The Annual Notice of Change (ANOC) informs Medicare Advantage and Part D plan members about critical changes for the coming year. Understanding important changes in coverage, costs, and providers is crucial for beneficiaries to ensure their plan meets their needs.
Key Takeaways
- In September, you will receive the Annual Notice of Change (ANOC) regarding 2025 costs and coverages.
- The ANOC details changes to your Medicare Advantage or Part D plan for the upcoming year.
- It is important to review adjustments in costs, coverage, and provider networks.
- The Annual Enrollment Period, ending on December 7th, is the deadline to change plans if needed.
What is the Annual Notice of Change (ANOC)?
The ANOC is an annual notice sent by Medicare Advantage and Part D plan providers each fall. It outlines any modifications in premiums, copayments, coverage options, or provider networks for the upcoming year.
Beneficiaries typically receive the ANOC by the end of September.
Why the ANOC is Important
The ANOC is crucial because it helps beneficiaries understand how their plan changes and how those changes affect their healthcare.
Ignoring the ANOC can lead to higher costs or loss of access to specific providers, so it is essential to review it and take action, if necessary.
What to Look for in Your ANOC Letter
- Premiums and out-of-pocket costs
- Changes in covered services
- Changes in prescription drugs
- Provider networks
- Pharmacy access
Premiums and Out-of-Pocket Costs
One of the most critical parts of the ANOC is reviewing how your costs will change in the coming year. For example, if your monthly premium for your Medicare Advantage plan increases from $50 to $60, that’s a $120 increase over the year. Similarly, pay attention to changes in your out-of-pocket maximum.
If your copayments for doctor visits increase from $20 to $30 per visit, that may affect your spending, especially if you have frequent medical appointments.
Additionally, look for changes to deductibles. If your Part D plan’s deductible increases, you might need to pay more out-of-pocket for prescriptions before your coverage kicks in. Even small changes can add up significantly over the year, so understanding the financial impact is essential.
Changes in Covered Services or Prescription Drugs
Another critical section is the list of covered services or medication changes. For instance, if you rely on a specific treatment, such as physical therapy or diabetes management supplies, ensure these are still covered under your plan. If your plan no longer covers these services or has reclassified them to a higher cost tier, it may result in higher out-of-pocket expenses.
For prescription drug plans, closely examine any changes to the formulary (the list of covered drugs). For example, if a medication you take regularly is moved from Tier 2 to Tier 3, this may lead to higher copayments. Understanding which drugs are covered at what level is essential for managing your healthcare expenses.
Provider Networks and Pharmacy Access
Changes to your provider network can have a significant impact on your healthcare. For example, if your preferred primary care doctor or specialist is no longer in-network, you may need to find a new provider or face higher out-of-network costs. Similarly, if your plan changes its preferred pharmacies, this could affect where you can fill prescriptions at the lowest price.
Let’s say your local pharmacy is no longer considered in-network. This could mean higher prescription costs or longer travel distances to fill your medications. These network changes may seem small but can make a big difference in convenience and expenses.
How to Read Your Annual Notice of Change
According to an eHealth survey, only 36% of Medicare beneficiaries found their ANOC to be “readily understandable.”
Plan to spend around 30 minutes thoroughly reviewing your ANOC to pinpoint what’s changing for 2025. This review will help determine whether you need to switch plans during the open enrollment period. You can move from your current Part D plan to another, change Medicare Advantage plans, switch from Medicare Advantage to Original Medicare, or vice versa.
However, don’t feel pressured to switch plans just because of a slight premium increase or minor benefit reduction. If you’re satisfied with the overall coverage, staying with your current plan might still be the best option.
On the other hand, significant changes—such as a medication you rely on no longer being covered or your doctor being removed from the network—might prompt you to consider switching plans. Medicare.gov’s Plan Finder and CoverRight can help you compare Part D and Medicare Advantage plans for 2025.
If your Medicare Advantage plan no longer includes your preferred doctor or hospital in its network, it is required to help you find alternatives within the network.
