Annual Notice of Change (ANOC)

What is the Annual Notice of Change?

The Annual Notice of Change (ANOC) is a document your Part D or Medicare Advantage plan must send you every fall. It explains exactly how your plan will change for the upcoming calendar year — premium changes, formulary changes, copay changes, network changes, and more.

Your plan must send the ANOC by September 30 each year, so you have time to review it before the Annual Enrollment Period (October 15 – December 7) when you can switch plans.

Why the ANOC matters

Many seniors throw the ANOC away without reading it. That's a mistake. Plans change every year — sometimes significantly. The ANOC is your only formal notice of these changes, and it's the document you need to decide whether to stay with your plan or switch.

Common changes year to year include:

• Premium increases (or decreases)
• Drugs removed from the formulary — your medication might not be covered next year
• Drugs moved to a higher tier — meaning higher copays
• New restrictions like prior authorization or step therapy
• Pharmacy network changes — your pharmacy might leave the network
• Deductible changes
• Copay changes

What to look for in your ANOC

1. Premium changes

Look for the section showing your current monthly premium versus next year's. Even small premium changes ($5–$10/month) add up to $60–$120 over a year.

2. Your specific drugs

This is the most important section. The ANOC should tell you whether each drug you currently take will still be covered, whether it's changing tiers (which affects your copay), and whether new restrictions are being added.

If a drug you take is being removed from the formulary or moved to a higher tier, you have three options:

• Switch to a different Part D plan that covers your drug at a lower cost
• Ask your doctor about switching to a different medication
• Request a formulary exception from your plan (with your prescriber's support)

3. Pharmacy network changes

If your preferred pharmacy is leaving the network — or moving from preferred to non-preferred status — your copays could go up significantly. The ANOC should list any network changes affecting your area.

4. Coverage rules and restrictions

Look for new prior authorization requirements, step therapy rules, or quantity limits affecting drugs you take. These restrictions can delay or prevent you from getting your medication.

5. Out-of-pocket costs

The ANOC includes estimates of total out-of-pocket costs for typical scenarios. If your plan's estimated costs are jumping significantly, that's a red flag worth investigating.

What to do after reviewing your ANOC

If your plan is changing in ways that hurt you — drugs dropped, big premium increases, pharmacy network shrinking — use the Annual Enrollment Period (October 15 – December 7) to compare other Part D plans available in your area. Coverage takes effect January 1.

Compare plans using:

• Medicare.gov Plan Finder — the official tool, free, lists all plans in your ZIP code
• Your state's SHIP counselor — free, unbiased one-on-one help
• A licensed Local Medicare Agent — free service, can run plan comparisons for you
• PlanMatch.com — online plan comparison tool

Comparing alternatives if your plan changed for the worse

If your ANOC reveals significant negative changes, the Annual Enrollment Period (October 15 – December 7) is your window to switch. Run your medications through the Medicare.gov Plan Finder, compare plans on PlanMatch, or work with a licensed agent who can analyze the alternatives for you at no cost.

If you don't do anything

If you don't take action by December 7, you'll automatically be re-enrolled in your current plan for next year — with whatever changes are described in the ANOC. That's fine if the changes don't affect you. It can be expensive if the changes hurt you.

If your plan is being terminated by the insurer or by Medicare (which sometimes happens), you'll get a different notice and may qualify for a Special Enrollment Period to choose a new plan.

Common ANOC mistakes

• Throwing it away unread. Even if your plan worked fine last year, it can change dramatically next year.
• Only checking the premium. Premium changes are easy to spot, but formulary and pharmacy network changes can cost you much more.
• Waiting too long. The Annual Enrollment Period closes December 7. After that, you can't switch plans until the following October — except for limited Special Enrollment situations.
• Not comparing alternatives. Even if your plan looks reasonable, another plan in your area might cover your specific drugs at much lower cost.

Frequently asked questions