Your Medicare Annual Notice of Change (ANOC) Is Arriving: What to Check
If you have a Medicare Advantage or Medicare Part D plan, your coverage can change each year. Your Annual Notice of Change (ANOC) arrives each fall and explains changes taking effect January 1. Medicare recommends reviewing it to determine whether your plan will continue to meet your needs.
Medicare Open Enrollment runs from October 15 through December 7. During this period, you can keep your current coverage or, if needed, change Medicare Advantage or Part D coverage for 2027.
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What Is an Annual Notice of Change?
The ANOC shows what your Medicare plan is changing for the coming year. Depending on your plan, changes may involve costs, medical benefits, doctors and hospitals, pharmacies, or prescription drug coverage.
CMS provides standardized ANOC models for different Medicare plan types. Regular Medicare Advantage plans, stand-alone Part D plans, and Massachusetts Senior Care Options (SCO) and One Care plans do not all use the same layout.
However, they cover many of the same areas that matter when reviewing your coverage, including costs, providers, pharmacies, medical benefits, and prescription drugs. The sections below focus on these key items, rather than on a specific ANOC format.
What Should You Look for in Your ANOC?
Summary of Important Costs
Where to look: If your ANOC includes a Summary of Important Costs, it will usually appear near the beginning.
| Review Item | Details |
|---|---|
| What you will find | A quick comparison of major current-year and 2027 costs. Depending on the plan, this may include the premium, medical out-of-pocket limit, doctor visits, hospital care, or prescription costs. |
| What you may not find | Every cost or benefit change that could affect you. The summary is only a starting point. |
Bottom line: Use the summary to spot major changes quickly, then review the items below that matter to you.
Changes to Your Monthly Plan Premium
Where to look: Find the part of your ANOC describing premium or cost changes.
| Review Item | Details |
|---|---|
| What you will find | Whether your plan premium will increase, decrease, or stay the same for 2027. |
| What you may not find | Your total Medicare cost. The Medicare Part B premium and any applicable income-related surcharges are separate from the plan premium. |
Bottom line: Check the premium, but don't judge a plan by premium alone. Your copays, benefits, providers, and prescriptions can have a much greater effect on your total costs.
Changes to Your Maximum Out-of-Pocket Amount
Where to look: Find the maximum out-of-pocket or medical cost section.
| Review Item | Details |
|---|---|
| What you will find | The most you could pay for covered Medicare medical services during 2027 before the plan's applicable out-of-pocket limit is reached. |
| What you may not find | What you are actually likely to spend. Prescription drug costs and plan premiums are not included in the Medicare Advantage medical out-of-pocket limit. |
Bottom line: Compare the new limit with your current one. A higher limit increases your potential financial exposure if you need substantial medical care.
For most Medicare Advantage members, this is an important amount to review. SCO and One Care members generally have no cost-sharing for covered medical services because of MassHealth.
Changes to Your Doctors and Hospitals
Where to look: Find the section about network providers. Some ANOCs combine provider and pharmacy network changes in one section.
| Review Item | Details |
|---|---|
| What you will find | Information about changes to the provider network and directions for accessing the 2027 Provider Directory. |
| What you may not find | A personalized list telling you whether your own PCP, specialists, hospital, or other providers will remain in-network. |
Bottom line: If keeping a particular doctor or hospital matters, verify that provider for 2027. Do not assume that participation in 2026 continues next year.
Not sure whether your doctors or hospitals will remain in-network? Hesteon Solutions can help you review your plan's 2027 provider network.
Changes to Your Pharmacy Network
Where to look: Find the section about network pharmacies.
| Review Item | Details |
|---|---|
| What you will find | Pharmacy network changes and directions for accessing the plan's 2027 Pharmacy Directory. |
| What you may not find | What each prescription will cost at your pharmacy, or whether another network pharmacy could cost less. |
Bottom line: Confirm that your pharmacy remains in-network. If the plan uses preferred and standard pharmacies, also check which category your pharmacy falls into for 2027.
Changes to Your Medical Benefits and Costs
Where to look: Find the section describing changes to medical benefits, services, or costs.
| Review Item | Details |
|---|---|
| What you will find | Benefits and cost-sharing that are changing for 2027. This may include doctor visits, hospital care, outpatient services, dental, vision, hearing, transportation, OTC benefits, or other covered services. |
| What you may not find | Complete details about every benefit, especially benefits that are not changing. The ANOC may also omit detailed limits, exclusions, provider requirements, or prior authorization rules. |
Bottom line: Focus on benefits you actually use. Check whether the cost, coverage amount, limits, or rules are changing—not simply whether the benefit still exists.
