Your Medicare Annual Notice of Change (ANOC) is the letter your Medicare Advantage or Part D drug plan sends each fall listing what changes in your plan on January 1, 2027. It covers costs, covered drugs, benefits and rules. If you do nothing, you stay in the same plan with the new terms. If the changes don't work for you, you can switch plans during Medicare Open Enrollment, which runs October 15 to December 7, 2026. This guide walks through the 7 parts of the notice worth checking line by line, and what to do with what you find.
The ANOC Timeline at a Glance
| Date | What happens |
|---|
| By September 30, 2026 | Your plan must get the Annual Notice of Change to you (federal rules require it at least 15 days before Open Enrollment starts) |
| October 15, 2026 | Medicare Open Enrollment opens |
| December 7, 2026 | Last day to switch plans for January 1 |
| January 1, 2027 | The changes in your ANOC take effect, along with any new plan you picked |
| January 1 to March 31, 2027 | People in a Medicare Advantage plan get one more chance to make one change |
Medicare.gov says that if you don't get your notice, you should contact your plan. The phone number is on the back of your member card. Most plans also post the ANOC on their website, usually next to the Evidence of Coverage, which is the longer document that spells out every rule of the plan for the year.
For every date in the enrollment calendar, see our Medicare Open Enrollment dates guide.
Who Gets an Annual Notice of Change
You get an ANOC if you are in:
- A Medicare Advantage plan (Part C), with or without drug coverage
- A stand-alone Part D prescription drug plan
- A Medicare cost plan
You do not get one for Original Medicare itself or for a Medigap (Medicare Supplement) policy. Medigap premium changes come in a separate letter from the insurance company. If you have Original Medicare plus a Part D plan, your ANOC comes from the drug plan and only covers your drug coverage.
The 7 Things to Check in Your ANOC
Most notices open with a summary table comparing this year to next year. Start there, then read the detail pages for anything that touches care you actually use.
1. The monthly plan premium
Look for the line showing your plan premium for 2026 next to 2027. A $0 plan can start charging a premium, and a plan with a premium can raise it.
This number is only the plan's own premium. Most people also pay the Part B premium, which is set by Medicare, not your plan. The standard Part B premium is $202.90 a month in 2026. CMS had not announced the 2027 Part B premium when this page was published on November 9, 2026. It usually comes out in November. Some Medicare Advantage plans pay back part of the Part B premium, and the ANOC will show if that "giveback" amount is changing.
2. Your drugs: the list, the tiers and the rules
This is where many people find the surprise. Check each drug you take for:
- Still covered? Plans can drop drugs from their list of covered drugs (the formulary).
- Same tier? A drug moving from tier 2 to tier 3 can raise your copay even if the drug is still covered.
- New rules? Watch for prior authorization (the plan must approve it first), step therapy (you must try a cheaper drug first) or quantity limits.
The ANOC does not always list every drug change. Pull up the plan's 2027 drug list on its website, or enter your drugs in Medicare's Plan Finder, which prices them under every plan in your area.
Two federal Part D limits change in 2027, according to CMS's 2027 Rate Announcement:
| Part D figure | 2026 | 2027 |
|---|
| Highest deductible a drug plan can charge | $615 | $700 |
| Yearly cap on what you pay for covered drugs | $2,100 | $2,400 |
Your plan's deductible can be lower than $700, and many Medicare Advantage drug plans charge less, so check the number in your own notice. Once your out-of-pocket drug costs reach the cap, you pay nothing more for covered Part D drugs for the rest of the year. Our Part D 2027 guide explains how the cap works.
If you get Extra Help, CMS says the most you'll pay in 2027 is $5.80 for a generic drug and $14.40 for a brand-name drug, and less if you also have full Medicaid and income at or below the poverty line.
3. The yearly out-of-pocket limit (Medicare Advantage only)
Every Medicare Advantage plan has a yearly cap on what you pay for covered medical care in its network. Many plans raised this limit for 2027, and Medicare's ceiling for in-network care goes from $9,250 to $9,850. Find your plan's 2027 number in the summary table and ask yourself whether you could pay it in a year with a hospital stay or surgery. We break down how much plans raised it in our 2027 out-of-pocket limit report.