Impact of the $2,000 Prescription Drug Cap
In 2025, a significant Medicare change will introduce a $2,000 cap on out-of-pocket prescription costs under Part D plans. While this limit offers financial relief to beneficiaries, it also means insurers must cover a larger share of prescription costs.
To offset this, insurers may raise premiums, deductibles, and co-pays. The average premium for stand-alone Part D plans is around $43 a month, but that could increase significantly in response to the new cap. Some experts are also concerned that insurers might drop coverage for certain medications or increase the prices of others.
Medicare Advantage plans, often including Part D coverage, could also be affected. With profit margins tightening, some insurers might reduce or eliminate extra benefits, such as dental, vision, or hearing coverage, to maintain their $0 premiums. As a result, the additional perks that Medicare Advantage plans offer could be less appealing—or even disappear—by 2025.
How to Use the ANOC During the Annual Enrollment Period (AEP)
After reviewing your ANOC, determine whether the changes fit your healthcare needs. The Annual Enrollment Period (AEP) is Medicare’s 8-week open enrollment period from October 15 to December 7. This is the time to change your Medicare Advantage or Part D plan if your current plan no longer meets your needs.
If you notice an increase in premiums, changes in covered services, or a disruption in your provider network, it may be time to explore other Medicare plan options. You can compare plans using resources like Medicare.gov, but you can also seek personalized advice.
This is where CoverRight can help. Our Medicare experts assist you in reviewing your ANOC and guide you through the plan comparison process. We provide tailored advice based on your healthcare needs, ensuring you find the best value and coverage plan. If you need to switch plans, our experts will help you through enrollment, ensuring you don’t miss any critical deadlines.
Frequently Asked Questions
When will I receive my Annual Notice of Change?
Your ANOC letter should arrive by the end of September each year. Contact your plan provider or Medicare if you haven’t received it by early October.
What happens if I don’t receive my ANOC?
If your ANOC doesn’t arrive, contact your plan provider immediately. They are required to send the notice to all members.
How do I switch plans after reviewing the ANOC?
If you switch plans, use the Annual Enrollment Period to compare options and enroll in a new Medicare Advantage or Part D plan. Consulting with a Medicare expert, like CoverRight, can help you identify the best plan options based on your health and financial situation. Our team simplifies the process and ensures you find the right coverage for your needs.
Navigate Medicare with Confidence
CoverRight can help you navigate the complexities of the ANOC and find a Medicare plan that better suits your healthcare needs. Contact us today for personalized support and plan comparison.
Reviewing the Annual Notice of Change (ANOC) is essential to ensure your Medicare plan meets your needs. If any changes raise concerns, you can adjust your coverage during the Annual Enrollment Period.
What’s Changing in 2025
Prescription Drug Cap Changes
In 2025, Medicare beneficiaries will pay no more than $2,000 out of pocket for prescription drugs covered under Part D, Medicare’s outpatient prescription drug benefit. This new $2,000 cap comes on top of the elimination of 5% coinsurance in the catastrophic coverage phase of the Part D benefit, in effect for 2024, which translates to a cap of about $3,300 out of pocket for brand-name drugs.
These benefit design changes will save thousands of dollars for people who take high-cost drugs for cancer, rheumatoid arthritis, and other serious conditions.
Humana
Humana is planning to exit Florida, North Carolina, Georgia, Texas, and Illinois, impacting 560,000 members.
Wellcare/Centene
Centene is exiting six states through its WellCare Medicare Advantage subsidiary next year, impacting 37,300 members in Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island, and Vermont, but will continue to offer prescription drug plans in those states.
United Healthcare
United Healthcare will be consolidating their existing four prescription drug plans into two. All plans will be auto mapped into either the RX Saver or RX preferred plans.
Mutual of Omaha
Mutual of Omaha will no longer offer prescription drug plans at the end of 2024.
If you have questions about your plan, whether they relate to the Annual Notice of Change or anything else, contact us any time.
