-being. However, navigating the complexities of Medicare can be challenging.
For personalized guidance and more detailed information on how OEP works, it’s advisable to contact a knowledgeable Medicare team member. Pinnacle Financial Services provides expert assistance and can be a valuable resource in this process. You can contact us at 800-772-6881 x-7731 or email support@pfsinsurance.com for support. For more comprehensive insights and updates, visit our OEP page. The team can help you understand the nuances of Medicare plans and ensure that your choices are in the best interest of your client’s health.
Vice President, Marketing
Contact a Pinnacle Representative if you have any questions.
1 (800) 772-6881
support@pfsinsurance.com
by Serena Bugryn | Feb 7, 2023 | Blog |
A lot of acronyms in this industry, ya you know it.
Open Enrollment Period (OEP)-This time frame runs from January 1-March 31rst each year but is specific to Medicare Advantage ONLY. If someone is enrolled in a Medicare Advantage Plan, they have a couple of options. This was added back in 2019 and replaced the Medicare Advantage Disenrollment period which used to run from January 1st – February 14th.
- Switch to a different Medicare Advantage Plan
- Switch to Original Medicare (and join a stand-alone drug plan)
They can only use this election period ONCE during the time frame so when making a change make sure it is the right one. The change will take effect the first of the month following the request.
What’s the difference between the Annual Enrollment Period (AEP) and the Open Enrollment Period (OEP)?
Besides sounding alike AEP occurs in the fall October 15th – December 7th, with the coverage effective date beginning January 1st. AEP is open to anyone eligible for Medicare, and the last application is the one that applies. Applicants can change their minds many times with the last application before December 7th being the one to take effect.
Remember OEP is only available to those ALREADY in a Medicare Advantage plan as of January 1rst, and only allows a ONE TIME CHANGE there is no last application in the policy. Applicants Can NOT switch from Original Medicare to an Advantage plan because remember they must already be on an Advantage plan. They can NOT join a standalone drug plan if only enrolled in original Medicare since again they are NOT on an advantage plan already. Getting the gist now?
How can I market during OEP?
This time frame is a little more restrictive, hard to believe anything can be more restrictive right!?
This is a time frame where beneficiaries who are unhappy with the plan, they chose during AEP get a one-time oops let me make another choice. Remember it is not a free market.
Agents Can:
Provide OEP information upon a beneficiary request. Market to those turning 65 and LIS beneficiaries, focusing on other enrollment periods essentially. Follow up with your book of business to check in and make sure they are happy with no issues.
Agents Can NOT:
Target Medicare Advantage Enrollees knowingly, don’t run an ad like this, “Hate your plan call me.”
Contact any enrollees who chose a new plan during AEP (that would be targeting as mentioned above)
My best advice would be to use the OEP as a time to help any client that may realize they picked the wrong plan or made a mistake but continue focusing on those Turning 65 and the LIS beneficiaries. The OEP is a nice to have election period when needed but is meant to be just that WHEN needed.
This is quite a bit to review and understand so why not reach out to us to help you?
Work with one of the best Medicare FMOs in the business! Click here to get started
To sign up with Pinnacle complete the easy contracting form today:
https://pfsinsurance.com/spot-sb
Contact a Pinnacle Representative if you have any questions.
1 (800) 772-6881
support@pfsinsurance.com
by Jeff Palo | Dec 13, 2022 | Blog |
Understanding Medicare OEP Rules
The Medicare Open Enrollment Period (OEP) occurs each year between January 1st and March 31st. It is important to understand the Medicare OEP rules. 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 their Original Medicare and enroll in a stand-alone Prescription Drug Plan. The new plan would be effective the first of the month following the submission of the enrollment.
It is important to remember that, while the client may drop their MA plan and go back to Original Medicare and a PDP, they will NOT automatically be Guarantee Issue Acceptance for a Medicare Supplement plan. They would need to follow that state/carrier rules regarding plan acceptance. Using the OEP enrollment selection does not disqualify a client from using their quarterly Special Election period for a Dual Special Needs Plan if they have both Medicare and Medicaid.
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” takes 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 the 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.
Do
- Marketing 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
Vice president | health sales
Contact a Pinnacle Representative if you have any questions.
1 (800) 772-6881
support@pfsinsurance.com
by pfsinsurance | Dec 21, 2021 | Aetna, Medicare, News |
Aetna | Broker Survey | OEP | Think Agent | Update client PCP | Commissions | Monthly premium |
Thank you for partnering with us during AEP and for your ongoing commitment to our Medicare members.
We want to wish you and your families a happy and healthy holiday!
Medicare news
Your broker survey is on its way!
Your opinion matters… Be on the lookout today for a survey arriving in your email. We want to get your feedback on your interactions with your Aetna Medicare Broker Manager this year. It will take 3 minutes to complete.
Open Enrollment Period (OEP) starts January 1: Review the do’s and don’ts
During the Medicare Advantage OEP, beneficiaries who are enrolled in an MA/MAPD plan have a one-time opportunity to change plans. This election period is not available to those with Original Medicare or those enrolled in a standalone Prescription Drug Plan. How to assist your clients during OEP.
Think Agent: Your electronic resource
You have a new tool to help you with enrollment applications and more. Think Agent is the new electronic enrollment tool for Aetna MA/MAPD and SilverScript PDP products. The latest additions for Think Agent include:
You can join us for an in-depth training session on Think Agent. Live broker training begins February 2. You can sign-up now at www.aetnamedicareagenttrainning.com.
Help your client update their PCP – Call us on their behalf
Don’t forget! You can call the Aetna Medicare Broker Services Department at 1-866-714-9301 to request certain types of changes and updates, on behalf of your clients who are Aetna members. Select prompt 8 and then from there, you need to select the right product type and member ID identification. You will then be routed to the correct service center for support.
For example, you can now call to:
- Update the primary care physician (PCP) on file
- Inquire about a claim or billing issue
- Change a mailing address, and more
This policy allows you to deliver a more seamless customer service experience to your clients. Here’s how to make a request.
What to expect for commission payout of 2022 AEP Medicare business
The first payout of 2022 will begin to transfer to bank accounts on January 4th. To learn more go to the Medicare commission payout schedules located on Producer World in the Individual Medicare area from the Compensation tab.
Did you know? Members can pay their monthly premium at their local CVS store
Members can pay their premium in person at their local CVS store while out running errands or picking up their prescriptions. All monthly invoices contain a barcode giving members the ability to pay their premium at most CVS stores. This option is not available at CVS pharmacies within Target® and Schnucks®.
Contact a Pinnacle Representative if you have any questions.
1 (800) 772-6881
support@pfsinsurance.com
