Read Your Annual Notice of Change (ANOC)

As the Medicare Annual Enrollment Period (AEP) draws near, it’s crucial to support your clients in navigating their coverage choices. One key document they’ll receive is the Annual Notice of Change (ANOC), sent out by September 30. This document highlights essential updates to their current plans, including any changes for the upcoming year. Being well-versed in these updates is vital for making informed decisions during the AEP, which spans from October 15 to December 7. Read on to explore the details of the ANOC and gain valuable insights to assist agents in effectively guiding their clients.

What is the Medicare Annual Notice of Change?

The Medicare Annual Notice of Change (ANOC) is an official document that highlights any adjustments that will impact a client’s Medicare Advantage or Prescription Drug Plan (PDP) starting from January 1st of the upcoming year. It’s important to note that the ANOC specifically addresses changes related to Medicare Advantage plans and PDPs, as Medicare Supplement plans (also known as Medigap or Med Supp) are standardized by the federal government.

Understanding the Medicare Annual Notice of Change Letter

Now that you have a basic understanding of what the ANOC is, let’s address some common questions your clients might have.

What details are included in the Medicare Annual Notice of Change letter?

The ANOC letter provides an overview of any changes to a beneficiary’s Medicare Advantage or Prescription Drug Plan that will take effect on January 1st of the following year. These changes might involve:

• Premium increases
• Deductible adjustments
• Changes in copayments
• Coinsurance alterations
• Modifications to provider networks
• Updates to the formulary (list of covered drugs)
• Changes in out-of-pocket maximums
• Adjustments to prior authorization requirements
• Managed care or referral changes
• Alterations to covered benefits

It’s essential to be aware that drug plans can often be discontinued or revised. This can lead to automatic enrollment in a different drug plan offered by the same company, which may come with higher costs or other unexpected changes.

Three Reasons to Review Your Medicare Paperwork This Fall

1. A New Part D Cap is Coming

Starting in 2025, Medicare Part D prescription drug plans will introduce a cap on out-of-pocket spending at $2,000, which is a significant shift from previous years. While this sounds promising, remember that this limit only applies to drugs covered by your plan, and coverage can change annually.

Meredith Freed, a senior policy manager with the KFF Program on Medicare Policy, points out that “Part D plan sponsors may make changes to the Part D plan in terms of the list of covered drugs — also called the formulary — and cost-sharing tiers the drugs are on.” Additionally, premiums could rise, especially for stand-alone Part D plans.

This change also affects Medicare Advantage plans with prescription drug coverage, so it’s crucial for everyone to carefully check their Annual Notice of Change this fall.

2. The Annual Notice of Change is Critical

The Annual Notice of Change (ANOC) document is sent out each fall and contains important updates to your plan for the coming year. As Melinda Caughill, co-founder and CEO of 65 Incorporated, advises, “That document is typically a little short of 30 pages. It will have links to the formulary list, so take a look at that document. Don’t just throw it out.” It’s essential to review this information thoroughly to ensure your medications remain covered.

3. Compare Your Options to Save Money

After reviewing your plan’s updates for 2025, visit Medicare.gov and enter your prescription drugs with the exact dosage into the plan finder tool. This will help you compare other Medicare Advantage or Part D options. Pay close attention to the total out-of-pocket costs for each plan, as any drug not covered by your plan will require you to pay the full amount.

If one of your expensive medications isn’t covered next year, contact your doctor to explore alternative options. As Melinda Caughill emphasizes, “You could have a $0-premium drug plan but pay $20,000 a year because your medications aren’t covered.”

Potential Reductions in Medicare Advantage Benefits

1. Medicare Advantage Providers Might Be Reducing Benefits

Reports indicate that some Medicare Advantage companies may reduce benefits in 2025 due to financial pressures. This could manifest in a few ways, such as increased cost-sharing for certain services or a decrease in the range of benefits offered. As Meredith Freed explains, “Maybe the cost sharing will increase for certain services, [or] maybe the plan is less comprehensive in terms of benefits it covers.”

If additional benefits are essential to you, it’s crucial to carefully examine your plan documents to understand what changes are coming in 2025 and determine if another plan might be a better match for your needs.

For any questions about your plan’s coverage in 2025, you can get assistance by calling 800-MEDICARE (800-633-4227, TTY 877-486-2048) or through your State Health Insurance Assistance Program (SHIP). Freed suggests, “You can actually talk through it with someone and make sure you understand the changes to your plan — and potentially if you really want to stay in a certain plan.”

2. Medicare Advantage Providers Are Dropping Plans

Some Medicare Advantage companies have announced they’ll be discontinuing certain plans in 2025, and in some cases, even pulling out of entire states. If your provider is ending your plan in 2025, you have two options: switch to another Medicare Advantage plan available in your area or return to Original Medicare. If you take no action, you’ll automatically be switched back to Original Medicare.

If you decide to go back to Original Medicare because your plan is ending, you’ll have another opportunity to join a Medicare Supplement Insurance plan, or Medigap, without undergoing medical underwriting. Typically, this is only possible during your Medigap open enrollment period, which is the six-month period starting when you turn 65 and enroll in Medicare Part B.

As Melinda Caughill puts it, “When you are dropped from a plan based upon no action of your own, such as the plan going out of business, you have a Medicare do-over.”

A Final Note: Don’t Let Your Coverage Renew Without Review

No matter what, avoid simply allowing your coverage to renew without thoroughly reviewing the changes. Caughill advises, “This is work. You’ve got to put the time in. You are agreeing to the changes of [your provider’s] terms, and you need to know what these terms are.”