AEP is Over. Now What?

By: Rachel Brammeier

6 Things to Consider After AEP

1. The Service Area Reduction SEP starts December 8th and goes through to the end of February. This is a ONE-TIME election SEP for the client. A copy of the non-renewal notice is needed to submit, and the enrollment will begin the 1st of the following month. The best way to find the plans that are non-renewing is to pull the crosswalk data from CMS, then filter the Current Contract (column F) to Deleted (DEL).

2. Dual Special Needs Plan SEPs Blackout Period. Normally a Medicaid and/or LIS Eligible can get one election per calendar quarter, but in the 4th quarter AEP is used. This means from December 8th – December 31st, a dual eligible individual cannot move and is in a blackout until January when they can use the Dual SEP again. Check out our Dual-SNP Enrollment Blackout Period Guide

3. The Open Enrollment Period SEP is a one-time election that goes from January 1st to March 31st, but it CANNOT be advertised (see Medicare Communication and Marketing Guidelines § 422.2263(b)(7), 423.2263(b)(7)). A common misconception is OEP is a guaranteed issue period for a Medicare Supplement plan. This election can be used to move people from MA/MAPD to a PDP, but the client must qualify through underwriting on the Medicare Supplement plan. Ensure that the Medicare supplement plan is in force and active before using the OEP SEP for their Part D. The OEP SEP is not available for PDP or MSA plans. Check out our OEP Quick Reference Guide!

4. The Federal Health Emergency (FHE) will likely extend again on January 11th for another 90 days. The FHE was created to help those during the COVID-19 health crisis keep their Medicaid eligibility even if they no longer qualify. When the FHE ends, states will be able to re-evaluate their Medicaid qualifications and terminate those who no longer meet those qualifications. The estimate is 18 million people could lose Medicaid.

5. NEW FOR 2023: The Part B Immediate Enrollment in 2023. If your client is in their Initial Election Period for Part B (first 3 months of their IEP), the coverage now begins the first of the following month. Clients can also use the General Enrollment Period (GEP) and the coverage will now start the 1st of the following month.

6. NEW FOR 2023: Parts of the Inflation Reduction Act go into effect. Starting January 2023, vaccines recommended by the ACIP, like Shingles, COVID, and Flu, will be available to people with Medicare Part D at no cost. Starting January 1st, people enrolled in a Part D plan will not pay more than $35 a month for a month’s supply of insulin. Starting July 1st, people who receive insulin through a pump covered by Part B will not pay more than $35 for a month’s supply of insulin.

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