Sometime this month, an envelope from your Medicare plan will land in your mailbox. It’s thick. It’s dull. And most people toss it on the pile with the catalogs.
That’s a mistake that can cost you real money — hundreds, sometimes thousands of dollars — and you won’t find out until you’re checking out at the pharmacy counter in January.
The envelope is your Annual Notice of Change, or ANOC. If you’re in a Medicare Advantage plan or a stand-alone Part D drug plan, Medicare requires your insurer to send you one every September, spelling out exactly what’s changing in your coverage and your costs for the coming year.
Here’s the problem. Insurers write these letters to satisfy the government, not to help you. The changes that matter most are buried in tables, and the language is designed to be technically accurate and practically useless.
I’ve spent 35 years reading fine print for a living, so let me save you the trouble. There are three places in that letter where the money hides. Check them, and you’re ahead of most of the country.
Line 1: The drug list
Every Medicare drug plan has a formulary — the list of drugs it covers and which tier each one sits in. Plans can rewrite that list every year, and they do.
Your ANOC will include a section on formulary changes. Look for two things: drugs that have been dropped entirely, and drugs that have been moved to a higher, more expensive tier. Then compare that against every prescription bottle in your medicine cabinet.
This isn’t a rare problem. A study published this summer in Health Affairs Scholar tracked 59 brand-name drugs across Medicare plans nationwide from 2024 to 2026. Coverage in stand-alone drug plans fell from about 47% to under 36%.
Put another way, roughly 2.7 million people in those plans lost coverage of a drug they’d been taking.
If your plan drops your medication, you’ll pay full price — or fight for an exception — unless you switch plans during open enrollment. The letter is your only warning.
Line 2: Your doctors and your pharmacy
If you’re in Medicare Advantage, your plan works only with doctors and hospitals in its network. Those networks are narrower than most people realize.
According to the nonpartisan health research group KFF, the average Medicare Advantage enrollee has access to about 48% of the doctors available to people on traditional Medicare. One in five is in a plan that covers a third or fewer.
Networks also change from year to year. Your ANOC won’t necessarily list every doctor who’s leaving, so use it as a prompt. Call your primary doctor, your specialists and your pharmacy and ask one question: “Will you still be in my plan’s network on Jan. 1?”
The same goes for preferred pharmacies in drug plans. If your corner drugstore drops from “preferred” to “standard,” your copays go up even though nothing else changed.
Line 3: The numbers that move
This is the part of the letter that looks like a spreadsheet, which is why nobody reads it. Read it.
You’re looking for a side-by-side comparison of this year’s costs against next year’s: your monthly premium, deductible, copays and coinsurance, and your out-of-pocket maximum. Every one of them can move, and in 2027 many will.
Start with drug coverage. The maximum Part D deductible is rising to $700 in 2027, up from $615 this year, according to Kiplinger’s analysis of federal figures. The annual cap on what you pay out of pocket for covered drugs climbs to $2,400, from $2,100.
And more plans are actually charging that deductible. KFF found that 82% of Medicare Advantage drug plan enrollees now face a drug deductible, compared with just 23% in 2024. Plans are also swapping flat copays for percentage-based coinsurance, which means your cost rises with the drug’s price.
Premiums are moving too. The federal government has been subsidizing stand-alone drug plan premiums for two years to cushion the transition to new rules. That program ends after 2026, and KFF warns some enrollees could see bigger premium jumps than they’ve grown used to.
Don’t forget the number that’s not in the letter. The standard Part B premium, which comes out of your Social Security check, is projected by Medicare’s trustees to rise to about $209.50 a month in 2027, from $202.90. Stack that on top of whatever your plan is doing.
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The letter that isn’t an ANOC
Some of you won’t get an ANOC at all. You’ll get something worse: a notice that your plan is going away.
Insurers are pulling back. Humana alone is exiting plans that cover about 600,000 Medicare Advantage members for 2027. If your plan is one of them, federal rules require the insurer to tell you by early October.
The good news: Losing your plan triggers a special enrollment period that runs past the normal deadline, into late February. The bad news: If you do nothing, you could land in traditional Medicare with no drug coverage at all. Don’t let that happen by default.
What to do this month
First, find the letter. Plans are required to get it to you by Sept. 30. If it hasn’t arrived by then, call your plan and ask for it — and check your email, in case you opted for electronic delivery and forgot.
Second, take 20 minutes and, with a highlighter, mark every change in the three areas above: drugs, doctors and dollars. If nothing is changing and you’re happy, you can stop here. Most people won’t be that lucky.
Third, shop. Medicare open enrollment runs Oct. 15 through Dec. 7, and whatever you pick takes effect Jan. 1. The Medicare Plan Finder typically loads next year’s plans around Oct. 1. Enter your prescriptions and your pharmacy, and it’ll rank plans by what you’d really pay.
If the website makes your eyes glaze over, there’s a free alternative that almost nobody uses. Every state has a State Health Insurance Assistance Program, or SHIP, staffed by trained counselors who don’t earn a commission. They’ll sit with you, on the phone or in person, and compare plans.
You can also call 1-800-MEDICARE.
Why the system counts on you not looking
Here’s what insurers know that you should too. KFF’s research found that nearly 7 in 10 people on Medicare don’t compare plans during open enrollment. More than 4 in 10 Medicare Advantage enrollees don’t even review the changes to their own plan.
That inertia is worth a fortune to the industry. A plan can raise your deductible, drop your drug and shrink your network, and if you don’t act, you’ve agreed to all of it.
Your ANOC is the one moment each year when the insurer has to tell you the truth in writing. Open the envelope. Then, if you don’t like what you read, make them earn your business somewhere else.
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