Don’t Throw Away Your Medicare ANOC. This Important Notice Explains What Is Changing in Your Health Plan Next Year.

Every September, Medicare beneficiaries enrolled in Medicare Advantage or prescription drug plans receive an important document from their current plan.

It is called the Annual Notice of Change, commonly referred to as the ANOC.

Unfortunately, it can be easy to overlook.

The ANOC may arrive in an envelope that looks similar to other insurance mail. It may also be lengthy and contain terminology that is difficult to understand. Some people set it aside because they are satisfied with their current plan and assume everything will remain the same next year.

That can be a costly mistake.

Your Annual Notice of Change explains how your current plan’s coverage, benefits, and costs will change on January 1. Even if you want to keep your plan, you should read the notice carefully and make sure the coverage will continue to meet your needs.

What Is an Annual Notice of Change?

The ANOC is a document that your current Medicare Advantage or Medicare prescription drug plan sends you each year.

It compares important parts of your existing coverage with the coverage the plan expects to provide during the coming year.

Medicare explains that plans send the ANOC each fall to inform members about changes in coverage, costs, and other plan details that will take effect in January. Medicare recommends reviewing those changes to determine whether the plan will continue to meet your needs. Read Medicare’s explanation of the Annual Notice of Change.

The ANOC is not an advertisement for a different plan. It is information about the plan you already have and how that plan is changing for the next calendar year.

When Should You Receive It?

You should receive your Annual Notice of Change in September.

It may arrive by mail or electronically if you previously agreed to receive plan documents that way. Check your physical mailbox, email, and online plan account.

Do not assume it is junk mail.

If you have not received your ANOC, contact your current health or prescription drug plan and request a copy. You can also ask whether it is available through the plan’s website or member portal.

Medicare specifically advises beneficiaries who do not receive this important document to contact their plan.

Why Does the ANOC Matter?

Medicare Advantage and prescription drug plans can change from one year to the next.

The plan may keep the same name and insurance company while changing some of the details underneath it. Those changes could affect your healthcare access and what you pay.

Depending on your plan, the ANOC may describe changes involving:

• Monthly premiums

• Medical deductibles

• Copayments and coinsurance

• The annual maximum out-of-pocket limit

• Prescription drug coverage

• Pharmacy costs

• Provider network or service-area information

• Referral or prior authorization requirements

• Dental, vision, hearing, transportation, fitness, or other supplemental benefits

• Rules governing how particular benefits can be used

Some changes may be small. Others may significantly affect your healthcare or budget.

The purpose of reviewing your ANOC is not to assume that every change is bad. A plan may improve certain benefits, reduce some costs, or continue to work very well for you.

The goal is simply to know what you will have before the new plan year begins.

Which Sections Should You Review Most Carefully?

Your ANOC will contain a summary of important changes. Instead of trying to memorize the entire document, concentrate on the areas that are most likely to affect you.

Your Monthly Premium

Determine whether the plan’s monthly premium is changing.

Remember that a Medicare Advantage plan premium is separate from the Medicare Part B premium. Most beneficiaries must continue paying their Part B premium even if their Medicare Advantage plan has a $0 monthly premium.

Your Medical Costs

Review changes to what you may pay for services such as:

• Primary care visits

• Specialist visits

• Diagnostic tests and imaging

• Outpatient procedures

• Emergency room care

• Ambulance services

• Hospital stays

• Skilled nursing facility care

• Physical and occupational therapy

• Durable medical equipment

A small increase in a frequently used service could matter more to you than a larger change involving care you rarely receive.

Your Maximum Out-of-Pocket Limit

Medicare Advantage plans have an annual limit on what members pay out of pocket for covered Medicare Part A and Part B services.

Check whether your plan’s limit is changing.

This amount represents an important part of your potential financial exposure if you experience a serious illness, hospitalization, or year requiring extensive medical care.

Your Prescription Drug Coverage

If your plan includes prescription coverage—or you have a separate Part D plan—review changes affecting your medications.

Look for changes to:

• The plan’s formulary, or list of covered drugs

• The tier assigned to each medication

• Copayments or coinsurance

• The pharmacy network

• Preferred pharmacy pricing

• Mail-order options

• Prior authorization

• Step therapy

• Quantity limits

Do not assume that your medications will be covered in exactly the same way next year simply because you are keeping the same plan.

The ANOC may summarize important changes, but you may also need to review the plan’s formulary or contact the plan for details about your specific prescriptions.

Your Supplemental Benefits

Review any changes to dental, vision, hearing, fitness, transportation, over-the-counter allowances, or other supplemental benefits.

Determine whether:

• The benefit amount is changing

• The provider or vendor network is changing

• New limitations or eligibility rules apply

• The benefit will still be offered

• The way you access or use the benefit is changing

Supplemental benefits can be valuable, but remember that your medical coverage, prescriptions, provider access, and potential healthcare costs should remain the most important parts of your decision.

