What is Medicare Advantage Open Enrollment Period (OEP)?

OEP FAQs: What is OEP?

OEP is an election period from January 1 to March 31 that allows current Medicare Advantage plan beneficiaries to make changes to their plan. Beneficiaries may either switch MA plans (“apples to apples” change only – ex: HMO to HMO, HMO DSNP to HMO DSNP) OR disenroll from a MA plan and obtain coverage through Original Medicare. Beneficiaries may also add or drop PDP coverage if switching back to Original Medicare. A beneficiary cannot use the OEP election to change from an HMO to a PPO, PPO to HMO, etc., they would have to have a true Lock-in SEP to be able to do that type of change.

What plan types can MA beneficiaries switch to?

Beneficiaries can switch to an MAPD, MA only or Original Medicare. Beneficiaries may also add or drop PDP coverage if switching back to Original Medicare.

Can an individual who is currently enrolled in Original Medicare use OEP to join an MA plan?

No. OEP is only for those who are currently in an MA plan.

When is the effective date for an MA OEP election?

The effective date will be the first of the month following receipt of the enrollment application (for example, if the enrollment signature date is January 10, 2022, the effective date of the policy will be February 1, 2022).

What is the process to determine a beneficiary’s eligibility?

‍Eligibility is determined through the standard process; however, the beneficiary must reach out to an agent regarding OEP.

Can eligible beneficiaries use their OEP election more than once?

‍No. The election can only be used once, and the first application received by CareValue is the application that will be processed and will determine the AOR. Additional applications received after that will be rejected.