Medicare Annual Notice of Change (ANOC) 2026: What to Check

The Medicare Annual Notice of Change is the one piece of Medicare mail you should not toss. If you have a Medicare Advantage plan or a stand-alone Part D drug plan, your insurer must get this notice, usually called the ANOC, into your hands by September 30, 2026. It spells out every change to your premium, copays, covered drugs, and doctors that takes effect January 1, 2027.

This guide explains what federal rules force the ANOC to disclose, the 2027 numbers CMS has already locked in, a 20-minute checklist for reading yours, the red flags that should send you to Plan Finder, and the deadlines that follow. It closes with what to do if your plan is leaving Medicare or the plan does not honor what its ANOC said.

Key Takeaways

• Federal regulation 42 CFR 422.2267 requires plans to deliver the ANOC for receipt no later than September 30, and the full Evidence of Coverage by October 15.
• Every 2027 Part D plan starts from the same federal frame: a $700 maximum deductible and a $2,400 cap on out-of-pocket drug costs, up from $615 and $2,100 in 2026 (CMS CY2027 Rate Announcement, April 6, 2026).
• CMS is ending the Part D Premium Stabilization Demonstration after 2026, so stand-alone drug plan premiums lose the $10 subsidy and the $50 increase cap for 2027 (CMS, July 28, 2025 and July 28, 2026).
• KFF found 69% of beneficiaries did not compare coverage during Open Enrollment, and 43% of Advantage enrollees did not review their own plan’s coverage for the coming year.
• Open Enrollment runs October 15 to December 7, 2026. If your plan is not renewed, a Special Enrollment Period runs December 8 through the last day of February 2027.

What is the Medicare Annual Notice of Change?

The Medicare Annual Notice of Change (ANOC) is a standardized letter that every Medicare Advantage and Part D plan must send its members each fall. It lists the changes to premiums, deductibles, copays, covered benefits, the drug formulary, and the provider and pharmacy networks that take effect on January 1. Federal rules require plans to deliver it for receipt no later than September 30.

Medicare.gov describes it plainly: “your plan will send you a Plan Annual Notice of Change (ANOC) each fall. The ANOC includes any changes in coverage, costs, and more that will be effective in January.” The instruction that follows is the whole point of the document: review the changes “to decide whether the plan will continue to meet your needs in the next year.”

The ANOC exists because Medicare plans are one-year contracts. Your plan can raise your premium, drop a drug, cut a dental benefit, or lose your cardiologist, all on January 1, and still keep you enrolled. Nothing renews your choice. The notice is the only guaranteed warning you get, timed to land two weeks before Medicare Open Enrollment opens on October 15.

People with Original Medicare and no drug plan do not receive an ANOC. Medigap policies are not Medicare plans in this sense, so the ANOC rule does not apply to them. If you have Original Medicare plus a stand-alone Part D plan, your ANOC comes from the drug plan only.

When does the Medicare ANOC arrive, and what if it does not?

By September 30. Two parallel regulations say so in identical words: 42 CFR 422.2267(e)(3) for Medicare Advantage plans and 42 CFR 423.2267(e)(3) for stand-alone Part D plans. Both call the ANOC “a standardized marketing material” and require plans to “send for enrollee receipt no later than September 30 of each year.”

That is the receipt date, not the mailing date. The same two sections set October 15 as the deadline for the Evidence of Coverage to reach current members.

The disclosure rules behind that date, 42 CFR 422.111 for Advantage plans and 423.128 for Part D, require plans to notify members of January 1 changes “at least 15 days before the beginning of the Annual Coordinated Election Period.” Since that period opens October 15, September 30 is the last possible day.

If you joined a plan mid-year, the timing shifts. For members whose coverage starts October 1, November 1, or December 1, the plan must send the ANOC within 10 calendar days of getting CMS confirmation of enrollment, or by the last day of the month before coverage starts, whichever is later.

