The Medicare letter arriving in September, and why it’s worth reading

Sometime this month, an envelope from your Medicare Advantage or Part D plan will arrive that looks a lot like the junk mail already piling up ahead of open enrollment. It isn’t. It’s called the Annual Notice of Change — ANOC, if anyone shortens it in front of you — and federal rules require every plan to mail it to you by September 30, every year, without exception.

What it contains is a full list of everything about your specific plan that changes on January 1. Not a comparison to other plans, not a sales pitch — a disclosure of what your own plan is about to do differently.

Why 2027’s letter carries more weight than most

CMS finalized new Part D numbers for 2027 this spring, and they are a real jump. The annual out-of-pocket threshold on covered drugs rises to $2,400, up from $2,100 — that applies to every Part D plan. The defined-standard deductible rises to $700, up from $615 — that figure is the maximum a plan is allowed to charge; individual plans can and do set it lower, or waive it. Your ANOC will show what your specific plan actually charges for 2027, not necessarily the defined-standard number itself.

The premium is only one of the numbers that can change what your coverage costs over a year. Drug tiers, formulary changes, cost-sharing and pharmacy status can matter just as much.

Also on The Second Half Guide Long-term care: the numbers, before the sales pitch What long-term care actually costs in 2026, who pays for it, and what insurance does and does not do. One of the largest risks in retirement. Read it →

Where the real information is buried

Plans typically lead with the premium, since it is the easiest single number to compare across plans. It is also, for most people, not where the money actually moves.

A maintenance medication that sat on one pricing tier this year can move to a higher tier for 2027, pick up a new prior-authorization requirement, or drop off the formulary entirely — and none of that shows up in the premium line. Neither does a preferred pharmacy losing its preferred status, which can change what the same prescription costs at the same counter. The letter discloses all of this. It just doesn’t lead with it.

The practical habit is simple: don’t stop reading after the premium and deductible. Find the section listing drug tier and formulary changes, and check every medication you actually take against it — not just the ones you remember being expensive.

The other document in the envelope

Some plans mail the ANOC together with a second, much longer document called the Evidence of Coverage. They serve different jobs. The ANOC is a short summary of what’s changing. The Evidence of Coverage is the full rulebook — everything the plan covers, what you pay for each type of service, and how to appeal a denied claim — regardless of whether anything about it changed this year. If your plan didn’t include one, it’s available on the plan’s website or by calling member services, and it’s the document to check if a specific benefit matters to you beyond what the ANOC happened to mention.

If nothing arrives by early October, that’s worth following up on rather than assuming your plan has no changes this year. CMS requires plans to get it to you by September 30; call your plan directly to request a copy, and if that doesn’t resolve it, 1-800-MEDICARE can help.

Advantage plans and standalone drug plans get different letters

What’s inside the envelope depends on what kind of plan you have. A standalone Part D plan — drug coverage only, paired with Original Medicare — sends an ANOC that’s almost entirely about drug costs: premium, deductible, formulary and pharmacy network. Most Medicare Advantage plans include Part D drug coverage along with medical coverage (a minority don’t), so their ANOC typically covers more ground: the same drug-cost items, plus changes to the provider network, referral requirements, and the plan’s service area. Losing a doctor from the network is exactly the kind of change that shows up in an Advantage ANOC and never appears at all in a standalone Part D one — another reason the letter is worth reading in full rather than skimmed for the premium line.

What to actually do with it

• Find the formulary and drug-tier section and check every prescription you currently take against it, not just the ones you remember being expensive.
• Check whether your preferred pharmacy is still preferred. The same drug at the same counter can cost a different amount if that status changed.
• If you have Part D coverage, the 2027 out-of-pocket threshold rises to $2,400 no matter which plan you keep. The defined-standard deductible rises to $700, but that’s the maximum — check your own ANOC for what your specific plan actually charges.
• If anything in the letter concerns you, the window to act is October 15 to December 7. Outside that window, this year’s plan carries into next year automatically.
• The ANOC tells you what your plan is changing to. It does not tell you what a better-fit plan would cost — that comparison lives at the Medicare Plan Finder, separately.
• If you have an Advantage plan, check the network and referral sections too, not just drug costs — a doctor leaving the network is exactly the kind of change this letter exists to disclose.

Nobody enjoys reading insurance mail closely. This is the one piece of it each year built entirely out of things that are about to be true whether you read it or not — which is the whole case for reading it before October 15, rather than after.