4. Your doctors, hospitals and pharmacies
Networks can change from year to year, and the ANOC may not name every doctor or hospital leaving. Do this check yourself:
- Write down every doctor, specialist and hospital you use.
- Look each one up in the plan's 2027 provider directory, or call the office and ask: "Will you be in network with [plan name] in 2027?"
- Check that your pharmacy is still in network, and whether it is a "preferred" pharmacy. Preferred pharmacies often have lower copays.
If a doctor you rely on is leaving the network, that alone can be a reason to compare plans.
5. Copays and coinsurance for medical care
Compare the 2026 and 2027 columns for the services you use most:
| Service | What to look for |
|---|
| Primary care visit | Copay going up from $0 or a small amount |
| Specialist visit | Higher copay, or a new referral requirement |
| Hospital stay | Higher daily copay or more days you pay for |
| Skilled nursing facility | Change in which days you start paying |
| Outpatient surgery, imaging, labs | Copay changing to coinsurance (a percentage of the bill) |
| Emergency room and urgent care | Higher copay |
| Medical deductible | A new deductible, or a higher one |
A switch from a flat copay to coinsurance matters more than it looks. A $50 copay is $50. Twenty percent coinsurance on a $3,000 MRI is $600.
6. Extra benefits: dental, vision, hearing and allowances
Many Medicare Advantage plans offer benefits Original Medicare does not cover, such as dental, eyeglasses, hearing aids, gym memberships, transportation and allowance cards for over-the-counter items or groceries. These are optional for plans, so they are among the first things to shrink. Check:
- Has the dental dollar limit dropped, or have covered services narrowed?
- Has a monthly or quarterly allowance been cut, removed or limited to certain people?
- Do you now need to use a specific vendor or network for dental, vision or hearing?
If you picked the plan for one of these benefits, make sure it still delivers what you need.
7. Rules, plan type and whether your plan is still the same plan
The last section of most notices covers administrative changes that can still affect you:
- Prior authorization or referrals added for services that didn't need them before
- A plan merger, where your plan is folded into another plan with a new name or plan number
- A service area change that affects where you can get covered care
If your plan is leaving Medicare or your area entirely, you get a separate non-renewal letter, not just an ANOC. That letter explains your options and the special enrollment period you get, so you are not stuck if you miss December 7. Read the dates in that letter closely, because they depend on how the plan is ending.
What Your ANOC Findings Mean
| If your ANOC shows | What it can mean for you |
|---|
| A drug you take dropped or moved to a higher tier | Higher drug costs, or the need to switch drugs or plans |
| A higher out-of-pocket limit | Bigger worst-case bill in a year of heavy care |
| A doctor or hospital leaving the network | Paying more to keep seeing them, or finding a new provider |
| A new premium or a higher one | Higher fixed cost every month, even if you rarely use care |
| Cuts to dental, vision or allowances | Paying yourself for things the plan used to cover |
| Only small changes, none to care you use | Staying put may be reasonable, but compare anyway |
How to Compare Plans Before December 7
- Gather your list. Your drugs with doses, your doctors, your pharmacy and your current plan's 2027 numbers from the ANOC.
- Use Medicare's Plan Finder. Go to Medicare.gov/plan-compare, enter your ZIP code and drugs, and compare estimated total yearly costs, not just premiums. Plan Finder adds premiums and estimated drug costs together.
- Check star ratings. Medicare rates plans from 1 to 5 stars on quality and member experience. Our star ratings guide explains what the stars measure.
- Get free, unbiased help. Your State Health Insurance Assistance Program (SHIP) gives free one-on-one Medicare counseling and does not sell plans. Find yours at shiphelp.org. You can also call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, 24 hours a day.
- Enroll by December 7. Joining a new plan of the same type usually ends your old one automatically. You can enroll through Plan Finder, by calling 1-800-MEDICARE or by contacting the new plan.
