Medicare Annual Notice of Change 2026: What Seniors Must Check

That Important Envelope You Might Be Tempted to Ignore

Every fall, somewhere between the credit card offers and grocery store flyers, a document arrives in your mailbox that could save you hundreds — even thousands — of dollars. It’s called the Medicare Annual Notice of Change (ANOC), and if you’ve ever tossed it aside thinking it was just more paperwork, you’re not alone.

According to a 2023 survey by the Medicare Rights Center, nearly 40% of Medicare Advantage and Part D enrollees admitted they didn’t carefully review their Annual Notice of Change. That’s a costly mistake. This document spells out every change your plan is making for the upcoming year — from rising premiums to dropped medications to new prior authorization requirements.

The good news? Once you know what to look for, reviewing your ANOC takes just 15 to 20 minutes. And those few minutes can protect your health, your wallet, and your peace of mind. Let’s walk through exactly what this document is, why it matters, and the specific sections you need to read carefully.

What Is the Annual Notice of Change (ANOC)?

The Annual Notice of Change is a document that Medicare requires every Medicare Advantage plan and Part D prescription drug plan to send to their members each year. It arrives by September 30, giving you time to review it before Medicare’s Open Enrollment Period begins on October 15.

Think of the ANOC as a heads-up letter from your insurance plan. It outlines every change that will take effect on January 1 of the following year. These changes can include adjustments to:

• Monthly premiums
• Annual deductibles
• Copayments and coinsurance
• Prescription drug formulary (the list of covered medications)
• Provider networks (which doctors and hospitals are included)
• Coverage rules, like prior authorizations or step therapy requirements
• Extra benefits such as dental, vision, hearing, or fitness programs

Your plan is legally required to notify you about these changes. But it’s your responsibility to read them and decide whether your current plan still works for you. If it doesn’t, Open Enrollment — which runs from October 15 through December 7 — is your window to switch.

6 Key Areas to Review in Your ANOC

You don’t need to read every word of fine print. Instead, focus on these six areas that have the greatest impact on your health and finances. Grab a highlighter and a cup of coffee — this is worth your time.

1. Monthly Premium Changes

Your premium is the amount you pay each month just to have the plan. Even a small increase of $10 to $20 per month adds up to $120 to $240 over the year. Some plans raise premiums significantly, while others may actually decrease them. Check this number first — it’s usually near the top of the document.

2. Deductible Adjustments

The deductible is what you pay out of pocket before your plan starts covering costs. For 2025, the standard Part D deductible can be up to $590 (up from $545 in 2024). Your plan may have a different deductible, so compare last year’s amount to the new one. A jump in your deductible means higher costs early in the year.

3. Changes to Your Drug Formulary

This is one of the most critical sections, especially if you take multiple medications. Plans can move drugs to higher cost tiers, add new restrictions like prior authorization, or remove medications from the formulary entirely. The Centers for Medicare & Medicaid Services (CMS) reports that formulary changes affect millions of beneficiaries every year.

Action step: Make a list of all your current prescriptions. Then check each one against the new formulary. If a medication you depend on has been moved to a higher tier or dropped, this is a major red flag that it may be time to shop for a new plan.

4. Copayment and Coinsurance Changes

Your copay is the flat fee you pay for a service (like $30 for a specialist visit), while coinsurance is a percentage you pay (like 20% of the cost of a procedure). Review these amounts for:

1. Primary care visits
2. Specialist visits
3. Hospital inpatient stays
4. Emergency room visits
5. Outpatient surgeries and procedures
6. Lab work and imaging

Even small increases across multiple categories can add up quickly, especially if you have ongoing health conditions that require frequent care.

5. Provider Network Updates

If you have a Medicare Advantage plan, your doctors, hospitals, and specialists must typically be “in network” for you to receive full coverage. Your ANOC will note if the network is changing. However, specific provider removals may not always be listed in detail. It’s smart to call your doctors’ offices directly to confirm they’ll still be in your plan’s network next year.

According to the Kaiser Family Foundation, approximately 1 in 5 Medicare Advantage enrollees has experienced a provider leaving their network. Losing access to a trusted doctor is one of the most common — and most stressful — reasons people switch plans.

6. Extra Benefits and Program Changes

Many Medicare Advantage plans offer extras like dental coverage, vision exams, hearing aids, gym memberships (like SilverSneakers), transportation to medical appointments, and even over-the-counter health product allowances. These benefits can change from year to year. A benefit you relied on this year could be reduced or eliminated next year.

Pay particular attention to any dollar-amount caps on these benefits. For example, your dental allowance might drop from $2,000 to $1,000, or your OTC quarterly allowance might be cut in half.

What to Do After You Review Your ANOC

Once you’ve gone through the document, you’ll fall into one of two camps: your plan still works well for you, or it’s time to explore other options. Here’s what to do in each scenario.

If your plan still meets your needs: Great news — you don’t need to do anything. Your coverage will automatically continue into the new year with the updated terms. Just file the ANOC somewhere safe for reference.

If your plan no longer fits: Use the Open Enrollment Period (October 15 – December 7) to compare other plans and switch. You can:

• Switch from one Medicare Advantage plan to another
• Switch from Medicare Advantage back to Original Medicare (and add a Part D drug plan)
• Switch from one Part D plan to another
• Enroll in a Medicare Advantage plan if you’re currently on Original Medicare

You can compare plans at Medicare.gov, call 1-800-MEDICARE (1-800-633-4227), or contact your State Health Insurance Assistance Program (SHIP) for free, unbiased counseling. To stay organized during this process, be sure to download our free Medicare checklist — it walks you through every step so nothing falls through the cracks.

Common Mistakes to Avoid

Year after year, we see the same preventable errors. Here are the most common pitfalls — and how to sidestep them.

1. Assuming nothing changed. Plans change every single year. Even if your premium stays the same, your drug formulary or provider network may have shifted dramatically.
2. Confusing the ANOC with the Evidence of Coverage (EOC). The ANOC highlights what’s changing. The EOC is the full, detailed handbook of your plan’s terms. Both arrive in the fall, and both are important — but the ANOC is your quick-reference guide to changes.
3. Waiting until December to act. Open Enrollment ends on December 7, and last-minute decisions are often rushed decisions. Start reviewing your ANOC in early October so you have plenty of time.
4. Not checking the formulary. This is the number-one area where people get caught off guard. A medication that was Tier 2 this year could jump to Tier 4 next year, tripling your cost.
5. Ignoring the ANOC because “Medicare is Medicare.” Original Medicare (Parts A & B) is standardized, but Medicare Advantage and Part D plans are run by private insurance companies. They have wide latitude to change benefits annually.

For more guidance on navigating these decisions confidently, explore our Medicare Benefits Hub where we break down every part of Medicare in plain language.

Why This Matters More Than Ever

Healthcare costs continue to rise, and Medicare plans are adjusting right alongside them. The CMS reported that average Medicare Advantage premiums for 2024 were around $18.50 per month — but that average masks enormous variation. Some plans charge $0 monthly premiums but have high out-of-pocket costs. Others charge higher premiums but cover more.

The Annual Notice of Change is your early warning system. It gives you the information and the time to make smart, proactive choices about your healthcare — rather than being surprised by a bill in January.

Remember, you don’t have to navigate this alone. There are free resources available, including SHIP counselors in every state and the tools on Medicare.gov. And right here on our Medicare blog, we publish easy-to-follow guides throughout the year to help you stay informed and empowered.