The 5-star enrollment period for Medicare Advantage is actually an incredible opportunity to help senior clients. This SEP lasts for nearly a year as it runs from December 8 to November 30 of the following year.
Here's everything you need to know about the 5-star enrollment period, including how our team can quickly help you identify available 5-star plans at scale and how to develop a 5-star marketing plan.
What is the Medicare 5-star enrollment period?
If a Medicare Advantage plan, Part D drug plan, or Medicare Cost Plan with a 5-star rating is available in your client's area, they can use the 5-star Special Enrollment Period (SEP) to switch from their current Medicare plan to a Medicare plan with a “5-star” quality rating.
They can use this Special Enrollment Period only once between December 8 and November 30. If they want to utilize this SEP again in the future, they can, but they can only make a switch once during each Special Enrollment Period.
Your client can make this switch even if they're already in a 5-star plan. Their new plan would start the first day of the month after they enroll.
For example, say your client enrolls in a Medicare Advantage in October (during AEP). They can switch to a 5-star plan anytime from December 8th to the following November 30th (almost a whole year!). If they send in their enrollment request on May 10th, their new 5-star MA plan would start on June 1st.
What is a 5-star plan?
Medicare uses information from member satisfaction surveys, plans, and health care providers to give overall performance star ratings to plans. A plan can get a rating between 1 and 5 stars. A 5-star rating is considered excellent.
5-star plans are identified with this special icon:
Medicare updates these ratings each fall for the following year, and these ratings can change each year.
Here's what the star rating looks like on Medicare.gov's plan finder:
What are the compliance rules surrounding the 5-star enrollment period?
So, you can't conduct marketing activities related to the Open Enrollment Period, which lasts from January 1-March 31st. But what about the 5-star enrollment period?
Read more: Top 5 MA OEP Compliance Tips
Good news: agents are allowed to actively market the 5-star enrollment period! The Medicare Communication & Marketing Guidelines (MCMG) explicitly states in section 40.6.1 and 40.7 that you can market during this special enrollment period!
40.6.1 – Marketing Plans/Part D Sponsors with an Overall 5-Star Rating
- May market their ability to enroll beneficiaries through the 5-star special enrollment period (SEP).
- May not specifically target enrollees in poor performing plans.
40.7 – Prohibition of Open Enrollment Period Marketing
- During the OEP, Plans/Part D sponsors may conduct marketing activities that focus on other enrollment opportunities including but not limited to 5-star plans marketing the continuous enrollment SEP
The only thing you can't do is target enrollees in poor performing plans. For example, you can't single out a group of individuals in a 1-star plan.
Other than that, this SEP is an excellent marketing opportunity that many agents overlook.
Exclusive 5-Star Plan Software
Thanks to our partnership with Integrity Marketing Group, we have an incredible, exclusive tool we can use to identify available 5-star plans at scale.
This tool allows our team to quickly search by carrier and county to find available 5-star plans that fit your clients’ needs, available year-round.
At a bird's eye view, we can see where there are 5-star plans, and which areas of the country have the highest 5-star plan density.
For PY2022, we see a high concentration of 5-star plans in Pennsylvania, New York, Ohio, Wisconsin, Massachusetts, Michigan, Minnesota, and Florida.
For agents that sell in multiple states or counties, looking at this map can be a huge time saver.
Anyone can go to Medicare.gov and utilize the Plan Finder tool to filter 5-star plans. But you have to do this manually for each zip code.
If you have a list of states or counties you want us to check, simply fill out this form and we can utilize this tool to speed up the entire process. We can also filter by carrier, which helps you only get data about 5-star plans you're licensed to sell.
We may determine there's not much of a marketing opportunity if you don't have any great 5-star plans – or, we may uncover a gold mine!
In any case, having us utilize this tool for you is much faster than going through the Medicare.gov Plan Finder and filtering by 5-star plans, especially if you need to check multiple counties.
Marketing the 5-Star Enrollment Period
If you have some good 5-star Medicare Advantage plans in your county, it's time to come up with a marketing plan.
Because the 5-star enrollment period is so specific to the plans you have at your disposal, my top suggestion is to utilize pre-created marketing pieces from the carrier. That will allow you to be more specific in your marketing efforts.
For example, if Humana has a 5-star plan available in your county, log in to the Humana agent portal, go to the Marketing resource center, and browse the available marketing materials.
Humana has two items available with 5-star messaging:
- 2022 Star Rating presentations
- 2022 Star Rating campaign
The campaign includes an ad, brochure, flyer, and email. Keep in mind: you are responsible for only selecting plans that are available in the area in which you are licensed to sell.
Here's a quick look at the front side of the flyer (disclaimers are on the back):
Aetna also has some great marketing materials. Log into the Aetna Medicare Marketing Studio and search by Time of Year. Select Year-Round Enrollment. Then, select your state and county.
If your county has a 5-star plan available, you'll see marketing materials specific to that 5-star plan option.
As an example, in Aroostook County, Maine, there is a great 5-star lead gen postcard, which you could customize and order directly from the portal.
Again, you can only utilize these types of marketing materials if you're licensed to sell the product in that particular county.
Further Reading: How to Market Medicare Advantage Plans
If you have access to any 5-star Medicare Advantage plans in your county, don't forget about the 5-star enrollment period.
Anytime between December 8 and November 30, your client could potentially switch from their current Medicare plan to a Medicare plan with a “5-star” quality rating.
If you have any feedback or questions, please leave a comment below. You can also schedule a call with me by clicking the following image: