Medicare Advantage Enrollment Options

Now that the Annual Enrollment Period is over, what can you do if a member finds themselves enrolled in a Medicare Advantage plan that isn’t a good fit for them?

Medicare Advantage Open Enrollment Period (OEP)

Starting January 1st and continuing through March 31st, if a member is enrolled in a MA/MAPD plan they have a onetime opportunity during the OEP to disenroll from their current plan and enroll in a different MA plan, MAPD plan, or even go back original Medicare and enroll into a PDP plan. Also, if they can pass underwriting, they could enroll in a Medicare Supplement plan.

The key to this enrollment period is the member must be enrolled in an MA or MAPD plan as of January 1st. And remember, CMS does not allow any advertising of the OEP to members.

Also note that OEP does not apply to members who have a Medicare Savings Account (MSA).

Medicare Advantage 5 Star Enrollment Period

Another enrollment period that may be available to you is the 5-Star Enrollment Period.

If your client lives in the service area of a plan that has a 5-Star rating for that current year, they have a one-time opportunity to dis-enroll from their current MA, MAPD or PDP and enroll in the new MA, MAPD or PDP plan. This is a 12-month enrollment period.

Also, if you have a member that is on original Medicare without a PDP, that member can also enroll in the 5-Star plan. (Late enrollment penalties would still apply if the member has gone 3 or months without a PDP). Minnesota has two 5-Star plans, HealthPartners in the Metro area and Quartz in the Southeastern part of the state.

If you have questions, please contact our Medicare team at 651.739.2010