Medicare ANOC: Why You Must Read the Annual Notice of Change

If you have a Medicare Advantage plan or a Part D prescription drug plan, you get an Annual Notice of Change (ANOC) each September. This annual notice alerts you to important changes in your Medicare Advantage plan or your Part D drug plan that will take effect starting January 1 of the upcoming year.

The notice of change alerts you to changes that will affect your premium costs, deductibles and/or the medical providers, pharmacies, and drugs that are part of the plan. By reading it and comparing it to other options for you, you’ll be able to choose the best Medicare plan for you for the coming year.

Here’s why the ANOC matters — and what to do with the information it contains.

What Is the Purpose of the ANOC?

The ANOC lets you know how your plan will change in the upcoming year. It’s important to read because because premium costs, drugs covered, drug tier levels and pharmacies can change from year to year. For 2026, many people are likely to see a significant increase in their Part D premium as well as other important changes affecting their costs and drug coverage.

Reading the ANOC helps you decide whether your current coverage will still work for your health needs and your budget. It is sent out in September so you have enough time to review the changes, and consider alternatives so you will be able to make changes during allowed time periods (open enrollment.)

What’s Included in the ANOC?

You’ll find key details about changes in:

• Costs
  Look for increases (or decreases) in your monthly premium, deductibles, and co-pays.
• Coverage
  This includes shifts in medical services, benefits, and prescription drug formularies. Pay close attention if you rely on specific medications — your drug may move to a higher tier or be dropped entirely.
• Provider Network
  Check whether your doctors, hospitals, or pharmacies are still in-network. Network changes can lead to higher out-of-pocket costs or disruptions in care.

What If the Plan No Longer Fits?

You can only switch Medicare plans once a year during a specific time period. If the plan is no longer a good match for your needs, or you weren’t happy with it, you can switch plans during the Medicare Annual Enrollment Period (October 15 through December 7).

This is your yearly chance to:

• Change from one Medicare Advantage plan to another.
• Switch from a Medicare Advantage plan to Original Medicare.
• Enroll in or change your Part D drug plan.

If you are currently enrolled in a Medicare Advantage Plan, you can also switch plans during the Medicare Advantage Open Enrollment Period (MA OEP) from January 1–March 31.

Related reading: Medicare explained: How it works and plan options

Important Warning: Switching to Original Medicare Has Pitfalls

You can switch from a Medicare Advantage plan back to Original Medicare during the Annual Enrolment Period — but getting supplemental coverage may not be guaranteed.

Medigap Policies May Be Harder to Get

When you enroll in Medigap during your initial enrollment period (within six months of when you became eligible for Medicare), you can get a Medigap plan regardless of preexisting health issues.

However, if you didn’t enroll in a Medigap (Medicare Supplement Insurance) policy during your initial enrollment period — the six months after you first became eligible — you may face medical underwriting if you try to buy one later.

This means:

• You could be denied coverage.
• You might pay higher premiums based on your health.
• Pre-existing conditions could be excluded for a certain period.

This is one of the biggest obstacles people run into when trying to leave Medicare Advantage.

Exceptions: Guaranteed Issue Rights

There are specific situations where you where you can switch from a Medicare Advantage plan to Original Medicare and a Medigap plan without medical underwriting. These are called guaranteed issue rights. Despite the name, these are specific scenarios and not a general right and they include:

• Your Medicare Advantage plan is no longer available in your area.
• You move out of your plan’s service area.
• You joined a Medicare Advantage plan when you first became eligible for Medicare and want to switch to Original Medicare within 12 months.
• You previously had a Medigap policy, dropped it to join a Medicare Advantage plan, and want to switch back within 12 months.

In these cases, insurers must sell you a Medigap policy — no health questions asked.

State-Level Guaranteed Issue Rules

Where you live can influence whether you can switch to a Medigap plan without underwriting, too. Four states – Connecticut, Maine, Massachusetts, and New York have guaranteed issue protections for Medigap for all beneficiaries 65 and older. Thirty-five other states have limited protections. (Check with your state insurance department to determine the rules in your state.)

Bottom Line

The Annual Notice of Change isn’t just another piece of mail — it’s your roadmap to next year’s coverage. Review it carefully. Compare your options. And if you’re considering switching plans, especially from Medicare Advantage to Original Medicare, understand the fine print before making the leap.

Your health coverage should work for you — not surprise you.

Disclaimer: The information on this website is provided for informational purposes only and should not be considered as legal, tax, accounting, or medical advice. Please consult a licensed professional for help with any specific questions and issues you may have.