Medicare Annual Notice of Change: What Your ANOC Says and What to Check Before December 7

September 30. That's the date federal rules set for your Medicare Advantage or Part D plan's Annual Notice of Change to be in your hands, under 42 CFR 422.2267(e)(3) and 423.2267(e)(3). It's the one letter that lists what your plan is changing for next year, and the changes take effect January 1 whether you read it or not.

Today is November 5. Open Enrollment closes Monday, December 7, which leaves 32 days to read that notice, check it against the drugs you take and the doctors you see, and decide whether to keep the plan. If the envelope went into a drawer in September, now is the time to dig it out. If it never showed up, that's a phone call to make this week, not in December.

This post covers what the ANOC is, who gets one, which sections to read first, the government-set Part D numbers for 2027 you can check it against, and what happens if you do nothing. It explains rules and dates only. It doesn't compare plans or say anything about any particular plan.

Source: 42 CFR 422.2267(e); 42 CFR 423.2267(e); Medicare & You 2027, p. 13. Day count computed.

What the Annual Notice of Change actually is

The ANOC is a standardized notice your plan is required to send every year. The legal hook is short: under 42 CFR 422.111(d)(2) (Medicare Advantage) and 42 CFR 423.128(g)(2) (Part D), a plan that changes its rules for January 1 must notify every enrollee at least 15 days before the annual election period starts. Open Enrollment starts October 15. Count back 15 days and you land on September 30.

Medicare.gov describes it in one line: the Plan Annual Notice of Change "includes any changes in coverage, costs, and more that will be effective in January." The handbook's Part D section adds provider networks and the service area to that list.

It's not the same document as the Evidence of Coverage. The EOC is the long rulebook for next year: everything the plan covers and what you pay. The ANOC is the short list of what's different from this year. Plans have to get the EOC, the provider directory, the pharmacy directory and the drug list (formulary) to current members by October 15. The regulations let plans mail a notice telling you where to find those online instead of mailing the full books.

Who gets one, and who doesn't

Medicare.gov says you get an ANOC "if you're in a Medicare plan," and it defines Medicare plan as any way other than Original Medicare to get your health or drug coverage. The ANOC rules are written for Medicare Advantage organizations and Part D sponsors. That leaves out a lot of Floridians.

Source: Medicare.gov, Plan Annual Notice of Change; 42 CFR 422.2267(e); 42 CFR 423.2267(e); Medicare.gov, How Medigap works; Fla. Stat. 627.674.

If you have Medigap and a stand-alone drug plan, the drug plan's ANOC is the one that matters most this fall. Drug plans can change premiums, deductibles, drug lists and pharmacy networks every year. Medigap isn't part of the October to December election, so Open Enrollment doesn't change your Medigap policy.

The fall calendar, date by date

Source: 42 CFR 422.2267(e); 42 CFR 423.2267(e); 42 CFR 422.2263; CMS MA and Part D Enrollment and Disenrollment Guidance, CY 2027; Medicare & You 2027, p. 13.

One detail people miss: if you change plans during Open Enrollment and then change your mind, CMS guidance says you can generally submit another request before the effective date, and the last one the plan receives counts. So a choice made in late October isn't locked in until December 7 passes.

The sections to read first

The ANOC is a standardized CMS document, so the main sections look similar from plan to plan. Most people don't need to read every line. They need to check the lines that touch their own care. Before you open the notice, write down three things: every prescription with its dose, every doctor and hospital you use or expect to use, and the pharmacy you fill at. Then go through the notice with that list next to it.

Source: Medicare & You 2027, pp. 11, 66-69, 85-90; Medicare.gov, Part D costs.

Two of those rows deserve more attention than the rest.

The drug list. Every plan has its own formulary, and the handbook is clear that each plan's list differs. The ANOC tells you about drugs being dropped or moved to a different tier. It won't always tell you that a drug you take is fine. So don't stop at "I didn't see my drug mentioned." Look each one up in the plan's 2027 drug list, or enter them all in the Medicare.gov plan finder, which shows what each drug would cost under your current plan next year.

The network. Providers can join or leave a plan's network at any time during the year, and the handbook says that if it happens mid-year, you usually can't change plans for that reason alone. Open Enrollment is when you can act on it. If a specialist you see in Gainesville or a hospital system in Broward isn't in next year's directory, call the office and ask directly whether they'll be in network for 2027. The plan finder can also flag whether providers you add are in network.

And one thing I'd ignore in the ANOC: the marketing tone. The ANOC is a standardized CMS form, so the change tables are there whatever the cover letter says. Read the tables, not the headlines.

