Don't ignore this upcoming Medicare update - it could be the most important message of the year

By Richard Eisenberg

The ANOC has crucial information you need to see before Medicare's open enrollment begins on Oct. 15

Many people with Part D and Medicare Advantage plans don't bother to read their Annual Notice of Change.

A previous version of this column misstated the ability for people to enroll in Medigap if their Medicare Advantage plan is shut down. The column has been corrected.

If you have a 2025 Medicare Part D prescription-drug plan, a Medicare Advantage plan or both, in September you'll receive a missive with this sleep-inducing name: Annual Notice of Change. Odds are, you'll toss or ignore it.

Big mistake.

The Annual Notice of Change - sometimes called by its "ANOC" acronym - lays out how your costs and coverage will be different next year in your drug (Medicare Part D) or Medicare Advantage (Part C) plan, which is the alternative to original Medicare sold by health insurers. If you assume the 2026 plan will be identical to your 2025 plan, you'll be wrong.

"I don't think I've ever seen an Annual Notice that said 'no change,'" said Danielle Roberts, founding partner of Boomer Benefits, a brokerage firm that sells Medicare Advantage and Medicare supplement plans.

(There is no ANOC for Medicare parts A and B, known as traditional or original Medicare, because they are government plans and don't change each year.)

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Expect big changes in the notices of change

The notices for 2026 plans, experts say, are likely to contain especially dramatic changes due to turmoil at health insurers selling the plans and rising Medicare costs.

Some updates in the Annual Notice of Change will be to Medicare's 2026 premiums and deductibles, which may be sharply higher. Others will be decisions from insurers that could make your current plan more expensive, less attractive or generally worse for you when choosing next year's plan during Medicare's open-enrollment period, which runs from Oct. 15 to Dec. 7.

You could find your Part D plan won't cover certain prescriptions that it did in 2025 or will charge more for them, and might have a new or higher deductible. The pharmacy you frequent might no longer offer the lowest prices. Your Medicare Advantage plan could have different doctors and hospitals in its networks than this year, while prior-authorization rules to see specialists could get more restrictive and your out-of-pocket costs may get higher.

What's more, "your 2025 plan might be shut down entirely in 2026," said Ryan Ramsey, associate director of health policy and benefits at the National Council on Aging. UnitedHealthcare (UNH), the nation's largest Medicare Advantage insurer, has said it will drop plans affecting 600,000 people next year.

If your Medicare Advantage plan does shut down, you are then allowed to switch to original Medicare and enroll in a Medigap plan, which is private insurance that covers out-of-pocket costs. Medigap coverage is guaranteed as long as you enroll within a specific time period.

It's also possible, however, that some changes noted in your Annual Notice of Change will mean better coverage or lower costs - or both - compared to your 2025 plan.

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These Medicare notices are commonly ignored

One big problem: Many people with Part D and Medicare Advantage plans don't bother to read their Annual Notice of Change.

"We did a survey and found that only 48% of people who get these notices actually read them," said Whitney Stidom, vice president of Medicare enablement at eHealth, which sells Medicare plans.

There's no need to be intimidated by the heft and technical language of a 50-page Annual Notice of Change, though. The key updates are generally clearly noted in the first few pages. You can probably read them in 30 minutes or less.

If your Annual Notice of Change says your insurer won't offer the plan you've had in 2025, the company might automatically enroll you in a different one unless you opt out. Or it might exit the market, forcing you to hunt down a replacement plan.

Here's what to look for in your Annual Notice of Change and where to get help if what you see makes you want to consider Medicare alternatives for 2026.

Medicare Part D plans

Expect a little good news in your Part D plan's Annual Notice of Change if you take any of the 10 prescription medications in the new Medicare drug-price negotiation program taking effect in 2026.

Next year, all Part D plans must cover these drugs, which include popular blood thinners and diabetes medications. The government expects discounts on them of at least 38% to as much as 79% off list prices.

However, you'll want to see whether your Part D plan has any unpleasant changes for the year ahead.