If nothing has arrived by the first week of October, do three things. Check your email and the plan’s member portal, because CMS lets plans deliver the ANOC electronically if you agreed to that. Call the member services number on your plan card and ask them to resend it. If the plan cannot produce one, call 1-800-MEDICARE, because a plan that skips the ANOC is missing a federal deadline.

What the ANOC must disclose, category by category

The ANOC is tied by regulation to the disclosure list in 42 CFR 422.111(b) and 423.128(b). Those sections require plans to describe their service area, benefits and their limits, premiums and cost-sharing, provider network and out-of-network rules, the drug formulary and exceptions process, pharmacy access, appeal rights, and disenrollment rights. The ANOC reports what changed in each of those areas.

What the ANOC received in September 2026 must disclose, by category

Category	What to look for in the 2027 column	Rule
Premium	Monthly plan premium, and any change to the Part B premium reduction if the plan offers one	42 CFR 422.111(b)(2)
Medical deductible	Any deductible that applies to medical care, separate from drugs	42 CFR 422.111(b)(2)
Part D deductible	The drug deductible, up to the $700 federal maximum for 2027	42 CFR 423.128(b)
Copays and coinsurance	Primary care, specialist, hospital stay, ER, lab, imaging; drug tier copays	42 CFR 422.111(b)(2)
Out-of-pocket maximum	In-network and combined limits for Advantage plans	42 CFR 422.111(b)
Benefits	Dental, vision, hearing, fitness, over-the-counter allowance, transportation: added, cut, or capped	42 CFR 422.111(b)(2)
Formulary	Drugs removed, moved to a higher tier, or given new prior authorization or quantity limits	42 CFR 423.128(b)
Network	Whether the provider or pharmacy network changed; the directory shows who left	42 CFR 422.111(b)(3)
Service area	Counties the plan will serve in 2027; a dropped county means you must move plans	42 CFR 422.111(b)(1)

One gap to know about. The ANOC tells you the network changed; it does not have to name the doctors who left.

Federal rules require individual advance notice when your own primary care or behavioral health provider is terminated (at least 45 days before) or when a specialist you are seen by on a regular basis is terminated (at least 30 days before). For everyone else, you have to check the 2027 provider directory yourself.

What 2027 changes will show up in every ANOC?

Some of the numbers in your ANOC are not the plan’s choice. CMS sets the Part D benefit frame each April, and every plan builds on it. For 2027, the CY2027 Rate Announcement published April 6, 2026 sets the standard deductible at $700, up from $615, and the out-of-pocket threshold at $2,400, up from $2,100. A plan can charge less than the deductible, never more.

The cap matters most for anyone on an expensive brand-name drug. Once your out-of-pocket drug spending reaches $2,400 in 2027, you pay $0 for covered drugs for the rest of the year. Our Medicare Part D costs guide walks through how the cap and the monthly payment option work.

Two more federal moves shape 2027 premiums. CMS set the 2027 Part D base beneficiary premium at $41.33, up from $38.99, in its July 28, 2026 bid announcement. In the same notice CMS said it “will discontinue the demonstration at the end of CY 2026,” ending the Premium Stabilization Demonstration that cut participating stand-alone drug plan premiums by $10 and capped their year-over-year increases at $50 in 2026.

KFF’s July 29, 2026 analysis of that decision warns that “some Part D stand-alone drug plan enrollees could face a larger premium increase for drug coverage next year than in recent years.” If you have Original Medicare with a separate drug plan, the premium line of your ANOC deserves a hard look.

For people with Extra Help, the 2027 copay ceilings for most full-subsidy enrollees rise to $5.80 for generics and $14.40 for brand-name drugs, per the same CMS announcement. People in institutions and those under the poverty level pay less. Your own amounts arrive in a separate mailing, the LIS Rider, which 42 CFR 423.2267(e)(11) also requires by September 30.

