Medicare AEP vs OEP: What Agents Need to Know
Whether you’re a new insurance agent preparing for your first time navigating Medicare season or a seasoned pro, understanding the difference between AEP and OEP is essential. These enrollment periods may sound similar, but they serve very different purposes. In this guide, we’ll break down what AEP and OEP are, what you can and cannot do as an agent during each, and how to help clients make the best decisions about their health plan, current plan, or prescription drug plan.
What Is Medicare AEP?
The Annual Enrollment Period (AEP) — also known as the Annual Election Period — is the most critical time of year for Medicare agents. It’s when most Medicare beneficiaries can review and update their Medicare coverage, whether it’s adjusting Medicare Part D, switching healthcare providers, or selecting a different Medicare Advantage plan.
Key Dates and Duration
AEP runs from October 15 through December 7 each year. Any changes made during this window take effect on January 1 of the following year.
What Agents Can Do
During AEP, agents can:
- Enroll new clients in Medicare Advantage or Medicare Part D plans
- Switch clients from Original Medicare to a Medicare Advantage plan, or vice versa
- Help beneficiaries move to a Medicare Supplement or evaluate cost-sharing in their current plan
- Review plan copays, premiums, and networks to ensure the client’s needs are still being met
- Compare prescription drug plan options based on formularies, copays, and pharmacy access
This period is especially important for clients experiencing increased healthcare needs, new prescriptions, or upcoming changes to their health plan in the following year.
Who It Applies To
AEP is available to:
- Clients with Original Medicare (Part A and Part B)
- Those enrolled in Medicare Advantage or Medicare Part D
- Anyone needing to adjust their current coverage before the next benefit year begins
What Is Medicare OEP?
The Open Enrollment Period (OEP) is a time when beneficiaries enrolled in Medicare Advantage plans can make a one-time change. Unlike AEP, OEP is not for marketing or prospecting—it’s focused on support and retention.
Key Dates and Rules
OEP runs from January 1 through March 31. This period is also known as the Medicare Advantage Open Enrollment Period and is exclusively for beneficiaries already enrolled in an MA plan as of January 1.
During OEP, clients can:
- Switch to a different Medicare Advantage plan
- Drop MA coverage and return to Original Medicare (Part A and Part B)
- Add a standalone Medicare Part D prescription drug plan if returning to Original Medicare
Changes made during this period also go into effect for the following year if applicable, but most will apply within that same plan year.
What Agents Are Not Allowed to Do
As an insurance agent, you:
- May not market or promote OEP
- Cannot run events or advertisements aimed at getting clients to switch plans
- May only assist current clients who reach out with questions or concerns
OEP is about helping clients who feel their current plan isn’t the right fit after AEP.
Who Can Use This Period
Only those enrolled in a Medicare Advantage plan on January 1 can make a change during OEP. Others must wait for AEP or qualify for a Special Enrollment Period.
AEP vs OEP: The Key Differences
While both enrollment periods allow plan changes, the rules and flexibility are very different.
H3:Marketing Rules
- AEP: Agents can market and advertise plans.
- OEP: No marketing allowed. Communication must be initiated by the client.
Client Eligibility
- AEP: Available to all Medicare beneficiaries
- OEP: Only for those in a Medicare Advantage plan as of January 1
Scope of Enrollment Options
- AEP: Clients can enroll in or drop Medicare Part D, switch to a different Medicare Advantage plan, or explore Medicare Supplement options.
- OEP: Only one plan change is allowed, usually focused on addressing gaps in coverage, copays, or provider access.
How to Prepare for AEP and OEP
Midwestern Marketing equips agents to be successful during every enrollment season, whether it’s your first time or your fifteenth.
Certifications and Carrier Contracts
To be ready, you’ll need:
- Completed AHIP certification
- Carrier contracts in place for Medicare Advantage, Medicare Part D, and Medicare Supplement plans
- Up-to-date understanding of plan changes, copays, and benefits for the following year
We help ensure nothing slips through the cracks during onboarding and certification season.
Prepping Your Book of Business
To prepare:
- Identify clients whose current plan is changing in the following year
- Highlight those experiencing high copays, limited prescription drug plan access, or restricted healthcare provider networks
- Flag beneficiaries aging into Medicare or qualifying for the initial enrollment period
This approach leads to smoother enrollments and higher retention.
Tools to Stay Compliant and Efficient
Midwestern Marketing provides:
- Enrollment tools for health insurance and Medicare Part D
- CRM systems for tracking follow-ups and plan comparisons
- Support for interpreting CMS rules on plan benefits, deductibles, and drug coverage
With these tools, agents stay compliant and productive.
Compliance Reminders for Each Period
CMS guidelines are non-negotiable, and MWM helps you stay up to date on every change.
CMS Rules You Should Know
- You must have a Scope of Appointment before discussing coverage
- All marketing must follow CMS guidelines—especially during OEP
- Plan comparisons should include accurate deductibles, copays, and drug tier information
- Don’t present yourself as the government or imply guaranteed savings
Our team keeps you compliant and protects your license.
Avoiding Common Mistakes
Be cautious of:
- Marketing during OEP
- Overlooking updates to Medicare Part D drug tiers
- Ignoring Special Enrollment Period qualifications
- Not explaining copays and prescription drug plan differences clearly to clients
We’ll help you avoid these common pitfalls with training and one-on-one support.
FAQs
What is AEP vs OEP Medicare?
AEP (Annual Election Period) is when most Medicare beneficiaries can make changes to Medicare Advantage, Medicare Part D, or Medicare Supplement plans. OEP is more limited and only for MA enrollees.
H3: Can agents market during OEP?
No. CMS does not allow marketing during the Medicare Advantage Open Enrollment Period. Agents may only assist current clients who reach out.
What can agents do during AEP?
Agents can market, enroll, and assist with changing health plans, switching to a different Medicare Advantage plan, enrolling in Medicare Part D, or exploring Medicare Supplement options.
When does Medicare AEP start and end?
AEP runs from October 15 through December 7 every year, with changes starting in the following year.
Who can switch plans during OEP?
Only Medicare beneficiaries already in a Medicare Advantage plan can make a one-time change during OEP.
Understanding AEP and OEP isn’t just about checking boxes—it’s about helping people make informed decisions that improve their access to care and reduce costs. Whether it’s evaluating copays, changing prescription drug plans, or enrolling for the first time, Midwestern Marketing gives agents everything they need to serve clients with confidence.
Want help preparing for AEP or OEP?
Let’s talk. Midwestern Marketing offers carrier access, tech tools, and personal support to help you succeed in the following year and beyond. Contact us today and let’s get started.