The Annual Notice of Change, or ANOC, is the letter your Medicare Advantage or Part D plan sends each fall to tell you what will be different on January 1. It covers premiums, deductibles, copays, drug coverage and provider networks. It is not a flyer. Read it before December 7, because that is the last day to switch plans for 2027 during open enrollment.
If you are reading this in mid-October 2026, your letter should already be in your mailbox or inbox. This guide walks through what is inside it, what to check first, and what to do if you do not like what you find.
TL;DR
- The ANOC comes from your plan, not from Medicare, and it lists changes that take effect January 1, 2027.
- Plans must send it by September 30. If yours has not arrived, ask your plan for a copy now.
- Check four things first: premium and deductible, your drugs on the formulary, your doctors and pharmacy in the network, and your out-of-pocket maximum.
- Open enrollment runs October 15 to December 7. Doing nothing usually means you stay in the plan with its new rules.
- Medigap policies and Original Medicare alone do not produce an ANOC, but your drug plan still does.
Table of Contents
- What the Annual Notice of Change actually is
- When it should arrive, and what to do if it does not
- How to read it: five things to check in order
- A worked example
- Compare, then decide before December 7
- Income and the premium letter you might also get
- What we see from Southwest Florida
- Common mistakes with the ANOC
- A simple timeline for the next seven weeks
- Get a second set of eyes on your notice
- Frequently asked questions
- Sources
What the Annual Notice of Change actually is
Medicare.gov explains that if you are in a Medicare plan, your plan sends you a Plan Annual Notice of Change each fall, listing changes in coverage and costs that take effect the following January. Healthline’s overview describes it as a letter sent by Medicare Advantage or Part D plans, which is the group that gets one.
Three points trip people up.
It is a legal notice, not marketing. It looks like the many mailers that arrive in the fall, and plenty of people toss it with the rest. It is a required document that outlines changes to your plan’s contract. Treat it the way you would treat a bank statement showing new fees.
It comes from your plan. Medicare does not mail it. The envelope carries your insurance company’s name, often alongside an Evidence of Coverage, which is the longer document with all the plan rules.
Your plan renewing is not the same as your plan staying the same. Even if your Advantage plan is still sold next year, the formulary, network and cost-sharing can change enough that it becomes a different product. That is why a fresh comparison every year makes sense.
When it should arrive, and what to do if it does not
Plans must send the notice by September 30, according to a recent consumer report on the 2027 notices. Many arrive earlier in September, by mail or by email if you chose electronic delivery.
If nothing has come by early October:
- Check your email spam folder and any online portal your plan gave you.
- Call the member services number on your plan ID card and ask for the 2027 ANOC and Evidence of Coverage.
- Ask them to confirm how you receive notices, paper or electronic, so next year does not repeat the problem.
Not receiving the letter does not pause the calendar. Medicare.gov’s guidance is that failing to review your plan’s changes can leave you in a plan with very different coverage or costs. Request the copy rather than waiting.
How to read it: five things to check in order
Most ANOCs run several pages. You do not need to read every line the first time. Start here.
1. Premium, deductible and copays
Look for the table that compares 2026 with 2027 side by side. Note the monthly premium, the medical and drug deductibles, and the copays you use most: primary care, specialists, urgent care, emergency room and inpatient stays. A premium that looks flat can hide a higher specialist copay.
Find the maximum out-of-pocket amount too. For an Advantage plan, this is the ceiling on what you pay for covered medical services in a year, and it matters most in the year you have a serious illness.
2. Your prescriptions
Plans change their drug lists, which Medicare calls the formulary. A drug can move to a higher tier, need prior authorization, or be dropped. Medicare’s own Your Yearly Medicare Review tells you to review the notice from your plan and then compare options at Medicare.gov/plan-compare.
Go down your medication list one drug at a time. For each, write down the 2027 tier, any restrictions and the cost at your pharmacy. If you fill 90-day supplies by mail, check whether the mail-order price and pharmacy status changed. Our guide to Medicare mail order pharmacy and refill gaps covers what to verify.