What is not in any ANOC yet: the 2027 Part B premium and deductible. CMS announced the 2026 figures ($202.90 and $283, per our Part B premium guide) on November 14, 2025, and the 2027 amounts follow the same November pattern. A plan’s Part B premium reduction is a fixed amount, but what you will actually pay after it is unknown until then.

How do you read an ANOC in 20 minutes?

ANOCs follow a CMS model document that puts 2026 and 2027 side by side. Sit down with your plan card, your last three pharmacy receipts, and the names of the doctors you see. Then work through eight lines in order.

1. Monthly premium. Note the 2027 amount. A $0 premium plan can become, for example, a $30 plan without any other visible change.
2. Medical deductible and out-of-pocket maximum. The maximum is the most you can owe for covered in-network care in a year. A jump here matters more than any single copay.
3. Copays you actually use. Primary care, specialist, hospital stay per day, ER, and any therapy or dialysis you receive.
4. Drug tiers. Find each drug you take in the 2027 formulary. Check its tier, its copay, and whether prior authorization, step therapy, or quantity limits were added.
5. Part D deductible. Some plans exempt lower-tier drugs from the deductible. See whether that exemption survived.
6. Extras. Dental, vision, hearing, fitness, over-the-counter allowance, transportation. Plans trim these quietly.
7. Network. Open the 2027 provider directory online and search each of your doctors and your hospital.
8. Service area. Confirm your county is still listed for 2027.

Write the 2027 total next to each line, then add it up as if next year looks like this year: 12 premiums, your usual visits at the new copays, and your drugs at the new tiers. That number is what the plan will cost you in 2027. Compare it against two or three alternatives in Medicare Plan Finder, which shows 2027 plans starting October 1.

If your plan is an HMO and a doctor you rely on has left, the math changes entirely, because out-of-network care is generally not covered. Our Medicare HMO vs PPO guide explains what each network type lets you do when a provider leaves.

What are the biggest red flags in this year’s ANOC?

Five changes justify shopping even if you like your plan. Any one of them can cost more over a year than a premium increase of a few dollars a month.

1. A drug you take moved from a preferred tier to a non-preferred or specialty tier, or gained prior authorization.
2. Your primary care doctor, specialist, or hospital is missing from the 2027 directory.
3. The in-network out-of-pocket maximum rose by hundreds of dollars.
4. The plan dropped your county from its service area or announced it will not renew its Medicare contract.
5. A benefit you rely on, such as a dental allowance or transportation, was cut or capped.

A quieter flag is a change to the Part D deductible. A plan that charged no deductible in 2026 and charges $700 in 2027 will cost a brand-name user up to $700 more before coverage kicks in. The ANOC shows this on a single line that is easy to skim past.

Star Ratings are changing too. The CY2027 final rule, published April 2, 2026, is “removing 11 measures focused on administrative processes and areas where beneficiaries cannot distinguish performance between plans,” and adding a Part C depression screening measure. Because the measure set is being rebuilt, treat a star count as one input, not a verdict.

The deadlines that follow the Medicare Annual Notice of Change

The ANOC starts a clock that runs through March. The dates below come from Medicare.gov’s enrollment pages and the federal disclosure rules.

Two of these windows do different jobs. Open Enrollment, October 15 to December 7, lets anyone join, drop, or switch Advantage and drug plans, or move between Original Medicare and Advantage, with changes effective January 1. The Medicare Advantage Open Enrollment Period, January 1 to March 31, is only for people already in an Advantage plan and allows a switch to another Advantage plan or a return to Original Medicare.

The January window does not let you join a stand-alone drug plan from scratch or move from Original Medicare into Advantage. If the ANOC convinces you to leave, December 7 is the deadline that keeps every option open.

What if your plan is leaving Medicare in 2027?

Plans that will not renew their Medicare contract must tell CMS by the first Monday in June and must notify members “at least 90 calendar days before the date on which the nonrenewal is effective,” under 42 CFR 422.506. Medicare.gov says the change-in-plan-availability notice arrives in October, and it is blunt: “You must look for a new plan for coverage next year.”

