Your Annual Notice of Change: how to read the September letter before you decide anything

What is the Annual Notice of Change, and why did I get one?

The Annual Notice of Change, usually shortened to ANOC, is the letter your Medicare Advantage or Part D plan is required to send each autumn describing every change to your costs and coverage for the next calendar year. You got one because you are enrolled in a plan that is renewing. If you did nothing at all, the plan described in that letter is the plan you would have on 1 January 2027.

It is a comparison document. Most of it is laid out in two columns, this year and next year, so you can see exactly what moved. It does not tell you whether your plan is still a good fit, and it does not show you any other plan. That part is your job, and the letter is the starting point for it.

The letter also carries some of the most useful news of the year, buried in plain sight. If your plan is being merged into another of the carrier's plans, the ANOC says so. If your plan is leaving your county or leaving Medicare entirely, you get a separate non-renewal notice instead, and that one changes your options considerably. More on that below.

When should the letter arrive, and what if it has not?

Your plan must get it to you by 30 September. Plans usually mail in September; if you chose electronic delivery, it may have arrived as an email or a notice in your member portal instead of on paper.

If 30 September passes with nothing in the mailbox or the inbox, call the member-services number on the back of your plan ID card and ask for the Annual Notice of Change for 2027. Do not wait for it to turn up on its own. The letter is short on time already: you have just over two months between its deadline and the close of Open Enrollment, and most people need a week or two of that to compare properly.

Which parts of the ANOC actually matter?

Five: the premium, the maximum out-of-pocket, the drug coverage, the network, and the plan's other benefits. Most of the rest is required legal language, contact details and appeal rights, worth knowing exists but not where your money moves. Read the five in this order, because each one is a bigger number than the last for most people.

1. The premium

Start with the monthly plan premium, because it is the number you already know. Premiums vary by plan, and a premium that stays the same is not news. What is news is a premium that goes up, because that is a cost you pay every month whether or not you use care. A rise of $10 a month is $120 a year before you see a single doctor.

One thing the letter cannot tell you: the 2027 Part B premium. Medicare has not announced it yet; that usually happens in November. The 2026 Medicare Trustees Report projected $209.50 a month for 2027, against $202.90 in 2026. Treat that as a projection, not a price. You pay the Part B premium whatever plan you choose.

2. The maximum out-of-pocket

The maximum out-of-pocket, or MOOP, is the most you could pay in a year for covered medical services on a Medicare Advantage plan. It is your worst case. It does not include the premium or your prescription drugs, which have their own cap. If your MOOP is rising, the plan is shifting more of the risk of a bad year onto you, and that matters more than any copay line, because a bad year is when you will be least able to shop around.

3. The drugs: formulary, tiers and the Part D deductible

This is where most of the surprises live. The letter summarizes changes to the deductible and to each drug-payment stage, and it points you to the 2027 formulary (the plan's drug list) for drug-by-drug detail. Check every medication you take, by name and strength, against the new list. Three things can happen to a drug you rely on: it can stay put, it can move to a more expensive tier, or it can come off the list entirely. A drug can also stay on the same tier and pick up a new restriction, such as prior authorization or step therapy, which will not show in any premium comparison.

The 2027 Part D numbers moved too. The standard Part D deductible rises to $700, and the annual cap on what you pay out of pocket for covered drugs rises to $2,400. Once you reach the cap, you pay $0 for covered Part D drugs for the rest of 2027. Many plans set a lower deductible than the standard, or apply it only to certain tiers, so the figure in your own letter is the one that counts.

4. The network

The letter tells you whether the provider and pharmacy networks are changing and where to find the 2027 directory. It will not list your doctors by name. Each one needs checking, one at a time, and Sarah does that with you: each doctor, each specialist, the hospital you would go to, and the pharmacy you actually use. For an HMO, a doctor who leaves the network is a doctor you can generally no longer see except in an emergency. For a PPO, you can usually still see them, at the plan's higher out-of-network cost.

Networks can also change during the year, not only on 1 January. CMS cited protecting patients when their providers leave a network as part of the CY2027 final rule. That is helpful, but the cleanest protection is still the one you control: confirming your doctors before you commit to a plan for another year.

5. The other benefits

Some plans include services that promote your health and wellness, and these can change from year to year. Read what the letter says about them, and look up how they work in the Evidence of Coverage. The CY2027 final rule set clearer rules for how some of these benefits are paid, so the way yours works may also be described differently this year.

Keep these in proportion. A change here is rarely as much money as a higher MOOP or a brand drug moving up two tiers. Read them last for that reason.

How is the ANOC different from the Evidence of Coverage?

