Every fall, millions of Medicare beneficiaries receive a document that many set aside without reading. The Annual Notice of Change (ANOC) tells you exactly how your Medicare Advantage or Part D plan will change on January 1 — giving you time to compare alternatives before enrollment windows close. Here is how to read it, what to check, and what your options are if you do not like what you see.
What the ANOC Is
The Annual Notice of Change is a required document that Medicare Advantage plans and standalone Part D prescription drug plans must send each year, timed so members receive it by September 30 — before the Annual Enrollment Period begins on October 15.
The ANOC shows a side-by-side comparison of your plan's current-year details and what they will look like starting January 1, generally covering changes to:
- Costs — premiums, deductibles, copays, coinsurance, and out-of-pocket limits
- Coverage — which services and drugs are covered, and at what level
- Rules — network requirements, prior authorization, referrals, and pharmacy arrangements
Because plans may change significantly from year to year, the ANOC deserves a careful read every fall. It pairs well with a broader AEP checklist so nothing slips through.
The Six Things to Check
Focus on the six areas most likely to affect your budget and your care.
1. Monthly Premium
Check whether your plan's monthly premium is going up, staying the same, or going down. Even a plan with a longstanding $0 premium may add one. With Medicare Advantage, you generally continue paying your Part B premium in addition to any plan premium, so factor both into your budget.
2. Deductibles, Copays, and Coinsurance
Look at the deductible for both medical services and prescription drugs. The maximum allowable Part D drug deductible is $615 in 2026, and a plan with no drug deductible this year may add one next year. Then review the copays and coinsurance for the services you actually use — primary care, specialists, hospital stays, lab work — since small per-visit increases add up over a year of regular care.
3. Maximum Out-of-Pocket Limit
Every Medicare Advantage plan has a maximum out-of-pocket (MOOP) limit — the most you can be required to pay for covered in-network medical services in a year. For 2026, the in-network MOOP can be as high as $9,250. Your plan may set a lower limit, but that limit can rise from one year to the next, increasing your worst-case annual exposure — which matters most if you have ongoing health conditions.
4. Formulary Changes for Your Specific Drugs
Check every medication you take by name against the plan's updated drug list for formulary changes:
- Tier moves — a drug moving to a higher tier generally means a higher copay or coinsurance
- Drugs removed from the formulary — you may need to switch medications or pay full price
- New prior authorization requirements — the plan may require approval before covering a drug it covered automatically this year
- New step therapy requirements — you may be required to try a lower-cost drug first
If any of your prescriptions are affected, our guide to how formularies and drug tiers work explains what these changes mean in practice.
5. Provider and Pharmacy Network Changes
Plans adjust their provider networks and pharmacy networks every year. Check whether:
- Your doctors, specialists, and hospital will still be in-network next year
- Your preferred pharmacy will still offer preferred cost-sharing — losing preferred status can raise your copays even if the pharmacy remains in-network
The ANOC may not list every network change, so confirm directly with your plan or its online directory. For more on how networks affect your costs, see our guide to Medicare networks and provider directories.
6. Supplemental Benefits
Many Medicare Advantage plans offer supplemental benefits such as dental, vision, hearing, over-the-counter (OTC) allowances, fitness memberships, or transportation. These extras may be added, reduced, or removed from year to year. If a dental benefit or OTC card factored into your plan choice, verify it still exists next year — and whether its allowance or covered services have changed.
Why the ANOC Matters More Now
Recent regulatory changes make the ANOC even more important. Starting with contract year 2027, CMS eliminated the requirement that Medicare Advantage plans send members a mid-year notice about unused supplemental benefits — a reminder of extras you were entitled to but had not used. At the same time, plans continue to adjust their service areas, and a plan may exit your county entirely, which the ANOC (or a related non-renewal notice) would flag in the fall.
The practical takeaway: the ANOC may be your only advance warning of meaningful changes to your coverage. If you review your plan only once a year, fall is the time — though a mid-year Medicare checkup can also help you catch issues early.
ANOC vs. Evidence of Coverage (EOC)
Your plan provides two related documents each fall, and it helps to know the difference:
- Annual Notice of Change (ANOC) — a summary of what is changing in your plan for the coming year, presented side by side. This is the shorter document designed for quick review.
- Evidence of Coverage (EOC) — the complete explanation of how the plan works: every covered service, rule, cost-sharing amount, and your rights and appeal procedures.
Plans generally mail the ANOC and post the EOC on their website (you can request a printed copy). If the ANOC flags a change you do not fully understand — say, a new prior authorization rule — the EOC is where the full details live.
Didn't Get Your ANOC?
If September ends and no ANOC has arrived:
- Contact your plan — call the number on the back of your membership card and ask for the ANOC to be sent or pointed to online
- Check your Medicare.gov account — log in at Medicare.gov to confirm which plan you are enrolled in and review plan materials
- Verify your mailing address — make sure your plan and Social Security have your current address, especially if you have moved recently
If you opted into paperless communication, the ANOC may arrive electronically, so check your email and your plan's member portal as well.
What to Do If You Don't Like the Changes
If your ANOC reveals changes that do not work for you, you have options — which one makes sense depends on your situation:
- Compare alternatives during AEP — The Annual Enrollment Period runs from October 15 through December 7, with changes effective January 1. The official plan finder at Medicare.gov/plan-compare shows plans available in your area, and our guide on how to compare Medicare plans walks through the process.
- Medicare Advantage Open Enrollment — If you are enrolled in a Medicare Advantage plan and discover a problem after January 1, this period (January 1 – March 31) allows one switch to another Medicare Advantage plan or a return to Original Medicare with the option to join a Part D plan.
- Missed the window? — Depending on your circumstances, a Special Enrollment Period may apply. See our guide on what to do if you missed open enrollment.
If you are unsure how the changes affect you, help is available:
- 1-800-MEDICARE (1-800-633-4227) — Medicare's official helpline can answer questions about plan materials and enrollment windows. TTY users can call 1-877-486-2048.
- State Health Insurance Assistance Program (SHIP) — SHIP offers free, unbiased counseling from trained counselors who can help you read your ANOC and weigh your options. Find your local program at shiphelp.org.
- CMS.gov — Plan requirements and enrollment rules are published at CMS.gov.
Summary and Next Steps
Your Annual Notice of Change is your early-warning system for how your coverage will change on January 1. Key points:
- Plans must send the ANOC so you receive it by September 30, before AEP begins October 15
- Check six things: premium, deductibles and copays, the out-of-pocket maximum, your drugs on the formulary, your providers and pharmacy, and supplemental benefits
- The 2026 Medicare Advantage in-network MOOP can be as high as $9,250, and the Part D deductible can be up to $615
- The ANOC summarizes what changes; the EOC explains how the plan works in full detail
- If you did not receive an ANOC, contact your plan and verify your mailing address
- Depending on your situation, you may compare alternatives during AEP (October 15 – December 7); Medicare Advantage enrollees may also make one switch during MA Open Enrollment (January 1 – March 31)
When your ANOC arrives this fall, set aside 20 minutes to read it with your medication list and your doctors' names in hand. If anything looks unfavorable, your local SHIP counselor can provide free, personalized guidance.
