Your Parent’s Medicare Annual Notice of Change: What to Check
Every fall, your parent’s Medicare plan mails a letter that quietly decides what their prescriptions will cost next year. It’s called the Annual Notice of Change, and it often lands in a pile with a dozen glossy Medicare ads, so it’s easy to miss. If you help manage Mom or Dad’s medications, this is the one piece of plan mail worth reading closely now, while Open Enrollment is open through December 7.
The quick answer
The Annual Notice of Change (ANOC) tells your parent what is changing in their current Medicare Advantage or Part D drug plan starting January 1. Plans must send it so members receive it by September 30. For drug costs, focus on five things: the monthly premium, the drug deductible, whether each of their medications is still covered, what tier each drug is on, and whether their pharmacy is still in network. Then compare those numbers against other plans during Open Enrollment, October 15 to December 7.
If your parent does nothing, their current plan usually continues automatically, with all of next year’s changes included. That can be fine. It just shouldn’t happen by accident.
What is the Annual Notice of Change, and when does it arrive?
The ANOC is a summary of differences between this year’s plan and next year’s version of the same plan. It comes from the plan itself, not from Medicare. A second, longer document called the Evidence of Coverage (EOC) spells out the full rules of the plan. Plans must provide the EOC by October 15, and many send it by mail or point members to a copy online.
Here are the dates to keep on your calendar this year:
| Date | What happens |
|---|---|
| By September 30 | Your parent should have the Annual Notice of Change in hand |
| By October 15 | Plan provides the Evidence of Coverage for next year |
| October 15 to December 7 | Medicare Open Enrollment for 2027 coverage |
| January 1, 2027 | New plan or plan changes take effect |
| January 1 to March 31, 2027 | Medicare Advantage Open Enrollment (one change, Medicare Advantage members only) |
If the letter never showed up, call the plan’s member services number on the back of your parent’s card and ask for a copy. Many plans also post it on their website or in the member portal.
Step by step: how to read the letter for drug costs
Sit down with the ANOC, your parent’s current medication list, and their plan ID card. You don’t need to read every page. These are the sections that move the dollar amount at the pharmacy counter.
- Find the cost summary table. Most ANOCs open with a side-by-side chart of this year versus next year. Look at the monthly premium first. A small increase each month adds up over twelve months.
- Check the drug deductible. This is the amount your parent pays before the plan starts sharing the cost of some or all drugs. For 2027, no Medicare drug plan can have a deductible higher than $700. Some plans charge less, and some skip the deductible for lower tiers like generics.
- Look up every medication in the drug list section. The plan’s list of covered drugs is called the formulary. The ANOC usually tells you how to see next year’s full list, either online or by phone. Check each drug by name and strength, not just the ones that are expensive now. A drug that is covered this year may be dropped or replaced next year.
- Note the tier for each drug. Plans sort drugs into tiers, and each tier has its own copay or coinsurance. If a medication moves from a lower tier to a higher one, the cost per fill can jump even if nothing else changes.
- Look for new rules on specific drugs. Watch for prior authorization (the plan must approve the drug first), step therapy (your parent has to try a different drug first), or quantity limits. These don’t always change the price, but they can delay a refill in January if no one sets them up ahead of time.
- Confirm the pharmacy network. Check that your parent’s usual pharmacy is still in network next year, and whether it is “preferred” or “standard.” In many plans, the same drug costs less at a preferred pharmacy. Mail-order pricing can differ too.
- Know the out-of-pocket cap. In 2027, once your parent’s out-of-pocket spending on covered Part D drugs reaches $2,400, they pay $0 for covered drugs for the rest of that year. That’s up from $2,100 in 2026. If your parent takes a costly brand-name drug, this number matters more than the premium.
- If they’re in a Medicare Advantage plan, check the medical side too. Look at doctor and hospital network changes, specialist copays, and the plan’s maximum out-of-pocket amount for medical care. A drug-friendly plan isn’t a good deal if your parent’s cardiologist leaves the network.
