Medicare cost-sharing

Charlie Ferrell, National Sales Manager

About the Author: Charlie started his senior insurance career after a brief 30-year stint in the restaurant industry. In the 12 years since then, he has been blazing trails and setting standards for excellence all over! A native of Utah, he has been a state manager for RBI as well as an MGA for UHC, Coventry, Molina and other carriers! Charlie came to RBI as the National Sales Manager in 2015, and has been dubbed the “Medicare Encyclopedia” our staff and agents alike. Charlie specializes in the Dual-Eligible market and is leading the charge behind many of RBI’s new training initiatives!

MA-OEP is Back!

Beginning this year the Centers for Medicare & Medicaid Services (CMS) have given Medicare Advantage (MA) beneficiaries an additional enrollment period called the Medicare Advantage Open Enrollment Period (MA-OEP.) The beneficiary must currently be enrolled in an MA plan in order to take advantage of the MA-OEP, as it does not apply to PDP only members.

What this means for Beneficiaries

Each year, starting on January 1st, Medicare Advantage members will be able to make a one time plan change through March 31st of each year.

Agents that have been around for a while remember that the MA-OEP was critical for people who failed to change plans during the Annual Election Period (AEP) or those who made the wrong choice and only realized it when they tried to use their plan in January. This new enrollment period is an added layer of protection for beneficiaries who don’t know their plan will be changing, or don’t go into detail when looking at how their plan is changing. It seems I always have at least one client who calls me once the new year starts saying that “my doctor doesn’t accept XYZ carrier anymore,” (never the numerous voicemails I left wanting to go over how their plan will be changing in the new year…) Now I no longer have to regrettably tell my client that they missed the boat!

It’s in your and your Client’s best interest

For new agents who have yet to experience an MA-OEP, you might be scared that all your your new clients could leave and all of your commissions would be charged back and … you would be right! This puts more burden on you the agent to put them in the correct plan in the first place, which is a good thing if you ask me! Make sure you call your clients the first week in January and find out if their plan is working correctly for them. MA-OEP gives you a chance to correct plans if you find out that your client’s doctors are no longer in network after the first of the year. It also allows YOU to market yourself and gain new clients from those agents that are not returning phone calls or following up on their clients needs.

How does the MA-OEP protect your business?

It never fails that I have someone call me after December 7th saying they want to sign up for the plan now and I have to tell them “It’s too late, you are locked into your current plan until the end of next year unless you move out of the county.” Even worse is the client that calls me in January looking for my help and another agent put them on a different plan just to make a commission. I have had it happen. An agent “stopped by” just to go over her Medicare even though she told them she had an agent and was already signed up. Next thing you know they are on a different plan and I can’t help them. MA-OEP gives you the chance to keep that business and allows you to inoculate your clients from agents that want to poach your business. It forces you to do your job… or someone else will do it for you!

21st Century Cures Act

The 21st Century Cures Act was signed into law by congress brought back the Medicare Advantage Open Enrollment Period. The law also prohibits carriers and individuals from advertising to consumers to utilize the MA-OEP to change plans. It’s up to us to educate our clients and potential clients of the upcoming changes. If you have a penchant for reading ridiculously long and boring Congressional Statutes, then you can read about this new law in its entirety right here!

Keep up to date with the latest in Medicare news by subscribing to our blog on the right hand side of your screen! 

2022 AHIP
2020 ahip discount certification
Medicare cost-sharing
2019 Medicare Broker Compensation