How to Read Your Medicare Advantage Annual Notice of Change

Your Medicare Advantage plan sends you an Annual Notice of Change (ANOC) by September 30 each year. This important document tells you about any changes to your plan's costs, coverage, or benefits for the upcoming year, starting January 1.

Key Takeaways

• Your plan sends an ANOC document by September 30 each year.
• The ANOC explains all changes for the next calendar year.
• Reviewing your ANOC helps you decide if your plan still meets your needs.
• You can use the Annual Open Enrollment Period to switch plans if needed.
• Check costs, doctors, pharmacies, and drug coverage carefully.

What Is an Annual Notice of Change (ANOC)?

An Annual Notice of Change (ANOC) is a letter from your Medicare Advantage (Part C) plan. It tells you about any changes to your plan's benefits, costs, or service area for the next calendar year. You should receive this notice by September 30 every year.

Think of it as a preview of your plan's new terms for the coming year. This allows you to review these changes before the Medicare Annual Open Enrollment Period. That period runs from October 15 to December 7 each year.

If you have a stand-alone Medicare Part D prescription drug plan, you will also receive an ANOC. This notice explains changes to your drug coverage, including costs and formulary updates. Both types of ANOCs are crucial for making informed decisions.

Why Is Your ANOC Important?

Plans can change what they cover and how much you pay each year. Your ANOC is the main way your plan tells you about these updates. It helps you understand if your current plan remains an ideal choice for your health and budget in the upcoming year.

Medicare Advantage plans often offer extra benefits beyond Original Medicare, though these vary significantly by plan and location. These can include dental, vision, hearing, or fitness programs. The ANOC will highlight any changes to these valuable extras.

Carefully reading your ANOC helps you avoid surprises with your healthcare costs or coverage. It gives you time to compare other options during the Annual Open Enrollment Period. This period is a key time to switch plans if your current one no longer meets your needs.

What Information Does Your ANOC Contain?

Your ANOC is a detailed document. It compares your current plan benefits with the benefits for the next year. You should look for specific sections that cover costs, doctors, drugs, and other services.

Understanding these changes is key. It helps you decide if you want to stay with your current plan. Here are the main things to look for in your ANOC.

Are Your Premiums and Costs Changing?

The ANOC will show your new monthly premium, if any. Some Medicare Advantage plans have a $0 monthly premium. However, it's important to remember that you still need to pay your Part B premium. For more on this, you might find our article "Why '$0 Premium' Medicare Advantage Isn't Truly Free" helpful.

Check for changes to your deductible, copayments, and coinsurance amounts. These are the amounts you pay for medical services and prescription drugs. A deductible is how much you pay before your plan starts to pay. A copayment is a set amount you pay for a service, like a doctor's visit. Coinsurance is a percentage of the cost you pay.

Your plan's annual maximum out-of-pocket limit is also listed. This is the most you will pay for covered medical services in a year. Once you reach this limit, your plan pays 100% of approved costs. In 2026, the annual out-of-pocket cap for Part D prescription drugs is $2,100.

Will Your Doctors or Hospitals Still Be in Network?

Medicare Advantage plans use networks of doctors, hospitals, and other providers. The ANOC will tell you if your plan's provider network is changing. This is a very important section to review.

It is vital to confirm that your preferred doctors and hospitals are still part of your plan's network. Leaving the network can mean higher costs or needing to find new providers. Most plans will tell you to check their website or call to confirm your providers are in-network for the next year. You can also refer to our article on "Verifying Your Doctors in a Medicare Advantage Plan Network".

If your current doctors leave the network, consider if switching plans is right for you. Your ANOC may include a list of changes or tell you where to find an updated provider directory.

Are There Changes to Your Pharmacy Network?

Just like doctors, pharmacies can also be in or out of network. The ANOC will alert you to changes in your plan's pharmacy network. It is important to confirm that your preferred pharmacy still accepts your plan.

