The New and Improved Open Enrollment Period

Now as a part of the CMS Final Rule, Medicare beneficiaries have the option to switch into a different Medicare Advantage plan after AEP is over and done.

Previously, the only way beneficiaries could switch plans outside of the Annual Enrollment Period was either if they had a Special Enrollment Period or if they were using their trial rights. However, trial rights only allowed beneficiaries to switch from a Medicare Advantage plan to a Medigap plan (or Medigap to MA) if they decide after AEP that they need more or less coverage. The time period to make that switch is only from 60 days before their MA plan expires to 63 days after it ends – a small window that most beneficiaries don’t even know about!

Now, the Open Enrollment Period (OEP) will allow beneficiaries to change their minds (once) from January 1 through March 31. This will help prevent the frustration that comes with not fully understanding a plan until after it’s too late.

Pros and Cons

There really isn’t a “con” to this new rule for the beneficiaries, but there could be for you. If you enroll a beneficiary into a Medicare Advantage plan that doesn’t really work for them when there are better options available, they may turn around and buy from someone else during the Open Enrollment Period. This makes accuracy and honesty even more important for you than ever before, for retention.

On the “pro” side, you can pick up another agent’s slack. Open Enrollment is going to be the time for you to check in with your clients and make sure that they are still happy with their choices post-AEP. If they’re not, make sure you help them make a change before someone else does.

Preparing for Open Enrollment

What does this mean for you and your book of business? It means you’ll have to prepare for post-AEP instead of taking a month-long Christmas break! And, you’ll have to be EXTRA sure that you’ve gone over everything with your clients during AEP – costs, networks, formularies, benefits, etc. Make sure that your clients who don’t want to switch doctors don’t have to. Make sure that all of their drugs and necessary treatment options are covered. Make sure that their plan really WORKS.