The 2027 Part D numbers to check your notice against

Medicare sets the outer limits for drug coverage each year in the CMS Rate Announcement. No plan's drug deductible can be higher than the first number below, and the out-of-pocket cap applies to every Part D plan. These are government figures, not any plan's prices.

Source: CMS, CY 2027 Rate Announcement, Table V-2; Medicare.gov, Part D costs; Medicare & You 2027, pp. 87 and 92.

• 2026
• 2027

$0$1,000$2,000$3,000

DeductibleOut-of-pocket cap

Source: CMS CY 2027 Rate Announcement, Table V-2; Medicare.gov Part D costs page

Show the numbers

	2026	2027
Deductible	$615	$700
Out-of-pocket cap	$2,100	$2,400

How to use these: if your ANOC shows a drug deductible, it should be $700 or less. The $2,400 cap is the most you'd pay out of pocket for covered Part D drugs in 2027, counting certain payments made for you such as Extra Help. Once you hit it, Medicare.gov says you pay nothing more for covered Part D drugs the rest of the year.

Example, under the standard benefit design only: say your covered drugs cost $7,500 in total for 2027. You'd pay the $700 deductible, then 25% of the remaining $6,800, which is $1,700. That's $2,400, right at the cap. Real plans may use flat copays by tier instead, so your own ANOC and the plan finder are the place to get your actual number. My Medicare Part D in 2027 post walks through the rest of the drug benefit, and Medicare Part D in Florida has the Florida basics.

If you signed up for the Medicare Prescription Payment Plan (the option that spreads drug costs into monthly bills) and you stay in the same Part D plan, the handbook says your participation renews automatically for 2027. If you switch plans, you have to opt in again with the new plan.

How to compare without getting sold

The ANOC tells you about your own plan. It doesn't tell you whether something else fits you better. For that there are three neutral routes:

• The Medicare.gov plan finder. Enter your drugs and pharmacy, add your doctors, and it shows estimated 2027 costs for your current plan alongside others in your ZIP code.
• SHINE. Florida's State Health Insurance Assistance Program, run by the Florida Department of Elder Affairs with the local Area Agencies on Aging. Trained volunteers do one-on-one counseling. Call 1-800-96-ELDER (1-800-963-5337), TTY 1-800-955-8770. The handbook notes SHIPs aren't connected to any insurance company or health plan. Here's how SHINE counseling works.
• 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).

Bring the ANOC with you to a SHINE appointment. It saves the counselor from guessing what your plan changed.

A word on the phone calls and mailers that pick up in October. The Medicare & You 2027 handbook says plans can't sign you up over the phone unless you called them or gave permission to contact you, and it asks you to report plans or agents that call to enroll you, visit unexpectedly, or ask for personal information by phone or email. A legitimate review starts from your list of drugs and doctors, not from a pitch. If you want help from a licensed agent, see our Medicare in Florida page, but nobody should rush you, and the comparison tools above work the same either way.

What happens if you do nothing

Doing nothing is a choice, and for some people it's the right one. What it means depends on what your ANOC says about the plan itself.

Source: KFF, Medicare Open Enrollment FAQs (Oct 9, 2026); CMS enrollment guidance CY 2027, secs. 30.6.10 and 60.2.7; Medicare.gov, Special Enrollment Periods; Medicare.gov, Part D costs.

KFF's Open Enrollment FAQ puts the first row plainly: if you like your Medicare Advantage plan, you don't need to do anything, as long as the plan is offered next year. Its Part D FAQ says enrollment in a continuing drug plan carries over automatically too. The catch is that "like your plan" means like the 2027 version described in the ANOC, not the 2026 version you've been using.

If your notice says the plan is ending

A plan leaving Medicare sends a different letter: a non-renewal notice. Under 42 CFR 422.506 and 423.507, the plan must mail it at least 90 days before the plan ends, and for plans ending December 31 the regulations require it to be dated October 2. It has to explain your enrollment options, what happens if you do nothing, and (for Medicare Advantage) your right to buy a Medigap policy.

If you were in a Medicare Advantage plan and you don't pick anything, CMS guidance says you're defaulted to Original Medicare when the plan ends. That leaves you without Part D drug coverage unless you join a drug plan. You have a special window from December 8 through the last day of February: a request in December starts January 1, January starts February 1, February starts March 1. Still, using Open Enrollment before December 7 avoids any gap at all.

Leaving a non-renewing Medicare Advantage plan also opens a federal Medigap guaranteed-issue right: you can apply as early as 60 days before your plan coverage ends and no later than 63 days after, and the insurer can't use your health to turn you down for certain Medigap plans. Florida's rule, F.A.C. 69O-156.0095(2)(b) and (3)(b), runs that window from the notice to 63 days after coverage ends. Outside situations like this one, Florida has no birthday rule or annual right to buy Medigap without health questions. My Florida Medigap rules post has the details, and Special Enrollment Periods covers the other special windows.

