Medicare ANOC: How to Read Your Notice of Change
Your Medicare plan mails an Annual Notice of Change (ANOC) each September. Learn what the ANOC shows, how to read it, and what to do before Open Enrollment ends.
Your Medicare Advantage or Part D plan mails a Medicare Annual Notice of Change, the ANOC, every September. It spells out exactly how your plan will change on January 1. Reading it is the single most useful thing you can do before the Medicare Annual Enrollment Period, because a plan that fits you this year can look very different next year.
What is the Annual Notice of Change?
The ANOC letter is a document your plan must send by September 30 each year, ahead of the Annual Enrollment Period, which runs October 15 to December 7 and is usually shortened to AEP. Getting the ANOC letter early is the point: it gives you two weeks to weigh your Medicare options before AEP opens. It compares your current coverage against what the plan will offer in the new plan year, so you can decide whether to keep it or switch. It usually arrives with the Evidence of Coverage, or EOC, a longer document holding the full plan rules.
Only Medicare Advantage plans and Part D drug plans send one. If you have a Medicare supplement, also called Medigap, you will not receive an ANOC, because those plans are standardized and their benefits do not change from year to year. Your Medigap premium can still rise, so watch for a separate notice from that insurer.
What the ANOC tells you
Focus on these sections, and compare each one against what you have now:
| What changed | Why it matters |
|---|---|
| Monthly premium | A higher premium raises your fixed monthly cost, even on a "$0 premium" plan that adds one. |
| Deductible | Changes how much you pay before the plan starts covering costs. |
| Copays and coinsurance | Your cost-sharing per visit, service, or prescription can rise or fall. |
| Drug formulary | Your plan can drop a drug from the formulary, move it between drug tiers, or add restrictions. Check every medication. |
| Provider networks | Provider and pharmacy networks change every year, and a pharmacy can lose preferred status. |
| Service areas | A plan can stop operating in your county altogether. |
| Supplemental benefits | Dental, vision, hearing, over-the-counter and flex-card allowances change every year. |
| Out-of-pocket maximum | The ceiling on your out-of-pocket costs in a bad year. A higher cap means more risk. |
The drug changes people miss
Most readers check whether a drug is still on the formulary and stop there. That is only half the question, because your prescription drug coverage can get harder to use while the drug stays technically covered. Three restrictions can be added for the new plan year:
- Prior authorization. Your plan must approve the drug before it will pay. Your doctor has to submit paperwork, and it can take days.
- Step therapy. You must try a cheaper drug first and show it did not work before the plan covers the one you are on.
- Quantity limits. The plan caps how much it will cover in a given period, so a 90-day fill may become a 30-day fill.
Each of these can appear on a drug you have taken for years. Check the restriction column, not just whether the name is on the drug list, and check the drug tier as well: the same drug moved up a tier can cost noticeably more.
How to read your ANOC
Do not just skim the first page. Go line by line and mark anything that went up or changed:
- Your prescriptions: confirm each drug is still covered, at the same tier, with no new restrictions.
- Your doctors and pharmacy: make sure they are still in network and still preferred.
- Your costs: compare the new premium, deductible and copays to what you pay today, and write down the cost changes. Your Part B premium is billed separately by Medicare and is not in the ANOC.
- Your extra benefits: see whether the dental, vision, hearing or flex card benefits shrank.
For a full walkthrough, use our Medicare Open Enrollment checklist.
What to do after reading it
- If the plan still fits, you do not have to do anything. It renews automatically on January 1 with the changes listed.
- If your plan is leaving your service area, that triggers a special enrollment period, giving you more time than AEP alone to pick a replacement.
- If something important got worse, use the open enrollment period to switch to a better plan before December 7. You can also compare quality using the star ratings.
Medicare beneficiaries who end up overpaying are usually the ones who set the ANOC aside and let the plan auto-renew. A few minutes of reading can hold your healthcare costs down, and it is the reason plans change year to year in the first place (here is why).
Common questions about the ANOC
When does the Annual Notice of Change come out?
Plans must send the ANOC by September 30 each year, so it reaches you before the Annual Enrollment Period opens on October 15.
What is the difference between the ANOC and the Evidence of Coverage?
The Medicare ANOC summarizes what is changing for next year. The EOC is the longer document that spells out all of your plan's rules, costs, and covered medical services in full.
What should I do with my ANOC?
Read it, compare each change to your current coverage, and check that your drugs, doctors, and pharmacy are still covered. If the plan no longer fits, weigh your other Medicare options and switch during open enrollment.
What happens if I do nothing after the ANOC?
Your plan renews automatically for the new year with the changes it described. If your plan is being discontinued and you do nothing, you could lose that coverage and return to Original Medicare without a drug plan.
Do Medicare supplement plans send an ANOC?
No. Medigap benefits are standardized and do not change annually, so there is no ANOC. You may still get a rate-increase notice from the insurer.
Can my plan add prior authorization to a drug I already take?
Yes. Prior authorization, step therapy, and quantity limits can all be added for the new plan year even when the drug stays on the formulary. The ANOC is where that appears.
I did not get an ANOC. What should I do?
Contact your plan directly, since they are required to send it. You can also call 1-800-MEDICARE, or review your plan's next-year details at Medicare.gov with a licensed advocate.
Talk to a licensed Medicare advocate
Want a second set of eyes on your ANOC? A licensed Medicare Advocate will read through the ANOC letter with you and compare your plan against the other Medicare Advantage plans in your area, at no cost. Give us a call before December 7.