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Medicare OEP Open Enrollment Period

The Medicare Open Enrollment Period (OEP) runs annually from January 1 to March 31. It is specifically for individuals already enrolled in a Medicare Advantage (Part C) plan as of January 1.

This period does not apply to those with Original Medicare (Part A and B) only; it’s strictly for Medicare Advantage plan members who may want to make a one-time change.

What Changes Can You Make During OEP

Those enrolled in a Medicare Advantage plan, can make one change during the OEP. The options include:

• Switching to a different Medicare Advantage plan, with or without drug coverage
• Dropping your Medicare Advantage plan and returning to Original Medicare, with the option to add a Part D prescription drug plan

Changes You Cannot Make:

• Switch from Original Medicare to a Medicare Advantage plan
• Enroll in Part D drug coverage if you’re on Original Medicare and missed your IEP or AEP
• Make multiple changes; OEP only allows one switch

Watch a video on Medicare enrollment periods

Why Use the OEP

Here are a few common reasons beneficiaries take advantage of the Medicare OEP:

• Their current Medicare Advantage plan doesn’t cover a needed medication or provider
• They discovered higher costs or restrictions after using the plan in January
• They had a change in health and want a different plan with better specialist coverage
• They were unaware of better plan options during the Annual Enrollment Period (AEP), which runs from October 15 to December 7

How Is OEP Different from AEP

Important Considerations

• If you switch to Original Medicare during OEP, you may not be guaranteed Medigap (Medicare Supplement) coverage; unless you’re in a trial right or qualify for a Special Enrollment Period.
• Any changes made during the OEP become effective the first day of the month after the change is made (e.g., a change in February takes effect March 1).
• It’s important to review coverage early in the year to determine if your current plan still meets your needs.

Work with a Licensed Agent

The Medicare OEP is a valuable but limited opportunity to make corrections or improvements to your coverage. If you’re unsure whether your plan fits your health needs or budget, speak with a licensed Medicare agent. They can help you compare options, check provider networks and drug formularies, and make confident decisions about your healthcare.

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As AEP draws to a close some agents wonder what’s next. OEP is next, and we will go over a few reasons why Medicare OEP 2025 is important. After AEP, many agents want to take a break, we will discuss why this is not a great idea.

Click here to watch a YouTube video on Medicare OEP best practices

What enrollees can do during MA/MAPD OEP

First, we will discuss what you can do during the Medicare Advantage OEP. The OEP takes place from January 1 and goes through March 31 each year.

Those enrolled in a Medicare Advantage plan of any type can change from one MA/MAPD plan to another.

MA/MAPD plan enrollees can opt to disenroll from their plan and enroll in Original Medicare. If they opt to enroll in Original Medicare, they can add a PDP plan and possibly a Medicare Supplement plan. Please keep in mind, the Medicare Advantage OEP does not create a guaranteed Issue period for MS plans in underwritten states.

What enrollees cannot do during MA/MAPD OEP

Another important thing about the MA/MAPD OEP is knowing what you cannot do.

Beneficiaries enrolled in Original Medicare cannot enroll in an MA/MAPD plan. To take advantage of the MA/MAPD OEP, the beneficiary must be enrolled in some type of Medicare Advantage plan.

Plan enrollees cannot change plans more than once during this enrollment period.

Why the Medicare OEP 2025 is important

The 2025 OEP is especially important because of the amount of changes that are taking place. Many clients may decide to stay in their current plan and did not realize their plan had changed. Some plans have lost or lowered benefit amounts for specific services.

Because in 2025, Dual eligible plan enrollees do not have a quarterly SEP unless they change into an integrated plan, they may need to use the OEP as a way to make a plan change.

Watch a YouTube video on Dual Partial Dual and LIS member changes

Please note; Some plans have been discontinued for 2025. When this is the case, anyone enrolled in a discontinued plan should use an SEP for a plan term. The SEP for plans terminating runs from 12/8 through 2/28.

As always this is another way for agents to be sure their clients are happy with the plan they chose during AEP. If they are not, you have another chance to ensure they find a plan that provides the coverage they are looking for.

Things agents can and can’t do during MA/MAPD OEP

There are some things agents can do during the OEP (Jan 1 – March 31). They can market to people turning 65; this is what they should be doing year round. It is also market to anyone with an SEP. Agents can also check on clients to ensure they are happy with their plan choice and offer to answer any questions they have.

Click here and learn about SEPs

Agents cannot actively market the OEP. This includes sending beneficiaries communications about making changes using the MA/MAPD OEP specifically.

Medicare Advantage plans, also known as Medicare Part C, are popular choices for seniors who want Additional benefits not offered by Original Medicare. However, choosing the right plan means understanding the enrollment periods, each of which has specific rules and dates. Here’s a breakdown of the Medicare Advantage enrollment periods and who is eligible to use them.

