What is Healthcare Open Enrollment?

Senior women resting with Service Dog

Share this Content

Open Enrollment is one of the trickiest parts of health insurance and Medicare. We are here to give clarity around the term because different enrollment periods utilize this phrase. The three periods that exist and utilize the words “Open Enrollment” are:

These can often overlap other enrollment periods and have similar names, so let’s deeply dive into each one.

Medicare Supplement Open Enrollment (OE)

Medicare Supplement Open Enrollment is an enrollment period that starts when a Medicare beneficiary turns 65 or when their Medicare Part B becomes active. This period is critical because it can be some people’s one shot at getting a Medicare Supplement or Medigap Plan without answering any health questions.

This is essential for people who are currently or might be in poor health in the future. Medigap plans are accepted anywhere Medicare is, and no additional prior authorization is needed with claims. They pay (depending on the plan letter or a la carte design) almost all of the out of pocket associated with Medicare Parts A and B.

This version of Open Enrollment can be used in most states up to 6 months before and after the spark date. The effective date can only be the day or six months after the spark date. The effective date on a Medigap policy does not have to be on the first of the month with most insurance carriers. An exception is UnitedHealthcare/AARP because they require it to be on the first of the following month when the application is submitted.

If you are someone who will be in this period soon, it is pertinent that we make sure you have all of the information available to you in order to get you making the proper decision for your situation. Please schedule an appointment with us or call us at 662-844-3300. We understand that people who find these articles are typically folks who like to do a lot of research, but thankfully our agents meet every day to train on these topics. We can help!

Medicare Advantage Open Enrollment Period (MAOEP)

The Medicare Advantage Open Enrollment Period (MAOEP) has existed for quite some time, but the recently brought it back from the dead due to a lot of people needing to untangle mistakes they made in the Annual Election Period (AEP). The MAOEP exists to fix these issues so some of the things that can be done in AEP cannot be done during this period.
MAOEP starts January 1st and ends March 31st. If a Medicare beneficiary makes a change using this period, the change takes effect on the first of the following month. Changes that can be made using this enrollment period are as follows:

  • Change from one Medicare Advantage Plan to another Medicare Advantage Plan
    •Change from Medicare Advantage to Original Medicare (which would allow the beneficiary to use a Special Enrollment Period (SEP) to enroll in a stand-alone Part D plan)

One of the issues with using MAOEP to change back to Original Medicare is most people would not be guaranteed to be eligible for a Medicare Supplement or Medigap Plan. Since Original or Traditional Medicare has no out of pocket maximum or cap on potential risk exposure, we recommend either having a Medicare Advantage Plan or a Medicare Supplement Plan to protect the beneficiary from unlimited exposure to medical bills.

If you have found yourself in a pickle and are trying to find an enrollment period like MAOEP to get yourself out of it, you can call us at 662-844-3300 or sschedule an appointment with us. We have helped thousands escape bad advice from cookie-cutter call center agents.

Affordable Care Act Open Enrollment Period (OEP)

This period is the only one specifically named Open Enrollment Period. It is for choices related to the Affordable Care Act (ACA), also known as Obamacare Plans. The period also becomes a frenzy for products unrelated to ACA. Many people get duped into buying unregulated plans with extreme pre-existing condition requirements or no Major Medical stop loss or Maximum Out-of-Pocket component.

ACA Open Enrollment starts November 1st of each year and is currently set to end January 15th of the following year. If someone enrolls between November 1st and December 15th, their policy will go into effect January 1st. If they enroll between December 16th and January 15th, their policy will start February 1st. Any previous ACA policy they had would be automatically terminated courtesy of the Marketplace.

Bobby Brock Insurance is well known nationally for Medicare, but we have also helped thousands of people navigate the Affordable Care Act plans.
If you are shopping for these plans, you can shop through our Electronic Direct Enrollment partner link here: To self-enroll, click here or give us a call at 662-844-3300 for immediate assistance.

Remember, the Affordable Care Act is primarily for people under 65 and not eligible for Medicare. However, there are situations where Medicare beneficiaries still qualify for subsidies on the marketplace. One example is people who do not qualify for Premium Free Part A can still receive a subsidized marketplace plan past age 65.

Honorable Mention: Annual Enrollment Period (AEP)

The Annual Enrollment Period is often referred to as Open Enrollment, though it technically is not called that at all. This period is from October 15th to December 7th and is when Medicare beneficiaries can change their drug plan, Medicare Advantage Plan, change from Original Medicare to Medicare Advantage or from Medicare Advantage to Original Medicare. This is the busiest enrollment period for Medicare by far. Many insurance companies refer to it as the Fall Surge.
Some tips on this enrollment period include:

  • Review your Annual Notice of Change (ANOC)
  • If you have a quality agent, request an appointment to review your coverage.

If you do not have an agent, call us at 662-844-3300 or schedule an appointment with us.

Medicare is a robust pile of bureaucratic garble compounded over time with contributions from both sides of the aisle. Navigating it without an experienced agency that follows all Centers for Medicare and Medicaid Services compliance requirements and who has proper Errors and Omissions coverage is not advisable. You can read about this stuff for days and days and still find yourself feeling overwhelmed. It indeed is a long career for many people, and rightfully so. You can trust our large, well-trained team. If you don’t believe us, check out our reviews here:

 

Related Blog Posts

Picture of Justin Brock

Justin Brock

President & CEO of Bobby Brock Insurance