The AEP Is Over, But There’s Still Plenty to Do

As we wave goodbye to the Annual Election Period (AEP) for Medicare Advantage and Part D plans, which concluded on December 7, you might be tempted to wind things down and enjoy the holidays. And while it is important to take a breather and spend time with loved ones in the coming weeks, it's also important to recognize that there’s still plenty of work to do. While the AEP is the busy time of year for many of us, the close of this period brings with it new opportunities, particularly in the individual market.

Individual Market Open Enrollment: November 1 – January 15

Currently, we're in the middle of the open enrollment period for the individual market. Like the AEP for Medicare beneficiaries, this is the one time each year that individuals can sign up for coverage on a guaranteed-issue basis without experiencing a qualifying event. This gives agents an opportunity to pivot their focus and assist additional clients before the window closes. Key dates to keep in mind include:

1. December 15 Cutoff: This is the enrollment deadline for individuals who would like a January 1 effective date, and it’s already passed. But don’t worry, there’s still time to help clients who haven’t yet signed up.
2. January 15 Cutoff: Those who miss the December 15 cutoff still have an opportunity to sign up for coverage with a February 1 effective date as long as they submit their application by January 15. In the past, December 15 was the last day to enroll, but the Biden administration expanded the enrollment period from six weeks to two-and-a-half months.

Of course, to sell individual health insurance products through the Marketplace (Healthcare.gov) and through state-based exchanges, agents do need to complete an annual certification requirement. There is no certification requirement for “off exchange” plans.

Medicare Advantage Open Enrollment and Other Enrollment Opportunities

Whether you choose to sell individual coverage or not, it’s important for agents who sell Medicare products to remember that the Medicare Advantage Open Enrollment Period runs from January 1 through March 31. This period allows individuals already enrolled in a Medicare Advantage plan to switch to a different Medicare Advantage plan or revert back to Original Medicare.

It's also worth noting that that some Medicare Advantage and Part D plans, specifically those with a 5-star rating, will accept applications any time during the year. Here’s more information from the Medicare.gov website:

“If a Medicare Advantage Plan, Medicare drug plan, or Medicare Cost Plan with a 5-star rating is available in your area, you can use the 5-star Special Enrollment Period to switch from your current Medicare plan to a Medicare plan with a “5-star” quality rating. You can use this Special Enrollment Period only once between December 8 and November 30 the following year.”

“Dual eligibles” can also change plans during the year. As Medicare.gov explains, Medicare beneficiaries who are also eligible for Medicaid can “join, switch, or drop” their Medicare Advantage Plan or Medicare drug coverage once during each of these periods:

• January–March
• April–June
• July–September

These enrollment opportunities can definitely keep agents busy during the “slow time” of the year.

Medicare Supplements: A Year-Round Opportunity

We should also remember that the AEP is designed for Medicare Advantage and Medicare Part D Prescription Drug Plans, not Medicare supplements. Medigap plans do not have an open enrollment period. This means eligible individuals can sign up all year long, provided they are relatively healthy and can successfully pass medical underwriting. Again, the fact that supplements are not restricted to a short five-week enrollment period like Medicare Advantage and Part D plans gives agents some sales opportunities throughout the year.

Unfortunately, Medicare beneficiaries normally cannot drop their Medicare Advantage plan during the year to move to a supplement. The exceptions are:

• if a client has had Medicare for less than a year, signed up for an Advantage plan right away, and now wants a Medigap plan, or
• if a Medicare beneficiary had a supplement, dropped it to join an Advantage plan for the first time, and changes his or her mind in the first twelve months.

Millions of New Medicare-Eligible Individuals

Last but not least, the Baby Boomer population continues to age into Medicare. As explained by Investor’s Business Daily, the U.S. Census Bureau projects that “about 12,000 people will turn 65 every day in the next year. That's about 4.4 million in 2024.” And, of course, this means that millions of new prospects will need help with their health insurance decisions. This expanding market presents a significant opportunity for agents to guide new beneficiaries through their Medicare choices.

Final Thoughts

While the AEP might have concluded, there are still a lot of opportunities for ambitious agents. Whether it's the last few weeks of the individual market's open enrollment period, the Medicare Advantage Open Enrollment Period, the year-round availability of Medicare supplements, or preparing for the influx of new Medicare beneficiaries, there's plenty to keep us engaged and busy.

At the same time, it's also important to strike a balance. The end of AEP is a perfect time to take a well-deserved break and enjoy the holiday season with your family. Taking the time to relax and rejuvenate is crucial; it’ll help us avoid burnout and give us the energy we need to get a great start to the new year.