Every September your Medicare plan mails you an Annual Notice of Change. It arrives in the same week as a pile of marketing from carriers you have never heard of, and it looks like more of the same.
It is not. It is the only document all autumn that is actually about your plan, and it tells you exactly what is changing on January 1.
Here is how to read it in about ten minutes.
1. Your drug tiers
Go here first. Find each of your medications in the next-year column and compare the tier against this year.
A drug moving from a preferred to a non-preferred tier is the single most common expensive surprise in Medicare, and it happens quietly. The plan is not doing anything wrong — formularies are renegotiated annually — but a drug that cost you a small copay in December can cost several hundred dollars in February.
Any upward movement is worth a phone call.
2. The premium and deductible
Both can change, in either direction. Note the size of the move, not just the fact of it. A modest premium increase on a plan that still fits is not a reason to switch; a large one on a plan whose formulary also got worse usually is.
Also check whether the deductible now applies to tiers it previously did not.
3. The out-of-pocket maximum
On a Medicare Advantage plan this is your worst-case number for the year. It is the figure that decides whether a plan is genuinely affordable, and it is re-set annually.
Compare it against what you could actually absorb in a bad year. If it moved up meaningfully, the plan got riskier even if the premium stayed flat.
4. Office and specialist copays
These drive your cost in a normal year. A five-dollar move on a primary care copay is noise. A jump in the specialist copay matters a lot if you see one monthly.
5. The inpatient hospital cost share
Usually structured as a fixed amount per day for the first several days of an admission. It is the largest single exposure most Advantage members have, and it is easy to skim past.
If it increased sharply, that is worth understanding before you need it.
6. The supplemental benefits you chose the plan for
Dental, vision, hearing and over-the-counter allowances are re-set every year. If a dental allowance was part of why you picked this plan, confirm it survived at the level you expected — and read how it actually pays, not just the headline number.
What the ANOC will not tell you
Whether your doctors are still in network. The document does not list them.
You have to check separately — call each practice and ask whether they will participate in your specific plan for the coming plan year, or check the plan’s provider directory for the new year rather than the current one. Networks are renegotiated annually and a practice can leave without you hearing about it.
The timeline
| When | What happens |
|---|---|
| September | ANOC and next year’s Evidence of Coverage arrive. Keep them |
| Early October | Gather your drug list, doctor list and current plan card |
| October 15 | Annual Enrollment Period opens |
| October–November | Re-run drugs and doctors; compare against other plans in your county |
| December 7 | Annual Enrollment Period closes |
| January 1 | Changes take effect |
| January 1 – March 31 | Advantage members get one more change, if something is wrong |
The February phone call we would like to prevent
It comes every year and it always starts the same way: “I went to pick up my prescription and they wanted four hundred dollars.”
The drug moved tiers on January 1. The notice arrived in September. The window to change plans closed on December 7. From there the only routes are a formulary exception request through the plan — which does work more often than people expect, with a prescriber’s support — or waiting until the following October.
Twenty minutes in October prevents all of it.
You do not have to do this yourself
An annual coverage review is exactly this exercise, done for you: we read the ANOC, re-run every prescription against next year’s formulary at your pharmacy, verify every doctor against next year’s network, compare against the other plans now available in your county, and give you a recommendation with the reasoning written down.
It costs nothing, and even if you did not enroll through us, bring your notice. If the answer is stay put, we will tell you that too — which happens more often than you might expect.
Related: what a free plan comparison includes and the Annual Enrollment Period guide.
Frequently asked questions
What is an Annual Notice of Change?
A document your Medicare Advantage or Part D plan is required to mail each September, setting out side by side what the plan looks like this year and what it will look like next year — premiums, deductibles, cost sharing, drug tiers and supplemental benefits.
Do I have to do anything if I want to keep my plan?
Administratively no, plans auto-renew if they still exist. The risk is that the plan you are auto-renewed into on January 1 is not the plan you signed up for, because the formulary, network and cost sharing all reset.
What if I miss the December 7 deadline?
If you are already in a Medicare Advantage plan you get one more change during the Medicare Advantage Open Enrollment Period from January 1 to March 31. Otherwise you generally wait for the next Annual Enrollment Period unless a Special Enrollment Period applies.