How to read the annual notice of change from your Medicare plan

Every September a document lands in the post from your Medicare Advantage or Part D plan, and almost everyone throws it away. It is called the Annual Notice of Change, and it is the only warning you get that your plan is about to become a different plan.

It is thick, it is grey, and it is written by people who would rather you did not read it. I understand the instinct to bin it. Do not.

The plan you signed up for is allowed to change every year: the premium, the deductible, which doctors are in the network, and crucially which drugs it covers and at what tier. None of that requires your agreement. The notice is the disclosure, and if you do nothing, you have accepted all of it.

Open enrollment runs from 15 October to 7 December, and changes take effect on 1 January. That is your window.

The four things worth checking

Skip the introduction. It says nothing.

Find the section that compares this year to next year side by side. Most plans lay it out in two columns, and the whole useful content of the document is in those few pages.

Start with the monthly premium. Then the annual deductible. Then the primary care and specialist copays. A plan can hold its premium flat and triple your specialist copay, and it will present that as stability.

Then find the drug list. This is where the real damage happens. Look up every single medication you take by name and check its tier. A drug that sat on tier two this year and moves to tier three next year can quietly double what you pay at the counter. Plans do this constantly and it is entirely legal.

Also check whether anything you take has been dropped from the list altogether, and whether the plan has added a prior authorization or a quantity limit. Prior authorization means your doctor has to argue with the insurer before you can have it. That is not a minor inconvenience. It can take weeks.

Last, check the provider network. Plans drop hospitals and physician groups every year. If your cardiologist is out of network in January and you find out in February, you are paying for that visit.

A note on Part B

The Annual Notice of Change covers your private plan. It does not cover the Part B premium, which is set by the federal government and announced separately, usually in November.

For 2026 the standard Part B premium is $202.90 a month and the annual Part B deductible is $283. Higher earners pay a surcharge on top of that, based on a tax return from two years earlier. If that applies to you, you get a separate letter about it.

What I tell people to do with it

Sit down with the notice, your current pill bottles, and a pen. Write down the name and dosage of everything you take. Then go through the drug list one at a time and write the tier next to each one.

It takes about forty minutes and it is the single most useful forty minutes of the year for anyone on more than two or three prescriptions.

If the numbers have moved against you, use the plan finder at medicare.gov. You can enter your medications and your pharmacy and it will price the plans available where you live. It is a genuinely good tool, which surprised me the first time I used it, because very little else about this system is.

The trap nobody warns you about

Switching plans is easy in October and impossible in February.

Outside open enrollment you are generally stuck until the following year, with a handful of narrow exceptions for people who move, lose other coverage, or qualify for extra help. There is a separate Medicare Advantage open enrollment period from January to March that lets you change or drop an Advantage plan, but it does not help someone on standalone Part D who picked wrong.

So the deadline is real. 7 December, and no amount of explaining your situation afterwards will move it.

At the plant I used to put a note in everyone's October pay envelope reminding them to read the thing. A few people did. Most did not, and every January I had the same conversations with the same people about drugs that had jumped a tier while they were not looking.

Keep the notice somewhere you will see it, read the comparison table, and check your own prescriptions against the list. The rest of the document you can ignore.