In September ofeach year, providers of Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (PART D)a r e required by the Centers for Medicare and Medicaid Services (CMS) to m a i lor email their
customers an “Annual Notice Of Changes” (or ANOC) document detailing what is going to be different
about their policies next year. The ANOC is usually sent along with the Plan’s “Evidence Of Coverage” (EOC) which is a comprehensive list of the plan’s costs and benefits. The EOC is a legal contract between
the plan and the member, and includes information on how to contact the plan, how to use the plan for medical services, the processes behind coverage decisions and appeals, and many things not found in theabridged”SummaryOfBenefits”(SOB)documentthatistypicallyfoundintheplan’sEnrollmentKit. Ifyou
would like to have an EOC for your plan, you can request one from your insurance carrier.
The ANOC usually shows up in the mail as a 20 to 40-page booklet printed on 11” X 17” paper, folded in half and stuffed into a large envelope with the carrier’s logo and the words “Annual Notice Of Changes enclosed” printed next to your name and address. Because they don’t look that much different from junk mail, ANOCs are sometimes discarded without being read. Due largely to the implementation of different stages of the “Inflation Reduction Act of 2022”, the Medicare Advantage Plan and Part DDrug Plan ANOCs for 2025 are likely to contain many more changes than we’ve seen in the previous years.
Many carriers are increasing premiums anddeductibles, modifying Service Areas, raising plan’s healthcare “Maximum Out Of Pocket” (MOOP) limits, raising copays for physician services or replacing them with coinsurance percentages, reducing or eliminating “Over The Counter” (OTC) benefitsfor non-prescription medicines and supplies, consolidating or eliminating specific plans, etc. If you’ve never gone through your plan’s ANOC before, this would be agreat year tostart.
fI your carrier is not renewing your plan next year and they don’t have a similar plan to move you over to, they are required to notify you by October 2nd so that you have time to look at other options. Your current coverage will continue until the end of the calendar year, but if you haven’t picked a replacement plan by the end of AEP on December 7th, there is a possibility that on January 1st you would be moved over to Original Medicare or be without prescription drug coverage for the entire year.
When a carrier discontinues a specific Advantage or Part D Drug Plan, they can move you over to one of their similar plans, and you would be notified of that in your ANOC. This process is called plan “consolidation” or “cross-walking”. Many Medicare Beneficiaries first become aware that they have been cross-walked when they get their membership card in the mail for the following year and notice it’s not the same plan they used to be on. If you’re switched to a similar plan that you like, you don’t need to do anything - you will automatically be enrolled ni the new plan effective January 1st. Sometimes, however, people do NOT like the plan they’ve been switched to, and in that case they only have until the end of AEP to sign up for a different plan either with the same carrier or with another carrier. None of us like surprises when it comes to our health or prescription drug insurance coverage, but you can stay ahead of the game if you’ve read your ANOC for next year. If you can’t find your ANOC, you can ask your insurance carrier to send you another one. Insurance carriers aren’t required to share their ANOCs with insurance agents, so it’s pretty much up to the Medicare Beneficiaries themselvest o find out about any changes.
