Medicare · Supporting
Your 2027 ANOC Is Not Junk Mail
Last reviewed September 24, 20265 min readBy the Goodsurance editorial team Reviewed by the Goodsurance editorial team
Every fall, Medicare Advantage and Part D plans mail their members an Annual Notice of Change, the ANOC. Most years, most people throw it away. This year, do not.
The short version
- Your plan must get its ANOC to you by September 30. It lists every change to your coverage that starts in January.
- Carriers are cutting plans again for 2027. Humana alone is exiting plans that cover about 600,000 members. If yours is one of them, the letter is where you find out.
- Check three things first: your premium, your drug list, and whether your plan still exists in your county next year.
- If your plan is ending, you have real protections: a special enrollment period and, in many cases, a guaranteed window to buy a Medigap policy with no health questions.
What the ANOC actually is
The ANOC is a side-by-side comparison: what your plan costs and covers this year, next to what it will cost and cover next year. Plans are required to send it before the fall enrollment window opens, so you can read it, compare, and act between October 15 and December 7. Whatever it says takes effect January 1 whether you read it or not.
That last part is the trap. If you do nothing, you are not keeping your current plan; you are accepting next year's version of it: new premium, new drug tiers, new networks, new benefit amounts. The letter is the only advance warning you get.
In short: the ANOC is your plan's confession of everything it is about to change. Silence on your part counts as a yes.
Why the 2027 letter deserves more attention than usual
Two things make this year different.
First, the plan exits. Carriers have been pulling back from Medicare Advantage markets, and 2027 continues the trend. Humana announced it will exit plans covering roughly 600,000 members, about 8% of its Medicare Advantage membership. Presbyterian Health Plan is discontinuing most of its MA plans, affecting about 30,000 people. Molina is dropping its MA Part D product. This follows a rough 2026: research published in JAMA found that about one in ten Medicare Advantage enrollees had their plan discontinued heading into this year. If your plan is on a 2027 exit list, your ANOC (or a separate non-renewal notice) is where you learn it.
Second, Part D pricing has more room to move. For 2025 and 2026, a federal demonstration program dampened year-to-year premium swings in standalone drug plans; in 2026 it subsidized premiums by $10 a month and capped increases at $50. CMS is ending that program after 2026. The national base beneficiary premium rises from $38.99 in 2026 to $41.33 in 2027, but that average tells you little about your plan. Individual plans set their own premiums, and without the stabilization guardrails, the number printed in your ANOC is the one that matters.
In short: more plans are disappearing, and drug plan premiums have fewer restraints on them than the last two years. The averages are calm; your specific plan may not be.
The three lines to read first
You do not need to study all of it. Start here:
- The premium and deductible table. Compare this year's column to next year's. Look at the medical deductible, the drug deductible, and the maximum out-of-pocket. A plan can hold its premium at $0 and still cost you more through the deductible and cost-sharing lines below it.
- The drug formulary changes. Your medications can move to a higher tier, gain a prior-authorization requirement, or leave the formulary entirely. If you take anything regularly, find each one by name.
- The service area and network section. This is where a plan says it will no longer operate in your county, or that a hospital system or preferred pharmacy is leaving the network. Your doctor being in network this year means nothing for next year unless the ANOC says so.
Supplemental extras (dental, vision, hearing, over-the-counter allowances) are worth a look too. These amounts are set plan by plan, and they are often the first thing trimmed when a carrier needs margin.
In short: premium and deductibles, your specific drugs, your specific doctors and county. Ten minutes covers it.
If your plan is going away
A discontinued plan does not leave you uninsured. Here is what federal rules give you:
- You will not be dropped into nothing. If your MA plan ends and you take no action, you are moved to Original Medicare on January 1. Note what that means: no drug coverage unless you pick a Part D plan, and no out-of-pocket maximum unless you add a Medigap policy.
- A special enrollment period. Members of a plan that is ending get a window that runs from December 8 through the last day of February to choose a new Medicare Advantage or Part D plan, beyond the ordinary October 15 to December 7 season.
- A guaranteed issue right for Medigap. This is the protection people miss. When your MA plan leaves and you return to Original Medicare, federal rules let you buy certain Medigap policies (Plan G among them) with no health questions and no waiting period for pre-existing conditions. The window generally runs from 60 days before your coverage ends to 63 days after. For anyone who left Medigap for Medicare Advantage years ago, or never had the chance to buy in, this is a rare second door. It closes if you enroll in another Medicare Advantage plan instead.