Stand-alone Part D premiums also deserve a hard look this year. Federal regulators are ending a temporary program that held down stand-alone drug plan premiums in 2025 and 2026, reports the same consumer article. Our explainer on Part D premium changes and coverage gaps breaks down the pieces of your drug bill.
3. Doctors, hospitals and pharmacies
Networks shift. A specialist you have seen for ten years can leave a network in December. Do not rely on the letter alone: call each doctor’s office, give the exact plan name, and ask whether they will be in network on January 1. Do the same for the hospital you would use in an emergency and for your pharmacy.
If you have a care routine that depends on a particular provider, such as a chiropractor, a dental office or physical therapy, check access and coverage rules for those services too. For dental in particular, many people assume more is covered than is. A plain-language guide to Medicare dental coverage and claims is a useful reference when you are trying to separate what Original Medicare pays from what a plan’s extra benefits might add.
4. Extra benefits
Dental, vision, hearing, over-the-counter allowances and fitness programs vary plan to plan and can be trimmed from year to year. If you picked your plan for one of these, confirm it is still there and read the limits: annual dollar caps, network restrictions and waiting periods.
5. Service-area and plan changes
Occasionally a plan reduces its service area or ends altogether. The notice will say so. If your plan is leaving your county, you will have additional options, but do not wait for the last day to explore them.
A worked example
Imagine a retiree in Lee County on a Medicare Advantage plan with a $0 premium. Her 2027 ANOC shows the premium still at $0, so she is tempted to file it away. Reading further, she finds that her blood thinner moved from tier 2 to tier 3, her cardiologist’s group is listed as leaving the network, and the specialist copay went up. Nothing in the headline number changed, yet her real costs and access did.
This is an illustration, not a real client. It shows why the premium line is only the first of five checks.
Compare, then decide before December 7
Once you know how your current plan will change, you compare it to the alternatives available where you live. The tool to use is the plan finder at Medicare.gov, which lets you enter your drugs, pharmacies and ZIP code. Healthline recommends pairing the notice with that tool so you can see revised costs against other plans in your area.
The timing is set by Medicare’s open enrollment page: open enrollment runs October 15 to December 7, and changes you make are effective January 1 of the next year. That means a choice made on December 7 still takes effect on time, but waiting leaves no room to fix a mistake.
Your realistic options are:
| Option | When it makes sense | What to confirm |
|---|---|---|
| Stay in your plan | Costs, drugs and doctors all still fit | Every drug, doctor and pharmacy checked, not assumed |
| Switch to another Advantage plan | Your plan got worse or a better fit exists | Network, formulary, out-of-pocket maximum |
| Change your Part D plan | Your drugs moved tiers or premiums jumped | Total annual drug cost, not just premium |
| Return to Original Medicare | You want any-provider access and nationwide flexibility | How you will cover the gaps, such as a Medigap policy |
Switching back to Original Medicare and adding a Medigap policy raises a separate question, because Medigap underwriting rules differ by state and by timing. Check the rules before you drop an Advantage plan. Our comparison, Medicare Advantage vs. Original Medicare in 2026 for Florida seniors, lays out the tradeoffs, and our Medicare Supplement page explains how Plan G and Plan N fit in.
Income and the premium letter you might also get
The ANOC is about your plan. A different notice can change what you pay to Medicare itself. The Income-Related Monthly Adjustment Amount, or IRMAA, is an extra charge on Part B and Part D premiums for higher earners, based on the modified adjusted gross income reported on your tax return from two years earlier. Social Security’s operations manual states that the figure generally comes from two years prior. For 2026, the threshold is $109,000 for single filers and $218,000 for married couples filing jointly.
If your income dropped because you retired or lost a source of income, you may be able to ask Social Security to use a more recent year. We cover the steps in our IRMAA guide and in how income affects Part B premiums.
What we see from Southwest Florida
Perspective
Every fall, people sit down at our table with an unopened envelope. They are not careless. They have been in the same plan for years, it worked, and the letter looks like one more piece of junk mail. The jolt comes when a pharmacy receipt is far higher than expected in January, or a doctor’s office says they no longer take the plan.