One of those could be higher out-of-pocket costs at the beginning of the year, because experts expect more Part D plans will have deductibles in 2026.

"I think nearly every plan will have a deductible, so that's probably going to be the biggest change," said Stidom. In 2025, 85% of standalone Part D plans and 60% of Medicare Advantage drug plans had deductibles, according to KFF.

The maximum Part D deductible will be $615 in 2026.

"If you didn't have a drug deductible and now you have a plan with a $600 deductible, the first times you go to the pharmacy next year will cost you more out of pocket, because you'll have to satisfy that deductible," said Roberts.

Some Part D plans will charge higher monthly premiums next year, too. Last year, the average monthly Part D premium was $39 for a standalone plan. Many Medicare Advantage Part D plans have $0 premiums.

A Biden administration rule limited monthly premium increases to $35, but the Trump administration is raising that to $50.

You'll also want to find out in the Annual Notice of Change whether your Part D plan will cover all your medications in 2026, what you'll be charged for each, and which local pharmacies will provide the lowest prices because they'll be the insurer's preferred ones.

Stidom expects some Medicare Advantage drug plans will trim back their over-the-counter medication allowance benefits in 2026.

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Medicare Advantage plans

The financial squeeze on Medicare Advantage insurers may mean a member's Annual Notice of Change will note that the plan will reduce or drop other supplemental benefits in 2026, too. These benefits are the ones original Medicare doesn't cover, such as dental, vision, hearing and transportation to doctor's appointments.

"Medicare Advantage plans are going to try to go back to basics, which means we aren't going to see some of the super-rich benefits we've seen before," said Roberts. "Maybe the plan used to cover dentures and now it doesn't, or used to have a $1,000 annual maximum for covered dental costs and now it's just going to cover preventive care."

The notice might also say your plan is shifting from being a PPO (preferred provider organization) to an HMO (health-maintenance organization). PPOs let you see out-of-network doctors but require you to pay more for them; HMOs only let you go to physicians in their networks.

"There are going to be less PPO options and more HMO options next year," said Roberts.

Be sure to see whether the Annual Notice of Change mentions that any of your doctors or hospitals won't be in its network next year.

Medicare Advantage premiums are expected to rise by about 5% from $17 a month in 2025, though many plans have $0 premiums. Some plans have deductibles and others don't. So you'll want to learn whether your current plan will charge a premium, have a deductible or both - and if so, how much.

If your Annual Notice of Change says your 2025 Medicare Advantage plan won't be offered in 2026, you'll have roughly 40 other plans to choose from during open enrollment, said Stidom.

Getting help choosing a plan

Your Annual Notice of Change's plan updates may leave you scratching your head about how the differences for 2026 will affect you. To find out, call your insurer, said Roberts.

If you want, or need, to shop for a replacement Part D or Medicare Advantage plan, you can get assistance in a variety of ways.

Starting in October, the Medicare site's Plan Finder will let you compare 2026 costs, coverage and details for options where you live. This tool is expected to soon include physician-network lists in its MedicareAdvantage plan descriptions.

Your State Health Insurance Assistance Program - known as SHIP - also has Medicare experts who provide free advice, though they can't tell you which Part D or Medicare Advantage plan to get. A 2025 Journal of the American Medical Association study found, however, that roughly 40% of SHIP requests couldn't be completed, often because people didn't get calls returned.

The National Council on Aging has a free helpline (800-794-6559) to assist you in navigating Medicare.

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The Medicare advisory firm 65 Incorporated offers a $30-a-year service called HeyMOE (MOE stands for "Medicare open enrollment") that reviews Part D plans and recommends the best ones for you.

You might also want to work with an insurance agent who sells Part D or Medicare Advantage plans and gets paid by the carriers. The National Association of Benefits and Insurance Professionals has a directory of agents; just search for ones specializing in Medicare.

Be aware, though, that some health insurers have decided not to pay agents to sell certain Part D plans. So if your agent won't earn a commission from a company, they might not recommend its plan, even if it would be your best choice.

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09-14-25 1927ET