That last decision, another MA plan versus Original Medicare plus Medigap, deserves an unhurried comparison, not a default. The guaranteed issue window is a one-time opening; underwriting applies almost everywhere once it passes.
In short: a plan exit comes with a longer shopping window and, often, a no-questions path into Medigap. Do not spend that opening on autopilot.
What to do this week
Check the mail, including the pile you have been meaning to sort. If your ANOC has not arrived by September 30, contact your plan and ask for it. Then put ten minutes on the calendar before October 15: premium table, your drugs, your county. If the letter says your plan is ending, start the Medigap versus new-MA comparison now, while the full seven-week window is still ahead of you.
Medicare's Plan Finder at Medicare.gov can compare every plan available in your ZIP code, and your State Health Insurance Assistance Program (SHIP) offers unbiased counseling at no cost to you.
Common questions about IRMAA appeals
Quick answers, fast .
Tap any question to expand. Each links to a fuller standalone answer.
Does Medicare pay for hearing aids
Original Medicare does not cover hearing aids or fittings.
Some Medicare Advantage plans may include a hearing benefit, but what they cover varies by plan.
Does Medicare cover ambulance services?
Yes, in limited situations.
Medicare Part B covers emergency ambulance transportation when traveling any other way could endanger your health, taking you to the nearest appropriate hospital or facility. You pay 20% of the Medicare-approved amount after the $283 Part B deductible in 2026. Air ambulance is covered only when ground transport cannot reach you or would take too long. Non-emergency ambulance trips, for example to dialysis, are covered only when a doctor provides a written order stating they are medically necessary. Medicare does not cover ambulance rides taken purely for convenience.
Does Medicare cover skilled nursing facility care?
Yes, on a short-term basis.
Medicare Part A covers skilled nursing facility (SNF) care after a qualifying inpatient hospital stay of at least 3 days, when you need daily skilled care like nursing or therapy. In 2026 you pay $0 for days 1 through 20 of each benefit period, $217 per day for days 21 through 100, and all costs after day 100. Coverage is for skilled care while you recover, not for long-term or custodial care (help with daily activities like bathing or dressing), which Medicare does not cover. Long-term nursing home care is generally paid through Medicaid or private funds.
Does Medicare cover physical therapy?
Yes.
Medicare Part B covers outpatient physical therapy that is medically necessary to treat your condition. You pay 20% of the Medicare-approved amount after the yearly Part B deductible ($283 in 2026). There is no longer a hard dollar cap on therapy, but once your physical and speech therapy together pass $2,480 in 2026, your therapist must add a note (called a KX modifier) confirming you still need care. Claims above $3,000 may be reviewed for medical necessity. Part A covers physical therapy you receive as a hospital inpatient or in a skilled nursing facility. A doctor or therapist must set up and regularly review your plan of care.
Does Medicare cover mental health services?
Yes.
Medicare covers mental health care across its parts in 2026. Part B covers outpatient services like therapy, counseling, and visits with psychiatrists, psychologists, and clinical social workers, and since 2024 it also covers marriage and family therapists and mental health counselors. You pay 20% of the Medicare-approved amount after the $283 deductible, and one depression screening each year is free. Part A covers inpatient mental health care, with a lifetime limit of 190 days in a freestanding psychiatric hospital. Part D covers most mental health medications. Many of these services are also available by telehealth, and Medicare Advantage plans cover at least the same benefits.
Does Medicare cover chiropractic care?
Partly.
Medicare Part B covers one specific chiropractic service: manual manipulation of the spine to correct a subluxation (when one or more bones of the spine are out of position) that a doctor confirms is medically necessary. You pay 20% of the Medicare-approved amount after the $283 Part B deductible in 2026. Medicare does not cover other services a chiropractor might offer, such as X-rays, massage therapy, acupuncture, or routine wellness visits, so you would pay the full cost for those. Some Medicare Advantage plans include extra chiropractic or wellness benefits beyond this.
Does Medicare cover home health care?
Yes, when you qualify.
Medicare Parts A and B cover home health care if a doctor certifies that you are homebound (leaving home takes a major effort) and need part-time skilled care, such as skilled nursing, physical therapy, occupational therapy, or speech therapy. A Medicare-certified home health agency must provide the care under a plan your doctor reviews. You pay $0 for covered home health visits in 2026, and 20% for any durable medical equipment. Medicare does not cover 24-hour home care, meal delivery, or homemaker services like cleaning when that is the only care you need.
