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How You Can (and Cannot) Help Members During Medicare Advantage Open Enrollment Period

Dec. 31, 2025

Applies to Medicare Markets

Medicare Advantage Open Enrollment Period runs Jan. 1 to March 31. It gives current Medicare Advantage enrollees a one-time opportunity to make a coverage change if their current plan isn’t meeting their needs.

What This Means for Members

During this time, Medicare Advantage (MA) enrollees can make one of the following changes:

  • Switch to a different MA plan, or
  • Drop their MA plan and return to Original Medicare. When returning to Original Medicare, they are allowed to also elect a Prescription Drug Plan.

However, these changes are not allowed to:

  • Switch from Original Medicare or Medicare Supplement to a MA plan.
  • Join or switch PDPs if the beneficiary started the year in Original Medicare.

OEP Sales Do’s and Don’ts for Producers

The Centers for Medicare & Medicaid Services prohibits unsolicited or targeted marketing to MA members and promoting the OEP itself.

To stay compliant, do not:

  • Send unsolicited ads, mailers, emails, etc. to current MA enrollees.
  • Advertise the ability to make an enrollment change or mention the OEP as a sales opportunity.
  • Use purchased lead lists to target members who changed plans during Annual Enrollment Period (Oct. 15 - Dec. 7)
  • Contact former clients who enrolled under another producer during AEP.

Big picture

Your marketing outreach must be generic – your name, your contact info and an invitation for members to reach out with questions.

What you can do:

  • Respond to member-initiated requests.
  • Meet one-on-one with beneficiaries who ask for help.
  • Focus marketing to clients who qualify for other enrollment opportunities.

Additional Enrollment Opportunities to Focus On

Consider your sales efforts on other enrollment periods that don’t have marketing restrictions like OEP.

Initial Enrollment Period

Applies to individuals turning 65 or newly eligible for Medicare. IEP runs 7 months (3 months before an individual’s 65th birthday, their birthday month and 3 months after). It allows beneficiaries to enroll in an MA, Medicare Supplement and/or a PDP plan for the first time.

Special Enrollment Periods

Triggered by certain qualifying life events, SEPs allow beneficiaries to make changes outside AEP.
Common SEPs include:

  • Moving outside of the plan’s approved service area
  • Entering or leaving a qualified institution, such as a nursing home
  • Qualifying for low-income subsidy assistance (Extra Help)
  • Enrolling in Medicaid
  • Plan non-renewals and terminations
  • Loss of employer or union coverage
  • Affected by a state or FEMA declared disaster or emergency

Bottom Line

OEP is not about making new sales. It’s about helping your current MA clients get coverage that works for them. If you have questions or need clarification, contact your regional sales representative.