The ANOC tells you what is changing; the Evidence of Coverage, or EOC, tells you everything the plan covers and every rule it follows. The ANOC is a summary of differences, usually a few dozen pages. The EOC is the full contract between you and the plan, often a few hundred pages, and plans generally make the 2027 version available online rather than mailing it.

You will also see a Summary of Benefits, which is a short marketing-format overview of a plan's costs, and the formulary, which is the drug list. When the ANOC and the Summary of Benefits seem to disagree, the ANOC and EOC describe your coverage; the summary is a shorthand. When anything is unclear, call the plan and ask them to show you the answer in the EOC.

What if my letter says my plan is ending, not changing?

Then you are in a different situation with more options and more deadlines. A plan that is leaving Medicare, or leaving your county, sends a non-renewal notice explaining that your coverage ends on 31 December. You will need new coverage for 2027, and the rules give you extra time and an extra right to choose it.

This is not hypothetical this year. Humana announced on 29 July 2026 that it will exit additional Medicare Advantage plans for 2027, affecting roughly 600,000 members nationally. Other carriers make service-area changes every year. Whether any particular Utah plan is affected is something only your own letter can tell you. Do not rely on a news story, a neighbor or an advertisement for that.

That window is unusual and worth taking seriously. Outside of your first Medigap enrollment and a few situations like this one, a supplement insurer can generally review your health before accepting you. For someone with health conditions who has wanted the predictability of a supplement, a plan exit can be the moment it becomes available without underwriting.

How do I review the letter step by step?

Sit down with four things: the ANOC, your list of medications with strengths, your list of doctors and the pharmacy you use, and last year's statement of what you actually spent. Then work through the list below. It takes about twenty minutes for the letter and longer for the drug and doctor checks.

1. Check the first page. Is this an ANOC (your plan continues), a crosswalk (you are being moved to another plan), or a non-renewal notice (your plan is ending)?
2. Write down the premium, 2026 and 2027, from the summary at the front.
3. Write down the MOOP, both years. For a PPO, note the in-network and the combined figure.
4. Note the Part D deductible and which tiers it applies to.
5. Look up every drug on the 2027 formulary: covered, tier, and any new restriction.
6. Check your pharmacy: still in network, and preferred or standard?
7. Check every doctor and your hospital by name in the 2027 directory, or call their office and ask whether they will take the plan in 2027.
8. List the copays you actually use: specialist visits, labs, therapy, imaging.
9. Note any other benefits you used this year and what the letter says about them for next year.
10. Add it up: the yearly cost change you can predict, and the change in your worst case.

What does a worked example look like?

Here is an illustrative review for a made-up member in Layton, in Davis County, on a made-up HMO called Plan X. The numbers are invented to show the method; they are not any real carrier's plan, and your letter will look different.

The drug arithmetic, rounded and simplified: in 2026 she pays $47 a month for the inhaler, or $564 a year. In 2027, using the plan's own estimate, her January fill costs about the $300 deductible, and the other eleven fills cost $95 each, or $1,045. That is about $1,345 for the year, roughly $781 more. It is still well under the $2,400 drug cap, so the cap does not help her here.

Nothing in her letter said "your plan got more expensive." Her plan premium did not change. But her plan will cost her about $840 more next year before she gets sick, and up to $1,000 more beyond that if she does. That does not mean she should switch. It means she now has two precise questions to take to Sarah in October: which plans with her cardiologist in network put her inhaler on a lower tier, and what MOOP do they carry?

What is the calendar from now until 7 December?

Read the letter in September, compare in October and November, and decide by 7 December. Here is how the autumn lines up.

Does the advice change depending on where in Northern Utah I live?

The method does not change, but the section to worry about does. In Salt Lake, Davis and Weber counties, the main questions are usually costs: the MOOP, the drug tiers and the premium. In Box Elder and Morgan counties, the first question is whether the plan and its network still reach you.

• Weber County (Ogden, Roy, North Ogden): check whether your doctors and the hospital you use are in the 2027 network by name, then compare costs.
• Davis and Salt Lake counties: more plans tend to be offered, so the comparison is mostly about drug tiers, MOOP and other benefits. Check providers who practice across the county line.
• Morgan County: check the service area first. Then check whether your doctors over the canyon are still in network.
• Box Elder County (Brigham City, Tremonton): check the service area, then your pharmacy, then every provider. If your plan is ending, look hard at the Medigap guaranteed-issue window, because a supplement has no network.

The bottom line

The Annual Notice of Change is the most useful piece of mail Medicare members get all year, and the most ignored. Read the five sections in order, write down both years, check every drug and doctor by name, and add up what moved. Then use October to compare, if you need to, and decide by 7 December. Your plan's own letter is the authority on what changes. If you would like someone to read it with you, that is exactly the work Sarah does every autumn. Grab a Cup. Let's Get You Covered.