The new year brings fresh opportunities for Medicare sales agents as the Medicare Advantage Open Enrollment Period (OEP) kicks off. From January 1 to March 31, individuals enrolled in Medicare Advantage (MA) plans, including those newly eligible for MA, have a one-time option to:
- Switch to another Medicare Advantage plan (with or without Part D coverage), or
- Return to Original Medicare (with or without a Part D plan).
This is your chance as an agent to help clients find better coverage that meets their evolving needs.
AEP vs. OEP: What’s the Difference?
The Annual Enrollment Period (AEP) runs from October 15 to December 7, and it allows beneficiaries to make broader changes to their Medicare coverage, including joining or switching MA plans or adding Part D coverage.
The Medicare Advantage Open Enrollment Period (OEP) is often confused with AEP—even by CMS in some cases! However, OEP is specific to Medicare Advantage beneficiaries and occurs from January 1 to March 31.
Key Rules for OEP
During OEP, clients enrolled in a Medicare Advantage plan have these options:
- Switch plans: Move to another MA or MAPD plan.
- Return to Original Medicare: With or without a standalone Part D plan (PDP).
However, those enrolled in Original Medicare cannot use OEP to:
- Enroll in a Medicare Advantage plan.
- Add or change a PDP.
Additionally, beneficiaries in Medicare Savings Accounts (MSAs), cost plans, or PACE programs are not eligible to make changes during OEP.
Helping Clients Switch to Medicare Supplements
Clients can move from a Medicare Advantage plan to a Medicare Supplement policy during OEP, but they’ll need to pass medical underwriting. It’s important to:
- Submit the Medicare Supplement application first: Wait for approval before enrolling the client in a PDP, which automatically disenrolls them from their current MA plan.
- Ensure compliance: Avoid simultaneous enrollment in both a Medicare Supplement and a Medicare Advantage plan.
Educate your clients about this process to ensure a smooth transition while protecting their coverage.
Understanding CMS Marketing Guidelines for OEP
CMS marketing rules are clear about what agents can and cannot do during OEP. Here’s a quick breakdown:
During OEP, You Can:
- Market to age-ins (T-65) who haven’t yet made an enrollment decision.
- Market to those with Chronic Illnesses if there are C-SNP plans available in the area. Those who qualify for a CSNP can make a change to a CSNP plan at any point if they are not already enrolled in a plan for their qualifying condition.
- Share general information about OEP on your website.
- Help people who may qualify and do not already have the benefits apply for LIS or Medicaid. Newly eligible or those who have a change in status have an enrollment period even though the quarterly DSNP/LIS election is no longer available in 2025.
- Respond to a beneficiary’s proactive request for information, provide one-on-one consultations, and share marketing materials.
During OEP, You Cannot:
- Advertise OEP as an opportunity to make additional changes.
- Target beneficiaries who made changes during AEP through mailing lists or other means.
- Contact former enrollees who switched plans during AEP.
- Send unsolicited materials promoting enrollment changes during OEP.
Why Agents Should Focus on OEP in 2025
Medicare Advantage OEP presents a unique opportunity to build relationships and help beneficiaries improve their coverage. By understanding the rules and focusing on compliance, you can position yourself as a trusted advisor.
Pro Tips for Success During OEP
- Leverage digital platforms: Post general information about enrollment periods on your website or social media.
- Focus on education: Empower clients with knowledge about their options, emphasizing personalized solutions.
- Target chronic clients: This audience often has more flexibility to make changes.
By staying informed and offering value-driven support, you can maximize your business potential during this critical window.
Grow Your Medicare Business with NCC
At National Contracting Center (NCC), we understand the importance of supporting agents during Medicare Advantage OEP. Our resources, training, and expert guidance ensure you have the tools to grow your business while providing exceptional service to your clients.
Ready to take your Medicare business to the next level? Contact us today to learn how NCC can help you thrive during OEP and beyond.
