2019 Medicare Annual Open Enrollment Period (OEP)

CMS Finalizes Policy Changes and Updates for Medicare Advantage and the Prescription Drug Benefit Program for Contract Year 2019 (CMS-4182-F)

On April 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare Advantage (MA) and the prescription drug benefit program (Part D) by promoting innovation and empowering MA and Part D sponsors with new tools to improve quality of care and provide more plan choices for MA and Part D enrollees.

Restoration of the Medicare Advantage Open Enrollment Period

The 21st Century Cures Act eliminates the existing MA disenrollment period that currently takes place from January 1st through February 14th of every year and, effective for 2019, replaces it with a new Medicare Advantage open enrollment period (OEP) that will take place from January 1st through March 31st annually. The new OEP allows individuals enrolled in an MA plan, including newly MA-eligible individuals, to make a one-time election to go to another MA plan or Original Medicare. Individuals using the OEP to make a change may make a coordinating change to add or drop Part D coverage.

• The annual OEP will occur from Jan 1st -March 31st. The OEP allows individuals enrolled in an MA plan to make a one-time election during the first 3 months of the calendar year to switch MA plans or to disenroll from an MA plan and obtain coverage through Original Medicare.
• Newly eligible MA individuals can only use the OEP during the first 3 months in which they have both Part A and Part B.

• another MA-PD plan
• an MA-only plan; or
• Original Medicare with or without a PDP

• another MA-only plan
• an MA-PD plan
• Original Medicare with or without a PDP

• Part D changes for individuals enrolled in Original Medicare, including those with enrollment in stand-alone PDPs (i.e., No PDP to PDP changes)
• Individuals enrolled in Original Medicare or other Medicare health plan types, such as cost plans, are not able use the OEP to enroll in an MA plan, regardless of whether or not they have Part D.