Your Annual Notice of Change: The 5 Lines to Read Before You Renew Your Medicare Plan

If you’re in a Medicare Advantage plan or a stand-alone Part D drug plan, your insurer had to get a document to you by September 30. It’s called the Annual Notice of Change, or ANOC. It may have come as a thick envelope or, if you signed up for paperless delivery, as an email pointing you to your online account.

It looks like the rest of the fall mail from insurers, and that’s the problem. This one isn’t an ad. It’s your plan telling you, in writing, what it’ll charge and cover starting January 1, 2027.

Do nothing between October 15 and December 7 and you’re renewed into the 2027 version automatically. KFF found that 43% of Medicare Advantage enrollees didn’t review their own plan for cost changes during a recent open enrollment.

What follows is the whole job, in order. Twenty minutes with a pen, then a few phone calls.

Step 1. Find the notice

Look for a thick envelope from your insurer postmarked September, or an email from the plan with “annual notice” in the subject line. Both are easy to mistake for advertising.

If you can’t find either, call member services at the number on the back of your card and ask for the 2027 Annual Notice of Change. While you’re on the line, have them confirm your mailing address, and ask whether you’re set to paperless delivery. Many insurers also post it in your online account under plan documents.

Two cases where no notice is coming. If you have Original Medicare with a Medigap policy and no drug plan, you won’t get one at all: Medigap insurers send rate increase letters on their own schedule, and Original Medicare’s changes arrive in the “Medicare & You” handbook each fall. And if your plan is leaving your county, you got a non-renewal letter instead, which comes with different rights and a different deadline.

Step 2. Read five lines, not a hundred pages

Near the front there’s a summary table with two columns, this year and next year. Everything that matters to most people is in five rows.

Monthly premium. A jump from $0 to $24 is easy to spot. It’s also usually the least important of the five, because the others can cost more.

Maximum out-of-pocket amount. The most you can be billed in a year for covered medical care, which makes it your real exposure if the year goes badly. Federal rules let plans set it as high as $9,250 for in-network care in 2026. Plenty of plans sit well under that, which leaves them room to raise it.

Drug deductible and the copay for your tiers. Plans sort covered drugs into price levels called tiers, and higher tiers cost more. Watch for a deductible that now applies to tiers that used to skip it, and for a flat copay that’s turned into a percentage. A $47 copay becoming 25% coinsurance on a $600 drug means paying $150 a fill. The ceiling on what any plan can charge as a deductible rises to $700 for 2027, and a federal program that held down stand-alone drug plan premiums in 2025 and 2026 ends December 31, which plans are free to pass along.

Hospital and specialist copays. Inpatient stays are often priced per day for the first several days. A move from $295 to $395 a day doesn’t look like much until you multiply it.

Extra benefits. Dental, vision, hearing, over-the-counter cards and gym memberships aren’t required by Medicare, so they’re the easiest things for a plan to cut. Check the dollar allowance, not just whether the benefit still exists.

Here’s a made-up plan where every line is the kind of change a real notice can carry.

The premium is the smallest change on the page: $288 a year. One hospital stay, a brand-name drug and dental work add about $1,900 on top of it, and the ceiling on a truly bad year is $1,450 higher.

Someone who only checks the premium would call that a minor increase and renew.

Step 3. Check the one thing the notice doesn’t tell you

The notice says the provider network may change and points you to the new directory. It doesn’t say whether your cardiologist, your hospital or the pharmacy on the corner will still be in network in January.

The notice is a summary. The full rules for next year are in the Evidence of Coverage, which plans generally post online by October 15 and will mail if you ask. It often runs past a hundred pages, and nobody expects you to read it.

Treat it as a reference book you open for one question at a time.

A knee replacement on the calendar for spring sends you to the outpatient surgery and inpatient sections. Someone in physical therapy twice a week goes straight to the per-visit copay and whatever cap the plan puts on visits. If you head south for the winter, find the part about care outside the plan’s service area, because some plans pay only for emergencies and urgent care once you’re away.

The medical benefits chapter is laid out as a chart. Any single service takes a minute to find.

Step 5. Put it on one sheet, then decide

One page, written by hand, with your five lines and a yes or no for each doctor. That sheet is what you’d carry into a comparison, and it’s also what settles an argument in March if a bill doesn’t match what the notice promised. Keep the notice itself with your plan card.

If the answers are bad, the moves and their deadlines are laid out in the open enrollment checklist. One warning before you make the biggest of them: leaving Medicare Advantage for Original Medicare is easy, but the Medigap policy you’d want alongside it is not guaranteed. About 4 in 10 people in Original Medicare carry one, and outside a few protected situations, insurers in most states can ask health questions and turn you down. Get the Medigap approval in hand before you drop the plan, not after. The trade-offs are in Medicare Advantage against Medigap.

And if the answers are fine, write “kept plan, checked” and the date on the front of the notice. Come March you won’t remember otherwise.