OEP Dos & Don’ts
January 1st through March 31st
The Medicare Advantage Open Enrollment Period (OEP) is officially underway, and while it offers beneficiaries a valuable opportunity to make one change, it also comes with strict CMS marketing and communication rules. To keep you compliant and productive, here’s a quick guide to what you can and cannot do during OEP.
OEP DOs
These actions are allowed and encouraged—when beneficiary-initiated.
DO Assist Beneficiaries Who Contact You First
If a Medicare Advantage enrollee reaches out during OEP, you may:
- Review their current plan
- Compare options
- Complete an enrollment into another MA plan or Original Medicare (with/without Part D)
- Provide plan details, formularies, networks, and drug comparisons
Key condition: The contact must be initiated by the beneficiary, not you.
DO Educate Broadly (Not MA-Specific)
You may share:
- General Medicare education
- Information about enrollment periods
- Materials that help consumers understand their rights
As long as it’s not tied to specific MA plans.
DO Respond to Questions About MA or PDP Plans
If a member asks for information about:
- Benefits
- Cost changes
- Provider access
You may answer and provide full plan comparison information.
DO Document SOAs & Follow Normal Enrollment Protocols
A valid Scope of Appointment is still required for any personal MA or PDP discussion.
OEP DON’Ts
These actions are strictly prohibited by CMS during OEP.
DON’T Conduct Outbound Marketing for MA Plan Switching
You cannot contact beneficiaries with messages like:
- “Now is a great time to review your plan.”
- “You may be able to get better benefits during OEP.”
- “Your plan may not be the best option—let’s compare.”
No cold calls, texts, emails, flyers, or ads encouraging MA changes.
DON’T Target MA Members with Plan-Specific Benefits
Examples of prohibited targeting:
- “If you’re on Plan X, you might be missing out on…”
- Marketing aimed at members of poor-performing plans
- Mailers encouraging “upgrades” or “improved benefits”
DON’T Host Events Designed to Drive OEP Switching
Educational events are okay, but sales events promoting MA changes during OEP are not.
DON’T Mislead Beneficiaries About What OEP Allows
Avoid statements implying:
- Unlimited plan changes
- Guaranteed improved benefits
- That OEP is similar to AEP
- Liability if they don’t switch
Beneficiaries get one MA-to-MA or MA-to-OM change.
DON’T Create Ads That Reference OEP or Imply Availability of Better Plans
Prohibited phrases include:
- “Open Enrollment is here—switch now!”
- “You may be eligible for more benefits this time of year!”
- “Take advantage of OEP to find a better plan!”
Agent Best Practices
- Document all beneficiary-initiated contact
- Use neutral language: “If you’d like a review, I can help at your request”
- Protect PHI and follow SOA rules
- When in doubt, keep communication educational, not promotional
Sample Language for Agents
Compliant Response Example:
“If you would like to review your Medicare Advantage options, I’m happy to help at your request. OEP allows a one-time change between January 1 and March 31.”
Non-Compliant Response Example:
“You should review your plan now—there may be better benefits available.”
Final Takeaway
OEP is a valuable time to support existing MA members—but only when they request assistance. Staying compliant not only protects your license but builds trust with beneficiaries and strengthens long-term relationships.
Charle Howard, Manager of Provider Referral Operations and licensed insurance agent