You get extra time. Medicare.gov lists a Special Enrollment Period for members whose plan contract is not renewed, running “between December 8 and the last day in February of the following year.” If Medicare terminates your plan’s contract mid-year instead, the window opens one month before the contract ends and closes two full months after.

Leaving an Advantage plan because it left Medicare also unlocks a Medigap guaranteed-issue right. Medicare’s 2026 Choosing a Medigap Policy guide lists two qualifying situations for Advantage members, “Your plan is leaving Medicare” and “Your plan stops giving care in your area,” in which insurers must sell you Medigap Plan A, B, C, D, F, or G without health questions.

The deadline is the part people miss. You may apply up to 60 days before your Advantage coverage ends, or by the date in your plan’s termination notice, and no more than 63 days after coverage ends. Miss that window and an insurer can rate or refuse you on health.

Two limits come with the right. It applies only if you switch to Original Medicare rather than joining another Advantage plan, and Plans C and F are closed to anyone new to Medicare since January 1, 2020.

If you are weighing that route, our Medicare Advantage vs Medigap comparison lays out the cost and coverage trade-offs, and the Plan G vs Plan N guide covers the two Medigap plans most people choose between.

How many people actually read their ANOC?

Not many, and the cost shows up in January. KFF’s September 26, 2024 analysis of 2022 coverage data found that “nearly 7 in 10 Medicare beneficiaries (69%) did not compare their Medicare coverage with other Medicare options” during Open Enrollment. Among Advantage enrollees, 43% did not review their own plan’s coverage, and 44% did not review changes to covered “treatments, drugs, and services.”

The choice set is large enough to reward the effort. KFF counted 39 Medicare Advantage plans available to the average beneficiary for 2026, 32 of them with drug coverage, and CMS reported about 5,600 Medicare Advantage plans nationally for 2026 with an average premium of $14.00. CMS said it will publish the 2027 landscape “in mid-to-late September,” so the full 2027 menu appears within days of your ANOC.

For a first-principles look at whether Advantage or Original Medicare fits you at all, start with our Medicare Advantage vs Original Medicare guide before you compare individual plans.

ANOC vs EOC vs Medicare & You handbook

Three documents land in the same six weeks, and they answer different questions. The ANOC says what changed. The Evidence of Coverage says what the plan covers in full. The Medicare & You handbook says how Medicare itself works, plan by plan type, not company by company.

The three fall Medicare documents compared

Document	Sent by	Deadline	What it answers
Annual Notice of Change (ANOC)	Your Advantage or Part D plan	Receipt by September 30	What is different in 2027 compared with 2026
Evidence of Coverage (EOC)	Your Advantage or Part D plan	October 15 for current members	Every covered service, rule, cost, and appeal right for 2027
Medicare & You handbook	CMS	Mailed in the fall; online year-round	How Original Medicare, Advantage, Part D, and Medigap work in general
Change in plan availability notice	Your plan, if it is leaving	October (at least 90 days before the contract ends)	That you must pick a new plan for 2027

Medicare.gov describes the EOC as the document that “gives you details about what the plan covers, how much you pay, and more.” If the ANOC flags a change you do not understand, the EOC is where the full rule lives.

Federal rules at 42 CFR 422.2265(c) require Advantage plans to post both the EOC and the ANOC on their website by October 15, so check there if the paper copy is late.

What if the plan does not follow its own ANOC?

Pick the right process, because they do different things. A grievance is for how you were treated: rudeness, delays, a bill nobody will explain. Under 42 CFR 423.564 you must file one within 60 calendar days of the incident.

Money back is a different track. If a plan charges a copay above its own ANOC amount or bills a drug at the wrong tier, that is a coverage determination under 42 CFR 423.566, and a decision you disagree with goes to appeal. Ask for the determination in writing and keep the ANOC page with the receipt. A grievance alone will not get you reimbursed.