What to compare next during Open Enrollment
Once you know what’s changing, the next step is to see whether another plan would serve your parent better. The free comparison tool at Medicare.gov/plan-compare lets you enter their exact medications and preferred pharmacies, then shows an estimated total yearly cost for each plan in their area.
As a pharmacist, I’d tell you to sort by total estimated drug cost plus premium, not by premium alone. A plan with a $0 premium can still cost more over the year if your parent’s main medication sits on a high tier there.
When you compare, line up the same things you checked in the ANOC:
- Monthly premium
- Drug deductible, and which tiers it applies to
- Whether every medication is covered, and at what tier
- Prior authorization or step therapy on any of their drugs
- Whether their pharmacy is in network and preferred
- For Medicare Advantage: doctors, hospitals, and the medical out-of-pocket maximum
Save or print the estimate for their current plan so you have a baseline. If you’d rather talk it through with a person, your parent’s State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling. You can find the local office at shiphelp.org. You can also call 1-800-MEDICARE (1-800-633-4227).
Annual Notice of Change checklist to screenshot
Keep this list next to the letter while you go through it with your parent:
- Did the Annual Notice of Change arrive by September 30? If not, call the plan.
- What is next year’s monthly premium compared with this year’s?
- What is next year’s drug deductible, and does it apply to generics?
- Is every one of Mom or Dad’s medications on next year’s formulary, at the same strength?
- Did any drug move to a higher tier?
- Are there new prior authorization, step therapy, or quantity limits?
- Is their pharmacy still in network, and is it preferred?
- For Medicare Advantage: are their doctors and hospital still in network?
- Have you run their drug list through Medicare Plan Finder before December 7?
- Do you have a copy of the Evidence of Coverage (due by October 15)?
Common mistakes to avoid
- Tossing it as junk mail. The ANOC often looks like every other piece of plan mail. Ask your parent to set aside anything from their current plan in September and October.
- Only checking the premium. The premium is the most visible number, but tier changes and a dropped drug usually have a bigger effect on what your parent pays at the pharmacy.
- Checking only the expensive drugs. A low-cost generic can be removed from a formulary too. Look up every medication on the list, including inhalers, eye drops, and insulin.
- Assuming “no action” means “no change.” If your parent keeps the plan, next year’s premium, deductible, and drug list changes still apply starting January 1.
- Waiting until December. Open Enrollment ends December 7, and the new plan must receive the enrollment request by then. Pharmacies and SHIP counselors get busy in the final weeks.
- Counting on a fix in January. Medicare Advantage Open Enrollment from January 1 to March 31 only applies to people already in a Medicare Advantage plan, and it allows one change. Someone with Original Medicare and a stand-alone drug plan generally can’t use it to switch drug plans.
When to talk to your parent’s pharmacist, doctor, or plan
Call the plan if the letter never arrived, if you can’t tell whether a drug is still covered, or if you want to know how a new prior authorization rule will work. Ask them to confirm next year’s tier and copay for each medication by name.
Talk to the pharmacist if a medication is being dropped or moved to a much higher tier. They can tell you whether there’s a covered alternative worth raising with the doctor and whether a 90-day supply might cost less under next year’s plan.
Talk to the prescribing doctor before any medication change. If a drug is leaving the formulary, the doctor can decide whether a covered alternative makes sense or whether to ask the plan for an exception. Your parent shouldn’t stop or switch a medication on their own because of a coverage change.
The ANOC is one letter, but it holds most of what you need to make next year’s decision. Read it now, write down the changes that matter, and you’ll walk into Open Enrollment with a clear list instead of a guess.
This article is for educational purposes only and is not medical, legal, or insurance advice. Talk with your pharmacist, doctor, or health plan before changing your medications or coverage. Some links may be affiliate links; see our disclosure.