Does Medicare cover vision care?
Mostly no for routine care.
In 2026, Original Medicare does not cover routine eye exams for glasses or contact lenses, and it does not pay for the glasses or contacts themselves. It does cover some medical eye care: yearly glaucoma screenings for people at high risk, diabetic retinopathy exams, treatment for eye diseases, and cataract surgery (including one pair of standard glasses or contacts afterward). For those covered services you pay 20% after the $283 Part B deductible. Many Medicare Advantage plans add a routine vision benefit covering eye exams and an allowance for glasses.
Does Medicare cover hearing aids?
Original Medicare does not cover hearing aids or the exams used to fit them.
Some Medicare Advantage plans include a hearing benefit, but coverage varies by plan.
Does Medicare cover diabetes supplies and testing?
Yes.
In 2026 Medicare covers most diabetes care across two parts. Part B (outpatient care and equipment) covers blood sugar monitors, test strips, lancets, and continuous glucose monitors (CGMs) as durable medical equipment, plus diabetes screenings and a self-management training program. You pay 20% of the Medicare-approved amount after the $283 Part B deductible. Part D (drug coverage) covers insulin and related supplies like syringes, and in 2026 your insulin is capped at $35 for a month's supply. If you have a Medicare Advantage plan, it covers at least the same diabetes benefits, sometimes with added extras.
Does Medicare cover durable medical equipment?
Yes.
Medicare Part B covers durable medical equipment (DME): reusable medical gear your doctor prescribes for use at home, such as wheelchairs, walkers, hospital beds, oxygen equipment, CPAP machines, and blood sugar monitors. You pay 20% of the Medicare-approved amount after the $283 Part B deductible in 2026, and Medicare pays the other 80%. To be covered, the item must be ordered by a Medicare-enrolled doctor and supplied by a Medicare-enrolled supplier, and some items are rented rather than bought. Equipment meant mainly for use outside the home, or only for comfort or convenience, is not covered.
Which is better, Medigap or Medicare Advantage?
Neither is better for everyone; they suit different needs.
Medigap (also called Medicare Supplement, a private policy that pairs with Original Medicare) lets you see any doctor nationwide who accepts Medicare with no network and very predictable out-of-pocket costs, but you pay a monthly Medigap premium and add a separate Part D drug plan. Medicare Advantage (Part C, your Medicare benefits through a private plan) often has a lower or $0 plan premium, bundles drug coverage and extras like dental and vision, and caps your yearly out-of-pocket costs, but uses provider networks and may require prior approval. People who travel, want maximum doctor freedom, and prefer steady costs often lean Medigap; people who want low premiums, extras, and a network they are comfortable with often lean Medicare Advantage. With both, you still pay the Part B premium ($202.90 per month in 2026). To find out which fits your situation, reach out to a licensed Goodsurance advisor at 1-888-301-8091 (TTY 711), Mon to Fri 8 am to 5 pm PT.
References
- Medicare Part D 2027 National Average Monthly Bid Amount Information (CMS, July 28, 2026)CMS fact sheet establishing the 2027 national base beneficiary premium and the end of the premium stabilization demonstration.
- 2026 Medicare Part D Bid Information and Premium Stabilization Demonstration Parameters (CMS)CMS fact sheet with the 2026 base premium and the demonstration's subsidy and increase-cap parameters.
- Forced Disenrollments Among Medicare Advantage Beneficiaries Following 2026 Plan Exits (JAMA, February 18, 2026)Peer-reviewed study finding about one in ten Medicare Advantage enrollees were forced to disenroll for 2026.
- Humana to exit more Medicare Advantage plans in 2027 (Healthcare Dive, July 29, 2026)Trade coverage of Humana's announced 2027 plan exits and affected membership.
- 4 insurers exiting Medicare Advantage markets (Becker's, August 17, 2026)Trade coverage of additional carrier withdrawals for 2027, including Presbyterian and Molina.
- Annual Notice of Change (Medicare.gov)Medicare.gov explanation of the ANOC mailing and its September 30 deadline.
- Guaranteed issue rights (Medicare.gov)Medicare.gov rules on when you can buy Medigap without health questions, including after a plan termination.