If a federal error put you in the wrong plan, Medicare.gov lists a Special Enrollment Period for people who “joined a plan, or chose not to join a plan, due to an error, misrepresentation, or inaction by a federal employee or any person authorized by the Federal government to act on its behalf.” The window lasts two full months after the month you get Medicare’s notice of the error.

That right does not cover being misled by a plan’s own agent. In that case, call 1-800-MEDICARE and ask for a case review; Medicare grants special enrollment for exceptional circumstances case by case.

A separate protection exists for people in plans that have been sanctioned by CMS. Medicare.gov says the chance to switch “begins when the sanction is imposed and is available until the sanction ends or until you switch to another plan.”

What if the ANOC drops or re-tiers your drug?

You have two federal protections, and both have to be asked for. Neither one happens automatically because you spotted the change in your ANOC.

The first is a temporary supply. Under 42 CFR 423.120(b)(3), every Part D plan must run a transition process covering “current enrollees remaining in the plan affected by formulary changes.” It has to provide a temporary supply within the first 90 days of the new plan year, and that fill must be at least an approved month’s supply.

The plan then has three business days to send you written notice explaining it was a transition fill. Treat that letter as a deadline, not a receipt.

The second protection is an exception. 42 CFR 423.578 requires plans to have procedures that “address situations where a formulary’s tiering structure changes during the year and an enrollee is using a drug affected by the change.” Your prescriber submits a supporting statement, and an approved exception prices the drug at the lower tier.

The practical order is simple. Fill the prescription in early January to trigger the transition supply, then have your prescriber file the exception request during those weeks. That way you are never without the drug while the paperwork moves.

How do you find your ANOC online?

Your plan has to publish it. 42 CFR 422.2265(c)(1) requires Advantage plans to post four documents on their website by October 15 for the coming plan year, in a printable format.

• The Evidence of Coverage
• The Annual Notice of Change, for renewing plans
• The Summary of Benefits
• The provider directory and the provider and pharmacy directory

The same section requires plans to keep current-year contract content up through December 31, so last year’s documents stay reachable while you compare.

Three ways to get to yours. Sign in to your plan’s member portal and look for plan documents or plan materials. Search the plan’s own site for the notice by name and plan year. Or call the member services number on your card and ask them to mail or email a copy.

Every ANOC follows the same federal shape, because 42 CFR 422.2267(e)(3) and 423.2267(e)(3) classify it as a “standardized marketing material.” The wording your insurer uses will differ, but the categories it has to cover do not, which is why the checklist above works whoever your plan is with.

Where can you get free help comparing plans?

Every state runs a State Health Insurance Assistance Program, or SHIP, funded federally to give one-on-one Medicare counseling at no cost and with nothing to sell.

Medicare.gov says SHIPs help people “choose a plan, review coverage, understand costs, apply for Extra Help, file a complaint or an appeal.” That list is the ANOC task almost exactly. Find your state’s program through Medicare’s talk to someone page, or call 1-800-MEDICARE and ask for the SHIP in your state.

A SHIP counselor is not a broker. Brokers are paid by the plans for each enrollment under the compensation rules in 42 CFR 422.2274, and may represent only some plans, which is worth knowing before you take plan advice from a phone number in an advertisement.

The bottom line on your Medicare Annual Notice of Change

Open it the day it arrives. Check the eight lines above, add up what 2027 would cost on your current plan, and compare that number with two alternatives in Plan Finder once 2027 plans post on October 1.

If your plan still wins, do nothing and it renews. If it does not, enroll in the new plan by December 7 for a January 1 start. If the comparison is close or your formulary changed, a free SHIP counselor will work through it with you.

Watch for the 2027 landscape from CMS in late September and the 2027 Part B premium in November, because both change the comparison. If the ANOC never arrives, that alone is a reason to call your plan, and then Medicare. Related reading: the Medicare program guide for the full 2026 cost picture.