Using an out-of-network pharmacy can mean paying more for your prescriptions. Some plans offer preferred pharmacies where you pay less for your drugs. Check if your usual pharmacy is still a preferred or in-network option.

If your pharmacy leaves the network or becomes a non-preferred option, your drug costs could rise. This information helps you decide if you need to look for a new plan or a new pharmacy.

How Has Your Drug Coverage Changed?

Your plan's formulary is its list of covered prescription drugs. The ANOC will detail any changes to this list. Drugs can move to different cost tiers, or some drugs might no longer be covered.

It is crucial to compare your current drug list against the new formulary. Look for any medications you take regularly. See if their cost tier has changed or if they require new prior authorizations.

Prior authorization means your plan needs to approve a drug before you get it. This can affect how quickly you get your medications. For insights into this topic, you might want to read "Medicare Advantage Prior Authorization in 2026: Rules and Denials".

The ANOC will also cover changes to your Part D deductible and your annual out-of-pocket cap for drugs. For 2026, the maximum Part D deductible is $615, though some plans have a lower or $0 deductible. After your deductible, you move into initial coverage. Once you reach the $2,100 annual out-of-pocket cap for 2026, your plan pays 100% of covered drugs for the rest of the year.

If your drug costs are high, remember that the Medicare Prescription Payment Plan is available. This allows you to spread out-of-pocket drug costs over monthly bills. You pay $0 at the pharmacy counter. This benefit is offered by every Medicare drug plan.

Have Extra Benefits Been Added or Removed?

Many Medicare Advantage plans offer extra benefits not covered by Original Medicare; these specific benefits and their details vary by plan and location. These can include vision, dental, hearing, gym memberships, or even transportation to medical appointments. Your ANOC will highlight any changes to these benefits.

For example, your dental coverage might change from one cleaning a year to two. Or, your plan might introduce a new benefit like a healthy food allowance. Conversely, some benefits might be reduced or removed entirely.

Evaluate whether these changes impact your overall healthcare needs. An added benefit could be a pleasant surprise. A removed benefit might make your plan less appealing. Weigh the value of these benefits carefully.

What About Your Plan's Service Area?

The ANOC will also tell you if your plan's service area is changing. Your plan's service area is the geographic region where it offers coverage. If you move outside your plan's service area, your coverage may end.

If your plan shrinks its service area and you are no longer covered, this triggers a Special Enrollment Period. This allows you to switch to a new plan. It's rare, but important to check if you live near a border or if you're planning a move.

If your plan leaves Medicare or stops serving your area, you will receive a plan non-renewal notice. This is different from an ANOC and allows you to switch plans during a specific Special Enrollment Period. If you do not choose a new plan, you will automatically be moved to Original Medicare on January 1.

Understanding Your Plan's Star Rating

Medicare uses a Star Rating system to rate the quality and performance of Medicare Advantage and Part D plans. These ratings go from 1 (poor) to 5 (excellent). Your ANOC will tell you your plan's Star Rating for the upcoming year. You can learn more by reading our article, "Medicare Star Ratings: What 5 Stars Means for Your Plan".

A higher Star Rating often means better overall quality and member satisfaction. It covers things like how well the plan manages chronic conditions and member complaints. A plan's Star Rating can be a useful factor when comparing your options.

If your plan's Star Rating drops significantly, it might be a reason to look for other plans. However, remember that Star Ratings are just one factor among many. Consider your own needs and experiences with the plan as well.

Action After Receiving Your ANOC

After you get your ANOC, take the time to read it thoroughly. It's a key step in managing your Medicare coverage. This review helps you understand any changes that might affect your healthcare or your budget.

Do not just assume your plan will stay the same. Changes happen every year. Missing these changes could lead to unexpected costs or disruptions in your care. Your ANOC is your opportunity to be proactive.

If you have questions, call your plan directly using the number on your ANOC. They can clarify any details that are unclear. This step can save you time and worry in the long run.

