Providers|Agents & Brokers
Register
Supergraphic Hero Eggplant

Agent Insight
Medicare Updates.

Understanding the Medicare Advantage Open Enrollment Period (OEP).

The Medicare Advantage Open Enrollment Period (OEP) is a crucial time for beneficiaries to review and adjust their coverage to ensure it meets their needs. It is also a key period for agents, who must navigate compliance requirements carefully to effectively support members. The Medicare OEP is a time to assist members while adhering to the CMS regulations. If requested by a member, you can help them make informed decisions.

Here’s a guide to help you understand OEP and your role in it.

What Is the OEP? 

The OEP occurs annually from January 1 to March 31 and provides a one-time opportunity for beneficiaries enrolled in a Medicare Advantage (MA) plan to make specific changes: 
  • Switch to a different MA plan (with or without drug coverage) 
  • Drop their MA plan and return to Original Medicare (with or without a Part D plan) 

Who Can Use the OEP?

Eligible: 

  • Individuals currently enrolled in a Medicare Advantage (MA) or Medicare Advantage Prescription Drug (MAPD) plan. MA OEP occurs January 1 – March 31.
  • New Medicare beneficiaries who are enrolled in an MA plan during their ICEP, OEP occurs the month of entitlement to Part A and Part B – the last day of the 3rd month of entitlement. 
  • Individuals enrolled in an MA plan may add or drop Part D coverage during the OEP. Individuals enrolled in either MA-PD or MA-only plans can switch to:
    • MA-PD
    • MA-only
    • Original Medicare (with or without a stand-alone Part D plan) 

The effective date for an OEP election is the first of the month following receipt of the enrollment request.

Ineligible: Beneficiaries with Original Medicare who wish to join an MA plan or change their Part D plan.

Using the OEP Special Enrollment Period (SEP)

The OEP SEP allows beneficiaries to submit changes that take effect on the first of the month following the application’s receipt date. However, beneficiaries may only make one change during this enrollment period. 

Compliance and Marketing During OEP

As an agent, compliance is critical during OEP. Here are the guidelines you must follow:

Prohibited Activities

  • Unsolicited marketing: Avoid sending materials that promote the opportunity to switch plans or specifically reference the OEP.
  • Targeting OEP beneficiaries: Do not use mailing lists or other tools to identify and reach out to beneficiaries who recently made a plan change.
  • Direct contact: Do not contact former enrollees who switched plans during the Annual Enrollment Period (AEP).

Promoting OEP during agent activities: Avoid using OEP as a selling point during marketing activities. 

Permitted Activities

  • Marketing to age-ins: Individuals approaching Medicare eligibility.
  • Responding to beneficiary inquiries: Provide information or schedule one-on-one meetings if a beneficiary requests it.
  • Providing general information: Maintain enrollment details, including information about OEP, on your website.
  • Market to Individuals who recently moved to the area.

Marketing Tips

Focus on other opportunities: Highlight the Initial Coverage Election Period (ICEP) or other Special Enrollment Periods (SEPs) that beneficiaries might qualify for.

Leverage inbound inquiries: If a beneficiary contacts you proactively, address their needs while staying within compliance guidelines.

Educate, don’t promote: Share information about plan benefits and options without emphasizing OEP-specific opportunities. 

For additional questions or clarification on compliant activities during OEP, please reach out to your Sales Account Executive or the Medicare Advantage Agent Support (MAAS) Line at 801-442-7320.

New Video Resource: Flexible Benefits Made Simple.

Select Health has launched new videos designed to help you educate clients about the flexible benefits included in our Medicare plans. We encourage you to view these videos and share them with clients as needed. 

What the Videos Cover

  • Benefits Mastercard® Prepaid Card (Flex Card) Overview: An explanation of how the Flex Card works and its eligible uses. 
  • Eligible Expenses: Information on what can be purchased with the card, including groceries, over-the-counter items, and transportation. 
  • Using the Benefit: Step-by-step guidance on how to activate and use the Flex Card. 

How You Can Use These Videos

  • Share them with clients to clarify their benefits.
  • Use them during consultations to address common questions.
  • Direct prospects to the videos to highlight the value of Select Health plans.

Visit the page today and use these videos to help your clients better understand and utilize their benefits!

Special Enrollment Period Available for Colorado Residents.

The Governor of Colorado, Jared Polis, declaration of disaster/emergency due to a recent extreme winter storm, permits Medicare Beneficiaries who reside in Colorado a Special Enrollment Period (SEP) to elect to enroll in a Medicare Advantage plan. This SEP provides eligible individuals the opportunity to make enrollment changes outside of the standard election periods.

An individual is eligible for the government entity declared disaster or emergency SEP if they:

  1. Reside, or resided at the start of the SEP eligibility period described below, in an area for which a federal, state, or local government entity has declared an emergency or major disaster, or they do not reside in an affected area but rely on help making healthcare decisions from one or more individuals who reside in an affected area. 
  2. They were eligible for another election period at the time of SEP eligibility period; and 
  3. Did not make an election during that other valid election period due to the disaster or other emergency. 

Eligibility Period

This SEP is available until February 28, 2025, which is two full months after the conclusion of the emergency declaration on December 7, 2024. 

How to Use the Disaster SEP

When applying, be sure to reference the “Disaster Exception.”

In the enrollment application: 

  • Select “SEP” in the Special Enrollment field.
  • Enter the code “DST.” 
  • Include the date of the missed election period. Any changes made during the SEP will take effect on the first of the month following the receipt of the enrollment request.

This SEP is applicable only to residents in Colorado service areas impacted by the emergency declaration. Starting April 1, 2025, these changes must be processed directly through 1-800-Medicare.

Supporting Your Clients 
As an agent, you play an important role in guiding clients through this unique enrollment opportunity. Remember to:

  • Confirm that clients meet the eligibility criteria. 
  • Accurately complete and submit applications with the required SEP details. 
  • Reach out to Select Health’s Compliance team for clarification or assistance as needed. 

Let’s work together to ensure those affected by this disaster receive the support and coverage they need. If you have any questions, please reach out to your Sales Account Executive or the Medicare Advantage Agent Support (MAAS) Line at 801-442-7320.

Earn $50 for Helping Members Complete the Health Risk Assessment (HRA).

Encourage your Select Health Medicare Advantage enrollees to complete their HRA and earn a $50 incentive. HRAs help us understand new members' health concerns and offer the right resources and support. 

How to complete the HRA:

  1. Log in to Select Health Link. 
  2. Use the Member Search feature to find the member. 
  3. Complete the HRA within 14 days of the member’s enrollment to be eligible for the $50 incentive. 

DSNP Members Earn a Reward Too! Dual-Eligible Special Needs Plan (DSNP) members can also earn a $50 reward for completing their HRA. Encourage them to participate! 

Help your clients and secure your incentive. Log into Select Health Link today and get started! 

For questions, contact your Sales Account Executive, call the Medicare Advantage Agent Support (MAAS) line at 801-442-7320, or email MAAS@selecthealth.org.