CMS introduced a new enrollment period effective from January 1st, 2019 called Medicare Advantage Open Enrollment Period (MA OEP).
The MA OEP offers an additional opportunity for people enrolled with Medicare Advantage plans to change their coverage.
It is actually replacing the election period known as the Medicare Advantage Dis-enrollment Period (MADP), which used to run from January 1st to February 14th and allowed Medicare beneficiaries to go back to Original Medicare from Medicare Advantage Plans, but it did not allow them to change from one Medicare Advantage plan to another. But by using this MA-OEP Medicare beneficiaries can use a period called the Medicare Open Enrollment Period (OEP) to make a one-time change.
What?
The MA-OEP allows beneficiaries who are enrolled in a Medicare Advantage Plan to make a one-time change. Beneficiaries can use the Medicare Advantage OEP to:
- Switch from one Medicare Advantage plan to another Medicare Advantage plan (with or without Part D).
- Dis-enroll from a Medicare Advantage plan and return to Original Medicare, with or without a Part D drug plan
Why?
Life always offers you a second chance and while choosing right Medicare Advantage Plans, the second chance is called MA-OEP. Let me tell you how?
The reason for this MA Open enrollment Period might be to provide beneficiaries’ a second change to make a right choice. Medicare beneficiaries are often feel confused about Medicare Advantage plans, and once you enrolled into a Medicare Advantage Plan in Annual Enrollment Period (AEP) or in Initial enrollment Period (IEP), it locks you in for a whole calendar year and you get stuck in a plan that you may not be happy with.
Now the question is what is the enrollment period for MA- OEP?
Contrary to the popular belief Enrollment Period for MA OEP is not just January 1 – March 31 each year. Let’s see what we have (below) in CMS website before going to detail about it;-
Who ?
So, there are two categories of beneficiary who are eligible to use MA- OEP
- Medicare beneficiaries enrolled in Medicare Advantage as of January 1 have an opportunity to make a change
- So now Individuals enrolled in MA plan can following changes during MA – OEP
- Newly MA- Eligible member
When?
Let’s discuss that with examples
Example 1:
A beneficiary’s 65th birthday is on April 5th, 2019, and she is eligible for both Part A and Part B on April 1st.
Her Initial Coverage Election Period (ICEP) is 3 months before, the month of, and 3 months following the month of entitlement: Jan 1 – July 31, 2019.
She enrolls in an Medicare plan effective April 1st.
MA OEP for her begins the month of entitlement to both Part A and Part B (April) and continues through the last day of the 3rd month of entitlement (June). So her MA OEP runs from April 1 – June 30.
Example 2: A beneficiary’s 65th birthday is Feb 11th, 2019, and she is eligible for both Part A and Part B beginning Feb 1, 2019. But since she continues working, she didn’t enroll in Part B until she retires. She uses the Part B SEP to in enroll in Part B, August 1st, 2019. •
Her ICEP is from 3 months before Part B effective date to Part B effective Date: May 1 – July 31, 2019.
So she enrolled in Medicare Advantage Plan effective August 1, 2019.
MA OEP for her begins the month of entitlement to both Part A and Part B (August) and continues through the last day of the 3rd month of entitlement to both Part A and Part B (October). In other words, her MA OEP runs from August 1 – October 31.
What you can do?
- Elect to change from one Medicare Advantage Plan to another;-
- MA to MAPD
- MAPD to MAPD
- MA to MA
- MAPD to MA
- Drop your Medicare Advantage Plan and return to Original Medicare
- MA/ MAPD to Original Medicare (with or without Standalone Part D)
The effective date for an MA OEP election is the first of the month following receipt of the enrollment.
What you cannot do?
The MA OEP does not provide an opportunity for an individual enrolled in Original Medicare to join a MA plan.
It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand-alone Part D plans.
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