What if Your Plan Changes Too Much?

If your ANOC shows changes that you don't like, you have options. The Annual Open Enrollment Period (October 15 – December 7) is your chance to make changes to your Medicare coverage. During this time, you can:

• Switch from your current Medicare Advantage plan to a different Medicare Advantage plan.
• Switch from a Medicare Advantage plan back to Original Medicare.
• If you switch back to Original Medicare, you can also join a stand-alone Medicare Part D prescription drug plan.
• Switch from one stand-alone Part D plan to another.

If you decide to make a change, your new coverage will begin on January 1 of the upcoming year. It's important to choose wisely, as your next opportunity to change Medicare Advantage plans might not be until the Medicare Advantage Open Enrollment Period (January 1 – March 31).

If you do nothing after receiving your ANOC, you will automatically stay with your current plan. The new benefits, costs, and terms outlined in your ANOC will take effect on January 1.

How to Compare Your Options

Medicare.gov offers tools to help you compare plans. You can enter your current doctors, pharmacies, and prescriptions. The tool will show you plans available in your area that cover them. This makes it easier to see how different plans stack up against your needs.

Consider your overall health, budget, and desired benefits. Do you value lower monthly premiums, or would you prefer lower copayments for doctor visits? Do you take many prescription drugs? These questions can guide your comparison.

Look beyond just the monthly premium. A plan with a $0 premium might have higher deductibles or copayments. Compare the total estimated costs, including what you might pay for medical services and drugs. This full picture helps you make a choice that truly works for you.

Special Circumstances for Switching Plans

There are situations outside the Annual Open Enrollment Period when you can change plans. These are called Special Enrollment Periods. One common Special Enrollment Period occurs if your plan leaves Medicare or stops serving your area.

If your Medicare Advantage plan leaves Medicare or no longer covers your area, you get a special right. You can buy a Medigap policy without health questions. This right applies if you switch to Original Medicare, not another Medicare Advantage plan. This is a significant protection if your plan is ending.

This specific Medigap right is available from the date you get your non-renewal notice until 63 days after your plan coverage ends. It usually covers Medigap Plans A, B, D, and G. For those eligible for Medicare before January 1, 2020, Plans C and F may also be available. Some states offer additional Medigap protections.

This is different from the one-time 6-month Medigap Open Enrollment Period. That period starts the month you are 65 or older and enrolled in Part B. During that time, any insurer must sell you any Medigap policy it offers, regardless of your health.

People who qualify for Extra Help (the Low-Income Subsidy) or have Medicaid also have ongoing Special Enrollment Periods. Since January 1, 2025, they can switch to a stand-alone Part D drug plan once per calendar month. This allows them to switch drug plans or leave a Medicare Advantage plan for Original Medicare plus a stand-alone drug plan. It does not allow joining or switching Medicare Advantage plans. For more information on Extra Help, you might want to check out "Extra Help (LIS): Do You Qualify, and Its Value".

Don't Miss This Important Document

Your ANOC is not junk mail. It is a critical piece of information that empowers you to control your Medicare coverage. Take the time to review it carefully each fall.

Understanding the changes in your ANOC can lead to better health outcomes and lower costs. Make an informed choice about your Medicare plan for the upcoming year. Your healthcare journey is important, and staying informed is a key step.

If you have any questions about your ANOC or your Medicare options, resources are available. You can contact Medicare directly at 1-800-MEDICARE or visit Medicare.gov. You can also reach out to your local State Health Insurance Program (SHIP) for unbiased guidance. They offer free, personalized counseling to help you understand your Medicare choices.

Remember, your ANOC is your annual opportunity to ensure your Medicare Advantage plan still meets your needs for the year ahead. Use it wisely.

Have questions? Call 1-877-443-3251 to talk it through with a licensed insurance agent. They're paid by the plans they represent, never by you, and the decision stays yours.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Medicare has neither reviewed nor endorsed this information.