- Watch the mail. Your new plan should send a confirmation letter and, later, a new member card. Keep using your current plan until January 1.
If you are thinking about leaving Medicare Advantage for Original Medicare, check Medigap first. Outside of certain protected situations, Medigap insurers in most states can ask health questions and turn you down or charge more. Line up your Medigap options before you drop your Medicare Advantage plan.
What Happens If You Do Nothing
If your plan continues in 2027 and you take no action, you stay enrolled automatically. Every change in your ANOC applies on January 1, whether or not you read it. That is the main reason to read it now: after December 7, your options to change are limited until next fall, with a few exceptions.
The main exception is the Medicare Advantage Open Enrollment Period, January 1 to March 31, 2027. If you are in a Medicare Advantage plan on January 1, you can make one change during that window: switch to a different Medicare Advantage plan, or go back to Original Medicare and join a drug plan. People with only Original Medicare and a stand-alone drug plan can't use this window to switch drug plans.
Other special enrollment periods exist for events such as moving, losing other coverage, qualifying for Extra Help or Medicaid, or your plan leaving Medicare.
Frequently Asked Questions
What is the Medicare Annual Notice of Change?
It is a yearly letter from your Medicare Advantage, Part D or cost plan that lists the changes to costs, coverage, drugs and rules for the next year. For 2027 plans, it must reach you by September 30, 2026, and the changes take effect January 1, 2027.
When should I get my ANOC?
Federal rules require plans to notify members at least 15 days before Open Enrollment begins on October 15, so by September 30. If it never arrived, call the member services number on your card and ask for a copy, or look on the plan's website.
Do I have to do anything after I get my Annual Notice of Change?
No action is required. If you are happy with your plan's 2027 terms, you stay enrolled automatically. If you want to switch, you have until December 7, 2026 for the change to start January 1.
What is the difference between the ANOC and the Evidence of Coverage?
The ANOC is a short summary of what changes next year. The Evidence of Coverage (EOC) is the full rulebook for the plan year: every benefit, cost, rule and appeal right. If something in the ANOC is unclear, the EOC has the details.
Does Original Medicare send an Annual Notice of Change?
No. Original Medicare (Parts A and B) does not send an ANOC. Medicare mails the "Medicare & You" handbook each fall, and Part B premium and deductible changes are announced by CMS. A Medigap policy also does not send an ANOC; your Medigap insurer notifies you of premium changes separately.
Can I switch plans after December 7?
Only in certain situations. People in a Medicare Advantage plan can make one change between January 1 and March 31, 2027. Others need a special enrollment period, for example after a move, a loss of other coverage, or a plan leaving Medicare. Most people with Original Medicare and a stand-alone Part D plan who miss December 7 keep that drug plan for 2027.
My ANOC says my plan is merging with another plan. What does that mean?
Your coverage generally continues under the other plan, which may have a different name, plan number, network or costs. Read the notice for the new plan's 2027 premium, drug list and network, and compare it during Open Enrollment the same way you would compare any other plan.
Where can I get free help reading my ANOC?
Your State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling and can walk through your notice with you. Find your local office at shiphelp.org, or call 1-800-MEDICARE (1-800-633-4227).
Sources
- Medicare.gov, "Plan Annual Notice of Change (ANOC)": medicare.gov
- 42 CFR 422.111(d)(2), notice of plan changes at least 15 days before the Annual Coordinated Election Period: ecfr.gov
- CMS, "Announcement of Calendar Year (CY) 2027 Medicare Advantage Capitation Rates and Part C and Part D Payment Policies," April 6, 2026, Table V-2 (Part D deductible, out-of-pocket threshold and Extra Help copays): cms.gov
- CMS, "2026 Medicare Parts A & B Premiums and Deductibles" fact sheet, November 14, 2025: cms.gov
- CMS, Final CY2027 Part C bid review memo, April 22, 2026, Table 3 (Medicare Advantage out-of-pocket ceilings)
- Medicare Plan Finder: medicare.gov/plan-compare
- State Health Insurance Assistance Programs: shiphelp.org
