The Medicare Advantage OEP. Here's what you need to know!

The Medicare Advantage OEP is from January 1 through March 31! During this time, clients currently enrolled in Medicare Advantage can switch to another Medicare Advantage Plan with or without drug coverage or drop their Medicare Advantage Plan and return to Original Medicare. For more details, read below:

Medicare Advantage Open Enrollment Period (OEP)

• Who can enroll during the OEP?

• Only clients currently enrolled in a Medicare Advantage (MA) plan can use the OEP. Ensure you understand your enrollee’s current coverage status before reviewing plan options with them. During the OEP from January 1 - March 31, MAPD and MA-only members can switch to:
  • An MAPD plan

• An MA-only plan

• Original Medicare (with or without a stand-alone PDP plan)

• Who can't use the OEP?

• Clients currently enrolled in a stand-alone PDP and those in Original Medicare cannot use the OEP to change their plan.

• Is there a limit to prospects' choices during the OEP?

• MA/MAPD clients can make only one plan choice during the OEP. Once they choose their plan and their new plan takes effect, they can't use the OEP again, even before the March 31 deadline. Find out if your MA/MAPD member has already used their one plan choice during OEP.

• Where can I find additional rules and information?

• Medicare Advantage organizations and Third-Party Marketing Organizations (TPMOs) are subject to specific restrictions regarding who they market to and how they market during OEP. Refer to CMS's Medicare Communications and Marketing Guidelines for details. Get more information on OEP here.

Accessible Format Special Election Period (SEP)

• What is the Accessible Format Special Election Period (SEP)?

• The Accessible Format SEP (enrollment code ACC) is considered a SEP for "exceptional conditions." It is intended to support clients who need their CMS/Medicare Advantage (MA) materials provided in an accessible format but experience a delay in receiving them.

• When can this SEP be used?

• The SEP begins at the end of the election period, during which the enrollee sought to make an election. You may only use this SEP when all of the following conditions are met:

• The enrollee requested that required notices or information be provided in an accessible format such as large print, Braille, or audio.

• They do not receive the material within the same timeframe that CMS/the MA plan provided the material to other individuals who did not request an accessible format.

• The enrollee consequently had less time than other enrollees to make an enrollment decision during a given election period.

• What additional information must you obtain for this SEP?

• If this SEP is used, you must obtain information from the enrollee regarding the general content and format of their requested material so that these details can be retained as part of the recorded enrollment call.