The complicated rules and regulations for the Medicare enrollment periods make it difficult to navigate through the plans. As of now, the Centres for Medicare & Medicaid Services ( CMS) has selected four periods when Medicare-eligible individuals can enroll for Medicare plans or even switch their current ones. These are:
- Initial Enrollment Period (IEP)
- Annual Enrollment Period (AEP)
- Open Enrollment Period (OEP)
- Special Enrollment Period (SEP)
Each Medicare enrollment periods have sets of rules and limitations for clients and insurance agents.
1. Initial Enrollment Period for Medicare (IEP)
The IEP varies from person to person because it depends on their birthdate. For Medicare-eligible people, the IEP starts three months before their 65th birthday. It also includes the birthday month and three months after their birthday, concluding IEP as 7 months. Seniors can enroll for Plan A and/or Part B plans during these 7 months. However, seniors attaining services like social security from the government automatically register in Medicare Part A without paying any premiums. However, other seniors have to enlist manually. As for Part B of the Medicare plans, all enrollees have to reimburse premiums. It is more similar to what conventional health insurance seems to be. Keep in mind that the seniors will have to pay penalties on delay in both Part A and Part B.
2. Annual Enrollment Period for Medicare (AEP)
AEP spans from October 15 to December 7. However, the planning and arrangements start from June. Due to its significance, AEP becomes the busiest time for insurance agents, making the competition in the industry incredibly strong. That’s why you should find an efficient marketing plan to boost your closing rate. As reported by the CMS, no insurance agent or company has legal permission to advertise AEP until October 1. Such a short limit makes it hard, even impossible, to find exclusive leads. However, you can always find ways to stimulate the market without actual campaigns.
Start communications with prospective customers in mid-September. But at the same time, agents must learn what’s allowed and what’s not.
All the advertisements must be ambiguous before October 1. Agents must not use door-to-door or telephonic solicitation. There are many other guidelines that insurers have to follow. Like, at marketing campaigns, only light snacks should be given, not proper meals, etc.
3. Open Enrollment Period for Medicare (OEP)
As for OEP, it starts on January 1 and ends on March 31. OEP has more limitations than AEP, mainly because it allows Medicare enrollees to improve their existing plans.
Due to this, there are many restrictions when discussing OEP, and agents can’t publicly advertise or market OEP.
Agents are allowed to:
- Prioritize enrollment period when marketing only
- Send marketing emails or ads at the request of a potential client
- Give out details about OEP through call centers when requested
- Advertise to seniors below 65
Agents aren’t allowed to:
- Purposely use OEP to boost sales
- Reach out to enrollees who’ve already chosen a plan during AEP
- Knowingly victim Medicare Advantage and Part D enrollees
Special Enrollment Period for Medicare (SEP)
SEP is for enrollees under certain special circumstances only.
Eligibility criteria for SEP:
A Medicare enrollee is eligible for the SEP if:
- They shift to another place
A client who moves to an area that their plan doesn’t cover moves back to the USA from a foreign country, resides in a foundation (like nursing homes, etc.), or gets released from jail, is eligible for SEP.
- They lose their health coverage
A client who becomes ineligible for Medicaid, left their insurance agent or service provider, unintentionally lost their Medicare plan, denounced a cost plan providing drug coverage, or canceled a program, like the Program of All-Inclusive Care for the Elderly (PACE), is eligible for enrolling during SEP.
- Their plan modifies due to Medicare
If Medicare cancels a client’s plan because of some issue, they are eligible to apply in SEP.
- Some other circumstance occurs
Some other situations also make seniors eligible for enrolling during SEP. It includes global pandemics, severe and disabling conditions recognized by the SNP, unjustly suggested by a federal employee, etc.
