How to Read Your Medicare Annual Notice of Change

Every fall,

people with a Medicare Advantage plan or a Medicare drug plan receive a document that is easy to set aside: the Annual Notice of Change.

It usually arrives in late September, looks like routine paperwork and lands at a time of year when there is plenty of other mail.

That letter is one of the most useful things your plan sends all year.

It lists what will be different starting January 1, from premiums and copays to the drugs the plan covers and the doctors in its network.

This guide shows you how to read it quickly and what to do with what you find.

What the Annual Notice of Change is

Medicare health and drug plans can change their costs and coverage every year.

To make sure members know about those changes before they are locked in, plans send an Annual Notice of Change,

often called the ANOC, before the fall enrollment period begins. Plans usually send it by the end of September.

The ANOC compares this year with next year. It is not a sales brochure; it is a summary of differences.

That makes it the fastest way to see whether your current plan still fits, without reading the full plan documents.

Why it matters so much

If you do nothing during the fall enrollment period, which runs from October 15 to December 7,

you usually stay in the same plan for the next year, with all of its changes.

A plan that worked well this year can cost more next year, drop a drug you take or lose a doctor you see.

The letter is your early warning.

Reading it in October gives you time to compare options calmly instead of discovering a change at the pharmacy counter in January.

The five sections to read first

You do not need to read every page in order.

Start with these parts, which hold most of the changes that affect people:

1. Premium: the monthly amount you pay for the plan. Note whether it goes up, down or stays the same.
2. Deductible and out-of-pocket limits: what you pay before the plan starts paying, and the most you could pay in a year for covered services.
3. Copays and coinsurance: what you pay for doctor visits, specialists, hospital stays, tests and other common services.
4. Drug coverage: changes to the drug list, called the formulary, and to the tier each drug is on.
5. Network changes: doctors, hospitals or pharmacies joining or leaving the plan.

How to check your own drugs

Drug changes are where many surprises hide.

A medicine can move to a higher tier, which usually means a higher copay, or it can be removed from the list altogether.

New rules can also appear, such as prior authorization or limits on quantity.

Make a list of every prescription you take, with the dose and how often you take it.

Then look for each one in the drug section of the letter or in the plan's drug list for next year.

If something changed, note it. That list will also be the starting point if you decide to compare plans.

How to check your doctors

If you have a Medicare Advantage plan, your doctors and hospitals matter as much as the costs.

The ANOC may not list every network change, so do not stop at the letter.

Check the plan's provider directory for next year and, for anyone important to you,

call the doctor's office and ask whether they will be in the plan's network next year.

This is especially important for specialists and for any treatment that is ongoing.

A twenty-minute routine

• Minutes 1 to 5: find the premium, deductible and out-of-pocket limit, and write next year's numbers next to this year's.
• Minutes 5 to 12: check each of your drugs for coverage, tier and new rules.
• Minutes 12 to 17: check your doctors, hospitals and pharmacy.
• Minutes 17 to 20: decide whether you are happy with the changes or whether to compare other plans before December 7.

What to do with what you find

If nothing important changed and the plan still fits, you can stay.

If costs went up, a drug moved or a doctor left, it is a good year to compare.

The official Medicare Plan Finder on Medicare.gov lets you enter your drugs and pharmacy and see how plans in your area compare for next year.

You can also get free, unbiased help from your State Health Insurance Assistance Program, known as SHIP.

Counselors there are trained to walk through these letters with you.

Keep the letter with your plan papers

Once you have read it, keep the Annual Notice of Change with your other plan documents until the end of next year.

If a bill or a pharmacy charge surprises you in the spring,

the letter shows exactly what the plan said would change,

which makes it much easier to ask questions or file a complaint.

If you did not receive the letter

If you are in a Medicare Advantage or drug plan and did not receive your Annual Notice of Change by early October,

contact the plan using the number on your member card and ask for a copy.

Many plans also post it on their website or in the member portal.

Frequently Asked Questions

Do people with Original Medicare get this letter?

The ANOC comes from private plans, such as Medicare Advantage and drug plans.

If you have a separate drug plan or a supplemental policy, check the mail from those companies too.

Is the Annual Notice of Change the same as the Evidence of Coverage?

No. The Evidence of Coverage is the full, detailed description of the plan.

The ANOC is the short summary of what changes next year.

What happens if I ignore it?

In most cases you stay in the same plan, with next year's costs and rules.

Reading the letter costs twenty minutes; skipping it can cost much more over a year.

This guide is general information and is not affiliated with Medicare or any insurance plan.

For decisions about your coverage, use the official sources below or speak with a SHIP counselor.

Sources and Further Reading

• Medicare.gov — Joining a health or drug plan: when you can join, switch or drop a plan.
• Medicare.gov — Drug coverage (Part D): how drug plans, drug lists and costs work.
• SHIP — State Health Insurance Assistance Programs: free, unbiased Medicare counseling in every state.