If you have a Medicare Advantage plan or a Part D drug plan, your plan sent you an Annual Notice of Change, or ANOC, in September. It lists every change to your costs and coverage that takes effect on January 1, 2027. If you read only one piece of Medicare mail this year, make it this one.
I’m a researcher who spends a lot of time with these documents, not a licensed agent. Everything below comes from Medicare’s own guidance and the 2027 rules, and I link to the sources. If you want someone to go through your ANOC with you, your State Health Insurance Assistance Program (SHIP) does it for free.
What the ANOC is, and when it should arrive
Medicare.gov describes the ANOC as a notice your plan sends each fall listing changes in coverage, costs and more that start in January. Medicare lists September as the time you should get it. It may come by mail or email, or as a notice telling you where to find it online.
If you haven’t seen yours by now, check your email and your plan’s member website, then call the member services number on your card. Don’t skip it. Open Enrollment starts October 15 and ends December 7, and the ANOC is the document that tells you whether you need to shop.
If you’re in Original Medicare without a separate drug plan, you won’t get an ANOC. Original Medicare’s 2027 Part B premium and deductible haven’t been announced yet as of October 1.
The six lines to find and write down
You don’t need to read all 20-plus pages front to back. Most ANOCs open with a summary table comparing this year to next year. Find these six things, write the 2026 and 2027 numbers side by side, and you’ll know in a few minutes whether your plan still fits.
1. Monthly premium
Is it going up, down, or staying the same? If you’re in Medicare Advantage, remember you still pay your Part B premium on top of any plan premium.
2. Deductibles
Look for both the medical deductible (if your plan has one) and the drug deductible. No Part D plan can charge a drug deductible above $700 in 2027, up from $615 in 2026. Many plans charge less. If yours jumped, that’s a cost you’ll feel in January, when deductibles reset.
3. Your drugs
This is where most surprises hide. For each drug you take, check:
- Is it still on the formulary? Drugs can be dropped.
- Did it change tiers? A move from tier 3 to tier 4 can double your cost.
- Are there new rules? Prior authorization, step therapy (trying a cheaper drug first) or quantity limits can be added.
The ANOC usually summarizes formulary changes, but it doesn’t always list every drug. Check the full 2027 drug list on your plan’s website, or enter your drugs into Medicare Plan Finder for 2027.
4. Doctors, hospitals and pharmacies
Advantage plans can change their networks. If your ANOC mentions network changes, call your doctors’ offices and ask directly: “Will you be in network with this plan in 2027?” For your pharmacy, check whether it’s still “preferred,” because preferred pharmacies often have lower copays.
5. Out-of-pocket maximum (Medicare Advantage only)
Every Advantage plan caps what you pay for covered medical services in a year. For 2027, CMS set the maximum at $9,850 for in-network care, or $14,800 combined for plans that cover out-of-network care. Most plans set their own limit lower. Analysts reviewing the 2027 plan data have reported that many plans raised their maximums this year, so compare yours carefully. This number is your worst case in a bad health year.
6. Extras you actually use
Dental, vision, hearing aids, over-the-counter allowances, fitness and transportation are the benefits plans trim first. Only worry about the ones you actually use.
A quick worked example: reading a drug change
Say your ANOC’s drug section says one of your medicines moves from “Tier 3: Preferred Brand” to “Tier 4: Non-Preferred Drug” in 2027. Here’s how I’d think it through:
- Find the cost for each tier. The ANOC or the plan’s Summary of Benefits lists what you pay per tier, often a flat copay for lower tiers and a percentage (coinsurance) for higher ones.
- Work out your yearly cost for that drug at the new tier, remembering you pay the full price during the deductible stage if your plan applies the deductible to that tier.
- Ask about a cheaper alternative. Your doctor may be able to switch you to a drug on a lower tier, or request a formulary exception from the plan.
- Compare against other plans. Enter the drug into Plan Finder for 2027 and see whether another plan covers it at a lower tier.
The same steps work if a drug picks up a new prior authorization requirement. Ask your doctor’s office to start the paperwork in December, so you aren’t waiting at the pharmacy counter in January.
Medicare Advantage vs stand-alone drug plan ANOCs
If you have Medicare Advantage with drug coverage, your ANOC covers both medical and drug changes: doctor copays, hospital costs, the out-of-pocket maximum, extras, and the drug list. That makes it longer, and the network section matters a lot.
If you have Original Medicare with a stand-alone Part D plan, the ANOC covers only drug coverage: premium, deductible, formulary, tiers and pharmacies. Medigap policies don’t send an ANOC, so watch for premium notices from your Medigap insurer separately.
Either way, keep a one-page summary of the six lines above. Next September, you’ll be glad you can compare three years at a glance.
What the 2027 rules change for everyone
Some changes come from Medicare, not your plan, so they’ll show up in every drug plan’s ANOC:
- The Part D out-of-pocket cap rises to $2,400 (from $2,100). After you hit it, covered drugs cost $0 for the rest of the year.
- Fifteen more drugs have negotiated Medicare prices starting January 1, including Ozempic, Wegovy, Trelegy and Linzess. Your copay still depends on your plan.
- Medicare Advantage plans may process prior authorization requests electronically starting January 1, 2027, per Medicare’s 2027 fact sheet.
My full rundown is in Medicare changes for 2027, and drug plan details are in Part D in 2027.
A short script for calling your plan
If something in your ANOC doesn’t make sense, call member services and ask:
- “Are all of my drugs on your 2027 formulary, and at what tier?” (Read them your list.)
- “Are there any new prior authorization or step therapy rules on my drugs?”
- “Is my pharmacy preferred in 2027?”
- “What’s my 2027 out-of-pocket maximum, in network and out of network?”
- “Is Dr. ____ in network for 2027?”
Write down the date, the representative’s name and the answers. If a plan representative tells you something that turns out to be wrong, that record helps.
What to do after you’ve read it
If nothing important changed and your drugs and doctors are still covered at similar costs, you can stay. Your plan renews automatically.
If costs went up or a drug or doctor dropped out, compare 2027 plans during Open Enrollment, October 15 to December 7. My Open Enrollment guide covers the dates and choices, and my guide to finding the best plan in your area walks through Plan Finder.
If your plan isn’t renewing, you’ll get a separate non-renewal notice rather than a normal ANOC. You’ll have a Special Enrollment Period to choose new coverage, which I explain in Medicare Special Enrollment Periods.
FAQ
What is a Medicare Annual Notice of Change?
It’s a notice from your Medicare Advantage or Part D plan listing changes to your costs, coverage and other plan details that start January 1 of the next year. Medicare says plans send it in September.
What if I didn’t get my ANOC?
Check your email and your plan’s member website, then call member services using the number on your card. Ask them to send it or tell you where to find it online.
Do I have to do anything after I read it?
No. If you’re happy with your plan and it’s continuing, it renews automatically. If you want to change, use Open Enrollment, October 15 to December 7.
Is the ANOC the same as the Evidence of Coverage?
No. The ANOC summarizes what’s changing. The Evidence of Coverage is the full rulebook for your plan. Use the ANOC to spot changes, and the Evidence of Coverage when you need the details.
Does Original Medicare send an ANOC?
No. Only Medicare Advantage and Part D plans send ANOCs. Changes to Original Medicare costs, like the Part B premium, are announced by CMS each fall.
