Your Medicare Annual Notice Of Change (ANOC): How To Actually Read It

Every September, if you are enrolled in a Medicare Advantage plan or a standalone Medicare Part D drug plan, a thick envelope lands in your mailbox. The cover says "Annual Notice of Change," or ANOC for short. A lot of people I know glance at it, see the word "Medicare," feel a small wave of dread, and drop it in the pile of mail that somehow never gets sorted.

Do not do that. The ANOC is the single most important piece of mail your plan will send you all year. It tells you, in writing, exactly what is changing about your coverage for next year — your premium, your deductible, which drugs are covered, which doctors are in-network, and what you will pay out of pocket.

And crucially — you only have from October 15 to December 7 to do something about it during Medicare Open Enrollment. Miss that window and you are locked into whatever the plan decides until the following year. This guide will walk you through reading the ANOC in about 15 minutes and deciding whether to stay put or switch.

What Is The Annual Notice Of Change?

The ANOC is a document that federal law requires your plan to send by September 30 each year. It compares your current coverage (the year that is ending) with what that same plan will look like next year. If you are in a Medicare Advantage plan (Part C) or a standalone Part D drug plan, you get one. People on Original Medicare only do not receive an ANOC — they get a different document called Medicare & You.

Along with the ANOC, your plan usually mails a thicker booklet called the Evidence of Coverage (EOC). The EOC is the full contract — hundreds of pages. The ANOC is the summary of what changed. For most decisions, the ANOC is enough.

Quick definition: Medicare Advantage vs. Original Medicare. Medicare Advantage (sometimes called "Part C") is Medicare coverage delivered through a private insurance company. Original Medicare is the government-run Part A (hospital) and Part B (doctor) coverage you get directly from CMS.

What Changed For 2026 — The Big Three

Before I walk you through the document itself, here is what is actually different about 2026 coverage, because these changes affect almost every senior:

Medicare Part D out-of-pocket cap is now $2,100 (as of January 2026). Once you have paid $2,100 in covered drug costs in a calendar year, you pay nothing for covered prescriptions the rest of the year. This is a meaningful change for anyone on expensive medications — the cap was $2,000 in 2025 and the cap did not exist at all before 2025.
Telehealth benefits were extended through December 31, 2027, under the Consolidated Appropriations Act of 2026. That means your Medicare Advantage plan can keep offering telehealth for primary care, mental health, and specialists from home — a pandemic-era flexibility that was scheduled to expire.
2026 Social Security COLA flows into Medicare premium calculations. Higher Social Security checks this year (from the 2.5% cost-of-living adjustment) may also mean slightly higher Part B premiums for some income brackets. COLA stands for "cost-of-living adjustment" — the annual inflation raise applied to Social Security benefits.

All three of these show up in the ANOC. Let us look at where.

How To Read Your ANOC In Six Sections

The ANOC is organized in a standard order required by CMS (the Centers for Medicare & Medicaid Services). Open yours and follow along. Mine is on the table next to me as I write this.

Section 1: The Cover Letter

The first page is a plain-language letter that summarizes the three or four biggest changes. Read this carefully. If it says "your premium is going up by $35/month" or "Dr. Smith is leaving our network," that alone may be enough to trigger a decision. Circle anything that alarms you.

Section 2: Changes To Your Monthly Premium

This is usually a small table comparing the outgoing year's premium to the new year's premium. If your plan is a zero-premium Medicare Advantage plan, this might still say $0 — but double-check, because some plans add a small premium in 2026.

Action item: Write down the old premium and the new premium. Subtract. That is your annual change — multiply by 12.

Section 3: Changes To Your Deductible And Copays

Deductible is the amount you pay before the plan starts helping. Copay is the fixed dollar amount you pay per visit or prescription. Both can change year-to-year. A typical 2026 change: the Part D deductible cap is set by CMS, and many plans are now charging the full federal limit.

Section 4: Changes To Your Drug Formulary

The formulary is the list of drugs your plan covers. This is the section where seniors get hurt most often — a drug that was on Tier 2 last year may move to Tier 3 (higher copay), or get dropped entirely, or require "prior authorization" (your doctor has to call and justify it).

Action item: Open the formulary section. Find every prescription you currently take. For each one, note: Is it still covered? What tier is it on? Does it now require prior authorization or step therapy?

Section 5: Changes To The Provider Network

Your plan lists any doctors, hospitals, or facilities that are leaving or joining the network. If your primary care doctor is leaving the network for 2026, that is a major red flag — in a Medicare Advantage HMO plan, seeing an out-of-network doctor can mean paying the full bill yourself.

Section 6: Changes To Extra Benefits

This is things like dental, vision, hearing aids, meal delivery, over-the-counter allowances, and fitness memberships (SilverSneakers or equivalent). Plans change these benefits constantly. A dental allowance that was $1,500 last year might be $1,000 for 2026.

Decide: Stay Or Switch

Now that you have read all six sections, answer these three questions:

Are all my drugs still covered at a tier I can afford? If no — start plan-shopping.
Are my doctors still in-network? If no — start plan-shopping.
Is the total out-of-pocket maximum still workable for my budget? (In 2026, MA plans must cap in-network out-of-pocket at $9,350.) If no — start plan-shopping.

If you answered "yes" to all three, you are probably fine to stay. Do nothing and your current plan auto-renews on January 1.

If you answered "no" to any of them, here is what to do.

How To Compare Plans During Open Enrollment

Medicare Open Enrollment runs October 15 through December 7 every year. Any changes you make during this window take effect January 1. This is your one guaranteed chance to switch plans each year (with very narrow exceptions for life events).

The official comparison tool is the Medicare Plan Finder at medicare.gov/plan-compare. Log in with your MyMedicare.gov account so it pulls in your actual prescriptions. You can compare up to three plans side by side.

If you prefer a real human, two free resources:

1-800-MEDICARE (1-800-633-4227), open 24/7. Federal, free, no sales pressure.
Your State Health Insurance Assistance Program (SHIP) — unbiased one-on-one counseling by volunteers. Find yours at shiphelp.org.

Avoid random agents who cold-call or knock on your door. That is almost always a sales tactic, sometimes a Medicare scam.

Watch Out For Look-Alike ANOC Scams

Scammers know September and October are Medicare decision season, and they exploit it. Common tricks:

Fake ANOC mailers designed to look like official plan documents but from unrelated marketing companies, pushing you to call a 1-800 number.
Phone calls claiming "your plan is canceled — sign up now." Real plans do not cancel you this way.
Door-to-door "Medicare advisors." Federal rules prohibit unsolicited in-person sales pitches for Medicare Advantage and Part D plans.

If something feels off, hang up and call 1-800-MEDICARE or check the AARP Fraud Watch Network. You can also learn the broader pattern in our guide to Social Security scams the SSA never does.

Quick ANOC Checklist

Print this and work through it:

[ ] Premium change: ____ (old) vs. ____ (new)
[ ] Deductible change: ____ (old) vs. ____ (new)
[ ] Every prescription: still covered? same tier? prior auth?
[ ] Every doctor: still in network?
[ ] Extra benefits: dental, vision, hearing changes?
[ ] Out-of-pocket maximum: ____ (old) vs. ____ (new)
[ ] Decision: Stay / Switch / Need help (call SHIP)

Final Word

The ANOC feels intimidating because it is dense, but it is not complicated once you know where to look. Spend 15 minutes in October. Decide by Thanksgiving. Make any changes by December 7. That one afternoon of work can save you thousands of dollars over the coming year and spare you from a February surprise at the pharmacy counter.

Always verify the latest 2026 Medicare numbers on the official site before acting: medicare.gov.