Your Medicare Plan Maybe Changing for 2027: Don't Ignore This Letter

Every fall, people enrolled in a Medicare Advantage or Medicare Part D prescription drug plan receive an important document called the Annual Notice of Change, often referred to as the ANOC.

It may look like just another thick packet of insurance information, but don’t toss it aside. This letter explains how and if your current Medicare plan may change on January 1, 2027. Even if you have been happy with your plan, it is important to review it. Medicare Advantage and Part D plans can change their premiums, copays, provider networks, drug coverage and extra benefits every year.

What is an Annual Notice of Change?

Your Annual Notice of Change compares your plan’s current benefits and costs with what will change in the coming year. Your plan should send your Annual Notice of Change for you to receive by September 30, before Medicare’s Annual Enrollment Period begins on October 15. If you haven’t received it, contact your plan and request a copy. The ANOC is different from the Evidence of Coverage. The ANOC highlights what is changing, while the Evidence of Coverage provides the complete details about how your plan works.

What should you look for in your Medicare plan letter?

You don’t necessarily have to read every page from beginning to end. Start by looking for changes in the areas that affect you most.

1. Monthly premium

Check whether your plan’s monthly premium is increasing for 2027. Remember that a $0-premium Medicare Advantage plan doesn’t mean you have no Medicare costs. You must continue paying your Medicare Part B premium, and you may still have deductibles, copays and coinsurance when you receive care.

2. Medical copays and coinsurance

Review what you’ll pay for the services you use including:

• Primary care visits

• Specialist visits

• Outpatient surgery

• Diagnostic tests and imaging

• Emergency room visits

• Ambulance services

• Hospital stays

• Skilled nursing care

• Physical and occupational therapy

A plan’s premium may remain the same while some of its copays increase.

3. Maximum out-of-pocket limit

Every Medicare Advantage plan has an annual maximum out-of-pocket limit for covered Part A and Part B services. This is one of the most important numbers to review. It represents the most you could be responsible for paying during the year for covered medical services under the plan’s rules. Prescription drug costs generally don’t count toward a Medicare Advantage plan’s medical maximum.

4. Prescription drug coverage

Make sure each of your medications will remain on the plan’s formulary, which is its list of covered drugs.

Check whether:

• Your drug moved to a different tier

• Your copay or coinsurance changed

• A deductible now applies

• Prior authorization is required

• Step therapy or quantity limits were added

• Your preferred pharmacy status changed

For 2027, the maximum Part D deductible is increasing to $700, although some plans may have a lower deductible or no deductible. The annual out-of-pocket limit for covered Part D drugs will be $2,400 in 2027. Once you reach that limit through qualifying drug expenses, you’ll pay $0 for covered Part D prescriptions for the rest of the calendar year. This limit doesn’t mean every person will spend $2,400. Your actual costs depend on your prescriptions, your plan’s formulary, the drug tiers and the pharmacy you use.

5. Doctors and hospitals

Look for changes involving your plan, specialists, hospitals and other healthcare providers.

A doctor who participates in your Medicare Advantage plan this year may not necessarily remain in the network next year. Provider contracts can also change after plan materials are printed, so it’s wise to verify your providers directly with both the plan and the provider’s office. Don’t ask only whether the doctor “accepts Medicare.” Ask whether the doctor participates in your specific Medicare Advantage plan and network for 2027.

6. Pharmacy network

The pharmacy you currently use may move from preferred to standard status, which could increase what you pay for prescriptions.

Compare your costs at:

• Preferred retail pharmacies

• Standard retail pharmacies

• Mail-order pharmacies

The most convenient pharmacy isn’t always the least expensive under your plan.

7. Dental, vision, hearing and other extra benefits

Medicare Advantage plans may change their supplemental benefits from year to year.

Review changes to:

• Dental allowances and provider networks

• Routine vision coverage

• Eyeglass or contact-lens allowances

• Hearing exams and hearing aids

• Over-the-counter allowances

• Fitness programs

• Transportation benefits

• Meal benefits

• Grocery or utility allowances for eligible members

Pay close attention to eligibility requirements. Some benefits are available only to members who meet specific health or income-related qualifications.

8. Prior-authorization requirements

A service that didn’t require prior authorization in 2026 may require approval in 2027.

Prior authorization means your plan must approve certain services, procedures, medical equipment or medications before they’re covered. If you receive ongoing treatment, ask your plan and healthcare provider whether new approval requirements will affect your care.

What if you’re satisfied with your current plan?

Being satisfied with your plan is a good thing, but it’s still important to make sure the plan will continue meeting your needs in 2027.

Ask yourself:

• Are all my doctors still participating?

• Are my prescriptions still covered?

• Is my pharmacy still preferred?

• Can I afford the new copays and maximum out-of-pocket amount?

• Have any benefits I regularly use been reduced or removed?

• Have my own healthcare needs changed?

The question isn’t simply, “Do I like my plan?” The better question is, “Will this plan still work for me next year?”

You don’t have to change plans but you should review

Medicare’s Annual Enrollment Period runs from October 15 through December 7. During this time, eligible beneficiaries can review their coverage and make certain changes for the following year. You don’t have to change plans just because other choices are available. Sometimes keeping your current plan is the right decision. The important thing is to make that decision after reviewing the changes, not because the ANOC was never opened.

A plan that worked well for a friend or family member may not be the best fit for you. Your doctors, prescriptions, preferred pharmacies, health needs and budget should all be considered.

As a licensed health insurance agent, I help people understand their Medicare choices and how plan changes may affect them. If you have questions or need help understanding your coverage at any time throughout the year, I am happy to help.

Cheryl Lockhart

Licensed Health Insurance Agent

(656)228-4979

By calling this number or providing your information you agree to speak with a licensed insurance agent about Medicare Advantage, Part D Prescription Drug Plans or Medicare Supplements.  Not affiliated with any government agency including Medicare.