IEP (Initial Enrollment Period)

The Initial Enrollment Period is the first opportunity for beneficiaries to enroll in a Medicare Advantage plan. The IEP is a seven-month period is when beneficiaries first become eligible for Medicare, which generally happens when they turn 65. It includes:

1. The three months before their 65th birthday month
2. Their birthday month
3. The three months that follow their birthday month

During this time, they can enroll in Medicare Parts A and B and a Once both are in place, they may decide to enroll in a Medicare Advantage plan. This period is very important to ensure beneficiaries enroll in coverage that includes Part D (prescription drug) coverage to avoid facing potential penalties. One way to avoid this is to include an MAPD (Medicare Advantage Prescription Drug Plan).

AEP (Annual Enrollment Period)

The Annual Enrollment Period, often called the Open Enrollment Period, runs from October 15 to December 7 each year. During AEP, Medicare plan enrollees can make changes to their Medicare Advantage, prescription drug plans, or Medicare Supplement plans including:

1. Switching from Original Medicare to a Medicare Advantage plan
2. Changing from one Medicare Advantage plan to another
3. Moving from a Medicare Advantage plan back to Original Medicare
4. Changing from one Prescription plan to another

This period allows enrollees to review and adjust healthcare coverage based on current health needs and changes to the following year’s Medicare plan options.

MA-OEP (Medicare Advantage Open Enrollment Period)

The Medicare Advantage Open Enrollment Period takes place annually from January 1 to March 31. However, this period is only available to individuals who are already enrolled in a Medicare Advantage plan. This period It allows for limited changes, including:

• Switching to a different Medicare Advantage plan
• Dropping a Medicare Advantage plan and returning to Original Medicare (with the option to add a Part D prescription drug plan)

Please note; during the MA-OEP, enrollees can only make one change and cannot switch from Original Medicare to a Medicare Advantage plan. This period is a great way to change plan choices for those who discover their current Medicare Advantage plan doesn’t meet their coverage needs.

SEPs (Special Enrollment Periods)

Special Enrollment Periods are triggered by specific life events, these events provide an opportunity to make changes outside the regular enrollment periods. Common scenarios that qualify for SEPs include:

1. Moving: Enrollees who move to a new address outside their plan’s service area, can switch to a plan in the new service area
2. Loss of employer coverage: Those who lose employer-based health coverage qualify for an SEP
3. Qualifying for financial assistance: Enrollees who qualify for some financial assistance programs such as Medicaid or Part D Extra Help, may be eligible for an enrollment period
4. Moving in or out of a nursing home
5. Enrollees whose plan goes out of business
6. Weather or disaster related emergencies that cause enrollees to miss a valid enrollment period

These SEPs allow enrollees to adjust their Medicare Advantage coverage to meet their needs. This ensures beneficiaries are not left without the necessary coverage.

Five-Star SEP

All Medicare Advantage and PDP plans are rated on a scale of one to five stars, with five stars representing the highest quality. Beneficiaries can switch to a five-star Medicare Advantage plan if there is one is available in their area. They can do this even when they are outside a normal enrollment period. Enrollees can use this opportunity only once per year, from December 8 through November 30.

This SEP encourages beneficiaries to look for the highest rated plans. This encourages plan providers to provide higher levels of service and benefits.

Click here to download medicare.gov understanding Medicare Advantage Plans booklet

How to make the most of the Medicare Advantage enrollment periods

1. Review coverage annually: Health needs and plan costs change year-to-year, so it’s beneficial to reassess coverage options every AEP.
2. Consider budget and health needs: Look closely at premiums, out-of-pocket costs, the provider network and medication coverage (if appropriate) when evaluating plans.
3. Use SEP opportunities wisely: Major life changes can unlock SEP opportunities. Be sure to act within the timeframe allotted when these events occur.
4. Compare plan ratings: Medicare’s plan rating system provide insight into quality and satisfaction levels of available plans. Switching to 5-star plan can give enrollees peace of mind.

Navigating Medicare Advantage enrollment periods may seem overwhelming, but understanding these opportunities can help ensure that enrollees are in the best possible plan for their healthcare needs.

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There are only certain times when you can enroll/dis enroll or change a Medicare Advantage plan. Note that Medicare Advantage plans are sometimes called Medicare Part C or an MAPD plan.   There is a general period when someone turns 65 in which they can enroll.  This time frame is 3 months before the month they turn 65, the month they turn 65 and three months after they turn 65.  There is also the AEP period during which current members can make any type of plan change. This period runs from October 15th to December 7th every year. During this time, an application can be put in to make a change for a January 1 effective date.   The last type of period is the SEP period (Special Election Period) in which a change can be made at any time during the year.  Click on the link below for access to a grid showing all elections.

Medicare election period cheat sheet