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

For a lot of people that works out fine. For others, January brings a higher specialist copay, a drug that moved up a tier, or a dental allowance cut in half, and by then the main window to switch has closed.

Most of that is avoidable with twenty minutes and a pen. KFF found that 43% of Medicare Advantage enrollees didn't review their own plan for changes in premiums or other costs during a recent open enrollment, and 44% didn't check for changes in what it covers. Nearly 7 in 10 people on Medicare didn't compare their coverage with any other option.

Why read it closely this year?

Some years the changes are small. The 2027 plan year has more moving parts than usual.

The federal limits that drug plans build on are going up. The maximum Part D deductible rises from $615 to $700, and the cap on out-of-pocket drug costs goes from $2,100 to $2,400. A federal program that held down stand-alone drug plan premiums in 2025 and 2026 ends December 31, and plans are free to pass some of that along.

Insurers have been trimming, too. KFF counted 9% fewer Medicare Advantage plans in 2026 than in 2025, and among the plans that stayed, fewer offered an over-the-counter allowance (66%, down from 73%), a meal benefit (57%, down from 65%) or rides to appointments (24%, down from 30%). Some large insurers have said publicly that they're pulling back further for 2027.

None of that tells you what your plan will do. Only the notice does.

The five lines that move your costs

Near the front of the notice there's a summary table with two columns, this year and next year. Start there. You're looking for five lines.

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. It's the most you can be billed in a year for covered medical care, which makes it your real exposure if the year goes badly, say a hospital stay followed by weeks of outpatient treatment and specialist visits. Federal rules let plans set it as high as $9,250 for in-network care in 2026. Plenty of plans sit well under that. So they've got room to raise it.

Drug deductible and the copay for your tiers. 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.

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.

Say your notice looked like this. It's a made-up plan, but every line is the kind of change a real notice can carry.

In this example the premium is the smallest change on the page: $288 a year. A year with one hospital stay, a brand-name drug and dental work adds about $1,900 more, 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.

There's something else the notice won't tell you, and for most people it's the question that matters more than any copay. You'll have to go find the answer yourself.