Your Doctors and Hospitals

The ANOC may contain important provider-network information, but you should not rely on the ANOC alone to determine whether your doctors will participate next year.

Review the plan’s provider directory and confirm your important providers directly with both the plan and the provider’s office.

Ask about the exact plan—not merely the insurance company—because the same company may offer several plans with different networks.

Check your:

• Primary care physician

• Specialists

• Preferred hospital

• Medical group

• Laboratory

• Imaging facility

• Pharmacy

• Other frequently used providers

Provider networks can change during the year as well, so verification is always important.

The ANOC and Evidence of Coverage Are Different

Around the same time, your plan may also provide an Evidence of Coverage, often called the EOC.

These documents serve different purposes.

The ANOC highlights important changes between the current plan year and the upcoming year. The Evidence of Coverage provides more detailed information about how the plan will operate, including covered services, costs, rules, limitations, and member rights.

A simple way to remember the difference is:

• ANOC: What is changing?

• Evidence of Coverage: How does the plan work?

Medicare identifies both documents as important plan communications generally provided in September. See Medicare’s list of cost and coverage notices.

Keep both documents somewhere you can find them. They may be helpful when you have questions about coverage during the coming year.

What Should You Do After Reading Your ANOC?

After reviewing the notice, ask yourself:

• Will my important doctors and hospitals still participate?

• Are my prescriptions still covered affordably?

• Can I manage the new medical copayments and coinsurance?

• Has the maximum out-of-pocket limit changed?

• Do the plan’s referral and authorization rules work for me?

• Does the coverage fit my travel habits?

• Are changes to supplemental benefits important to my situation?

• Does this plan still meet my overall healthcare needs?

If the answer is yes, you may decide that your current coverage remains appropriate.

If you have concerns, you can compare other available options during Medicare Open Enrollment, also commonly called the Annual Enrollment Period.

Medicare Open Enrollment runs from October 15 through December 7 each year. Changes made during this period generally take effect January 1. During this time, eligible beneficiaries may be able to change Medicare Advantage plans, change prescription drug plans, or change how they receive Medicare coverage. Review Medicare’s Open Enrollment information.

Do not wait until the final days of the enrollment period to begin asking questions. Provider participation and prescription coverage can take time to verify.

Does Receiving an ANOC Mean You Must Change Plans?

No.

Every member receives an ANOC because plans are required to explain changes for the coming year. Receiving the notice does not automatically mean your plan is ending or that you need to choose another plan.

You may review the changes and determine that your current plan still fits you well.

In many cases, members who want to remain in a continuing plan do not need to submit a new enrollment request. Their coverage generally continues into the next year unless the plan’s notice says otherwise.

However, you should not let automatic renewal replace an annual review.

Your plan can change. Your medications can change. Your doctors can change networks. Your health and financial needs can change too.

Taking time to review your coverage each year is simply good Medicare housekeeping.

Beware of Confusing Mail and Marketing

The weeks leading into Medicare Open Enrollment bring a significant increase in advertisements, mailers, telephone calls, and invitations.

Your official ANOC comes from your current plan and concerns your existing coverage. Other mail may promote different plans or invite you to request information.

Keep your ANOC separate from advertisements so you can refer to it when comparing your options.

Also protect your personal information. Do not provide your Medicare number, Social Security number, banking information, or other sensitive information to an unknown caller or organization simply because they mention Medicare.

If you are unsure whether a document or telephone call is legitimate, contact your plan using the member-service number on your current identification card.

Bring Your ANOC When Asking for Help

If you have difficulty understanding your ANOC, do not be embarrassed.

These documents contain insurance terminology, charts, cost-sharing amounts, coverage rules, and references to other plan materials. Even people who work with Medicare regularly may need time to review the details carefully.

When asking for assistance, have the following available:

• Your Annual Notice of Change

• Your current plan identification card

• A list of your physicians and healthcare providers

• A current list of prescriptions and dosages

• Your preferred pharmacies

• Questions about the sections that concern you

This information makes it easier to determine whether the changes are likely to affect you personally.

Let PBC Help You Understand What Is Changing

Premier Benefit Consultants helps Medicare beneficiaries throughout Hawaiʻi understand their health plan coverage and annual changes.

Our independent Medicare agents can review your ANOC with you, explain unfamiliar terminology, identify changes that may affect your healthcare, and help you compare available options when appropriate.

Our assistance is complimentary.

If your Annual Notice of Change is confusing—or you simply want another set of eyes to review it—contact PBC. We can help you understand what is changing so you can make an informed decision before Medicare Open Enrollment ends.

When your ANOC arrives, don’t throw it away. Open it, read it, and ask for help if you need it.

Plan availability, premiums, benefits, costs, provider networks, formularies, and coverage rules vary by plan and may change from year to year. Reviewing your ANOC does not replace verification with the plan or healthcare provider.