We do not treat the ANOC as a sales moment. We treat it as a checklist. We ask which drugs you take, which doctors you see, where you fill prescriptions, and whether you spend part of the year up north. A snowbird needs a plan whose network works in two places, and many Advantage networks are local. That one question settles more decisions than any premium comparison.
We work with multiple carriers, so the comparison is not limited to a single company’s products. The best plan is the one that still fits your life next year, which is sometimes the plan you already have. Our job is to help you see that before December 7 and not after January 1.
— Alston
Common mistakes with the ANOC
- Reading only the premium. Out-of-pocket maximum, drug tier and specialist copays often move more.
- Assuming the network will not change. Verify every doctor by phone, using the exact plan name.
- Waiting until December 7. Call volume is high near the deadline, and you want time to double-check.
- Skipping it because you are happy. Satisfaction last year does not guarantee the same plan this year. Medicare’s own guidance stresses reviewing it annually.
- Ignoring emergency transport. Ambulance bills can be large, and some plans leave gaps. We explain the problem in emergency transport gaps in Medicare Advantage plans and the alternatives in emergency transport coverage options for seniors.
A simple timeline for the next seven weeks
- This week: Find your ANOC and Evidence of Coverage. If you cannot, call your plan.
- By October 31: List your drugs, doctors and pharmacy. Check each against the 2027 notice.
- By mid-November: Compare at least two alternatives using the plan finder and, if you want help, a licensed agent.
- By December 1: Decide. Confirm enrollment in writing or by confirmation number.
- In early January: Check your new ID card, pharmacy and first claims. If a prescription is denied, our Part D appeals checklist explains the first steps.
If you want to work through this with someone, our 2027 enrollment page describes the free one-on-one plan review.
Get a second set of eyes on your notice
XactInsure is a local agency serving Fort Myers, Cape Coral, Naples and neighboring counties. We offer free, no-obligation consultations in which we read your ANOC with you, check your medications and doctors, and compare your current plan with options from multiple carriers. There is no pressure to switch. If your plan is still the right fit, we will tell you so. Book a 2027 plan review or see our Medicare Advantage and emergency transport options.
Frequently asked questions
Do I get an ANOC if I only have Original Medicare and a Medigap plan?
The ANOC comes from Medicare Advantage and Part D plans. If you have Original Medicare with a Medigap policy and no drug plan, you will not get one. Your Medigap insurer may send its own renewal or rate notice, so read that mail as well. If you have a stand-alone Part D plan, you will get an ANOC for it.
Does Medicare have to be renewed every year?
Original Medicare does not need annual renewal. Medicare Advantage and Part D plans generally continue into the next year unless you change them, but their terms can change. That is why the ANOC matters: staying put means accepting the new rules.
What if I miss the December 7 deadline?
Open enrollment ends December 7, and changes made in it start January 1. After that, you can switch only if you qualify for a special enrollment period or another election window. Rules vary, so confirm your eligibility with Medicare or a licensed agent before assuming you can change later.
Is the ANOC the same as the Evidence of Coverage?
No. The ANOC summarizes what is changing. The Evidence of Coverage is the full document describing your benefits and rules. Use the ANOC to spot changes, then consult the Evidence of Coverage for details on a specific service.
Who can help me understand mine?
Start with your plan’s member services line and Medicare’s plan finder. A licensed local agent can also walk through your notice with you at no cost to you. In Southwest Florida, that is what our team does.
Sources
- Plan Annual Notice of Change (ANOC), Medicare.gov
- ANOC and Medicare: What it Is and What’s In it, Healthline
- Your Yearly Medicare Review, Medicare.gov
- Open Enrollment, Medicare.gov
- SSA POMS HI 01101.010: Modified Adjusted Gross Income
- Medicare Plans Must Send 2027 Change Notices by September 30, Medical Daily
Recommended
- Original Medicare vs Advantage: what changed in 2026?
- Demystifying Medicare Part D: How to Navigate Premium Changes and Avoid Coverage Gaps
- Your Free Medicare Annual Wellness Visit: What to Ask, What Gets Covered, and Why It Matters
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