What to do if you never got your ANOC

Medicare.gov's instruction is one line: if you don't get this document, contact your plan. In practice:

1. Call the member services number on the back of your plan card and ask for the 2027 Annual Notice of Change and Evidence of Coverage. Ask them to mail a printed copy if you want one.
2. Check your plan's member website or online account. The handbook says the ANOC can come as a printed or an electronic copy, so it may be sitting in your email or member portal.
3. Check the address on file, especially if you moved this year. A move out of your plan's service area is its own trigger for a special enrollment period.
4. If the plan can't help, call 1-800-MEDICARE or SHINE. Either can show you your current plan's 2027 costs in the plan finder even without the paper notice.

Don't wait for the letter to start comparing. The plan finder has 2027 information now, and December 7 doesn't move because the mail was late.

A Florida note on storms

Hurricane Isaias came ashore near Destin on October 9. The Governor declared a state of emergency under Executive Order 26-202, later expanded by EO 26-211 and EO 26-212 to 30 counties from the Panhandle and Big Bend to the Tampa Bay area. Federal rules (42 CFR 422.62(b)(18) and the matching Part D rule) create a special enrollment period for people in a declared emergency area who missed an enrollment window because of it. Open Enrollment is still open, so most people in those counties can simply use it. The disaster period matters if the storm keeps you from acting before December 7. If that's you, call 1-800-MEDICARE and say so.

ANOC questions

When does the Medicare Annual Notice of Change come out?

Federal rules require Medicare Advantage and Part D plans to send it so members receive it by September 30. The Evidence of Coverage follows by October 15.

What is the difference between the ANOC and the Evidence of Coverage?

The ANOC lists what is changing in your plan for next year, such as costs, coverage, drug list, networks and service area. The Evidence of Coverage is the full description of what the plan covers and what you pay for the whole year.

Do people with Original Medicare or Medigap get an Annual Notice of Change?

No. The ANOC comes from Medicare Advantage plans and Part D drug plans. If you have Original Medicare with a stand-alone Part D plan, you get an ANOC from the drug plan only.

What if I didn't receive my Annual Notice of Change?

Contact your plan's member services and check your online account. You can also call 1-800-MEDICARE or SHINE at 1-800-963-5337 and compare 2027 costs in the Medicare.gov plan finder.

What happens if I ignore my Annual Notice of Change?

If your plan continues next year, you stay enrolled under its new terms starting January 1. If your plan is not renewing, Medicare Advantage members go back to Original Medicare and lose drug coverage unless they choose a new plan.

Next steps if you're in Medicare Advantage and want room to adjust after January: read up on the Medicare Advantage Open Enrollment Period.

Federal Medicare rules, Florida law and your own plan documents control what applies to you. Confirm your situation with your plan, 1-800-MEDICARE, SHINE or a licensed agent, and talk to an attorney for legal questions.

Sources

1. eCFR: 42 CFR 422.111, disclosure requirements (changes in rules)
2. eCFR: 42 CFR 423.128, Part D disclosure requirements (changes in rules)
3. eCFR: 42 CFR 422.2267, required materials and content (MA)
4. eCFR: 42 CFR 423.2267, required materials and content (Part D)
5. eCFR: 42 CFR 422.2263, marketing start date
6. eCFR: 42 CFR 422.506, nonrenewal of MA contract
7. eCFR: 42 CFR 423.507, nonrenewal of Part D contract
8. eCFR: 42 CFR 422.62, election periods and SEPs
9. Medicare.gov: Plan Annual Notice of Change (ANOC)
10. CMS: Medicare & You 2027 handbook
11. Medicare.gov: Part D costs
12. CMS: CY 2027 Medicare Advantage and Part D Rate Announcement
13. CMS: Medicare Advantage and Part D Enrollment and Disenrollment Guidance, CY 2027
14. Medicare.gov: Special Enrollment Periods
15. Medicare.gov: How Medigap works
16. CMS: Choosing a Medigap Policy (2026)
17. Florida Administrative Code 69O-156.0095, guaranteed issue for eligible persons
18. Florida Statutes s. 627.674, Medicare supplement policy standards
19. Florida Statutes s. 627.6741, Medicare supplement policies
20. KFF: Medicare Open Enrollment FAQs, Medicare Advantage
21. KFF: Medicare Open Enrollment FAQs, stand-alone Part D
22. Medicare.gov: Plan finder
23. Florida SHINE program
24. Florida SHINE: contact
25. Office of the Governor of Florida: Hurricane Isaias update (Oct 10, 2026)
26. Florida Executive Order 26-212, amending EO 26-202 (Hurricane Isaias)