For full benefit details, check your plan's 2027 Evidence of Coverage (EOC). SCO and One Care plans may call this the Member Handbook/Evidence of Coverage.
Look under Plan Documents, Member Documents, Evidence of Coverage, or Member Handbook on your plan's website. If you cannot find it, call the Member Services number on your plan ID card and ask for the 2027 document.
Changes to Your Prescription Drug Coverage
Where to look: Find the section about Part D drug coverage, covered drugs, Drug List, or formulary changes.
| Review Item | Details |
|---|---|
| What you will find | Information about changes to the plan's Drug List. Drugs can be added or removed, moved to another tier, or become subject to different coverage requirements. |
| What you may not find | A personalized list showing what changed for every medication you take. You may need to check the complete 2027 Drug List. |
Bottom line: Check every prescription you regularly take. Verify that it is covered, its tier, and whether prior authorization, step therapy, or quantity limits apply.
If you're unsure how your prescriptions will be covered in 2027, Hesteon Solutions can help you review your medications and available Medicare plan options.
Changes to Your Prescription Drug Costs
Where to look: Find the section describing prescription drug costs or Part D cost-sharing.
| Review Item | Details |
|---|---|
| What you will find | Changes to deductibles, drug tiers, copays, coinsurance, or other Part D costs. |
| What you may not find | What your particular prescriptions will cost over the year. Your cost depends on the medications you take, their coverage and tiers, and where you fill them. |
Bottom line: Review drug coverage and drug costs together. A medication can remain covered and still cost you more in 2027.
What Important Information May Not Be in Your ANOC?
Your ANOC tells you what changed with your plan. It cannot tell you what changed with you.
Before deciding whether to keep your coverage, consider whether you:
- Started, stopped, or changed prescriptions
- Have new doctors or specialists
- Expect surgery or ongoing treatment
- Have different dental, vision, or hearing needs
- Changed pharmacies
- Moved or have different travel needs
- Had financial changes that may affect eligibility for Medicare cost assistance
A plan can change very little and still no longer fit your needs. Medicare specifically recommends considering changes in health conditions, prescriptions, and providers when reviewing coverage for the coming year.
What Other Plan Documents Should You Check?
The ANOC identifies changes. Other plan documents provide the details.
| Document | What to Check |
|---|---|
| Evidence of Coverage (EOC) / Member Handbook | Complete benefits, costs, limits, and coverage rules |
| Provider Directory | Doctors, hospitals, and other network providers |
| Pharmacy Directory | Network pharmacies and preferred pharmacy status, if applicable |
| Drug List / Formulary | Covered prescriptions, tiers, and drug restrictions |
These documents are available through your plan. Check the plan's member website or call the Member Services number on your plan ID card.
Do You Need to Change Plans During Medicare Open Enrollment?
No. Open Enrollment gives you the option to change coverage; it does not require you to switch plans.
If your plan will continue in 2027 and still meets your healthcare and prescription needs, you can keep it. If you make no change, existing Medicare health or drug coverage generally continues into the new year.
If something important has changed, Medicare Open Enrollment from October 15 through December 7 is your opportunity to compare other coverage for January 1, 2027.
What Should You Do After Reviewing Your ANOC?
Before deciding whether to keep your plan for 2027:
Look at your plan:
- Your costs
- Your doctors
- Your prescriptions
- Your pharmacy
- The benefits you actually use
Then look at your own needs:
- Has anything changed in your health, medications, doctors, expected care, or financial situation?
Your ANOC tells you what changed with your plan. Your annual review should also consider what changed with you.
If you're unsure whether your current Medicare coverage still fits your needs for 2027, Hesteon Solutions can help you review your plan and compare the options available to you.
Let Us Help You Review Your Options
You do not have to sort through Medicare, MassHealth, Medicare Savings Programs, Extra Help, and plan options by yourself.
At Hesteon Solutions, we help Massachusetts Medicare beneficiaries understand their current coverage, identify programs or benefits that may be worth exploring, and review Medicare options based on their individual healthcare and prescription needs.
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