Written August 24, 2026
Sometime in the next five weeks, a thick envelope arrives from your Medicare plan.
It doesn’t look urgent. It looks like every other Medicare-adjacent envelope that showed up this year, most of which were advertisements from companies you’ve never dealt with. It’s twenty-odd pages, the type is small, and the first page is a greeting.
That envelope is the Annual Notice of Change, and it is the only notice you get that your plan is changing in January. Your plan is allowed to raise its premium, drop your medication, move your doctor out of network, and shuffle its copays — once a year, all at once, effective January 1. This letter is where it tells you.
Two pages of it matter. The rest is boilerplate. Here’s how to find the two.
What this changes for you
- Act now: Watch the mail through September 30 for your plan’s Annual Notice of Change, and check two things in it — your prescriptions and your doctors. The window to switch anything is October 15 to December 7.
- Watch: The 2027 Part B premium and deductible are announced by CMS in November, after the letters go out and before the December 7 deadline. Fifteen more drugs — including Ozempic, Wegovy, Rybelsus, Trelegy and Xtandi — move to negotiated Medicare prices on January 1, 2027.
- Ignore for now: The 2027 premium projections circulating since spring. They’re forecasts, not figures, and there is nothing to do about them until CMS publishes the real ones in November.
- Who’s affected: Anyone enrolled in a Medicare Advantage plan or a standalone Part D drug plan — those are the plans that send this letter and change each January. People on Original Medicare with a Medigap policy and no drug plan get less out of this, though the drug-plan sections still apply if they have Part D.
The short answer
Open the envelope and turn to the table. Every Annual Notice of Change contains a side-by-side comparison — a column headed 2026 and a column headed 2027 — and it’s usually within the first five pages. That table is the whole letter.
Check three rows against your own life:
- The monthly premium. Did it move?
- Your prescriptions — still covered, and still on the same cost tier?
- Your doctors and your pharmacy — still in the network?
If none of those moved in a way that affects you, you’re finished, and you don’t have to do anything. Your plan renews automatically into its 2027 version on January 1. Staying put is a real choice and it requires no phone calls.
If something did move, you have until December 7 to change plans, and the change takes effect January 1.
And if you’d rather not do this alone: your State Health Insurance Assistance Program will go through the letter with you for free, and they don’t sell insurance. Find yours at shiphelp.org, or call 1-800-MEDICARE (1-800-633-4227), which is staffed 24 hours a day.
What’s actually happening
Medicare Advantage plans and Part D drug plans are annual contracts. Every autumn, the plan tells the government what it will cover next year and at what price, the government signs off, and the plan tells you.
That last step is the letter. It’s required, its contents are prescribed, and it has to reach you by September 30 — which is why it always arrives in the same fortnight, and why it always feels like it came out of nowhere.
Which gives you the one thing worth remembering about it:
It isn’t a brochure. It’s a list of what changed.
That’s why it reads so strangely. The letter isn’t trying to sell you anything or explain your coverage. It’s a legal disclosure of differences, written by people who had to be complete rather than clear, and that’s exactly why the important part is a table rather than a sentence.
The September mail pile, sorted
Four or five official-looking envelopes arrive in roughly the same three weeks, and they are not equally important. CMS publishes the schedule, and some of these notices are printed on a specific color of paper so they can be told apart on sight:
| What arrives | Who sends it | Roughly when | What it means |
|---|---|---|---|
| Annual Notice of Change (with the Evidence of Coverage) | Your plan | By September 30 | Your plan’s 2027 changes. This is the one. |
| Medicare & You handbook | Medicare | Fall | The general handbook. Useful, not urgent. |
| Plan non-renewal notice | Your plan | Early October | Your plan is leaving Medicare next year. You need to pick another one. You are not losing Medicare. |
| Loss of deemed status notice — gray paper | Medicare | September | You no longer automatically qualify for Extra Help with drug costs and would need to apply. |
| Change in Extra Help copayment — orange paper | Medicare | October | You still have Extra Help; the copay amounts are changing. |
| Reassignment notice — blue paper | Medicare | November | Your drug plan is ending or its premium rose past the subsidy limit, and you’ve been moved to another plan automatically. |
Everything else with a Medicare-sounding return address in September is almost certainly an advertisement from an insurance broker. The genuine notices come from your plan or from Medicare, and none of them asks you to call a number to “confirm your eligibility.”
What it means for you: what’s different for 2027
Four things are settled. One large one isn’t yet.
Confirmed: fifteen more drugs get negotiated prices on January 1
The second round of Medicare drug price negotiation takes effect with the new plan year. CMS announced the results in November 2025, and the discounts are against 2024 list prices:
| Drug | Used for | Discount |
|---|---|---|
| Ozempic, Rybelsus, Wegovy | Type 2 diabetes; heart disease; obesity | 71% |
| Janumet, Janumet XR | Type 2 diabetes | 85% |
| Tradjenta | Type 2 diabetes | 84% |
| Breo Ellipta | Asthma, COPD | 83% |
| Trelegy Ellipta | Asthma, COPD | 73% |
| Xifaxan | IBS with diarrhea; hepatic encephalopathy | 63% |
| Linzess | Constipation; IBS | 75% |
| Otezla, Otezla XR | Psoriasis; psoriatic arthritis; Behçet’s | 65% |
| Vraylar | Bipolar I; depression; schizophrenia | 44% |
| Austedo, Austedo XR | Huntington’s chorea; tardive dyskinesia | 38% |
| Ofev | Idiopathic pulmonary fibrosis | 50% |
| Calquence | Two blood cancers | 40% |
| Ibrance | Breast cancer | 50% |
| Pomalyst | Multiple myeloma; Kaposi sarcoma | 60% |
| Xtandi | Prostate cancer | 48% |
These join the ten drugs whose negotiated prices started in January 2026, for twenty-five in total.
Read that discount column carefully, because it is not your discount. The negotiated price is what the pharmacy and the plan settle up at. What comes out of your pocket is your plan’s copay or coinsurance for that drug — and that’s set by your plan, in the letter sitting on your table. If your drug is a flat $47 copay, an 84% cut to the underlying price may not change your $47 at all. Where it tends to show up is for people paying a percentage rather than a flat amount, and in how fast you move through the year toward the out-of-pocket cap.
It’s still a real change. It’s a change to what Medicare spends, which reaches you indirectly and unevenly. Anyone telling you your Ozempic is about to cost 71% less is guessing.
Confirmed: the out-of-pocket cap on drugs is still there, and still rises
Since 2025 there’s been a hard ceiling on what you pay out of pocket for covered Part D drugs in a calendar year. Once you hit it, you pay nothing more for covered drugs until January.
- 2026: $2,100. That figure is on Medicare.gov now.
- 2027: higher. The cap is indexed and moves every year. The exact number will be printed in your Annual Notice of Change, and on Medicare.gov once the 2027 pages go up in the fall.
I’m not printing a 2027 figure here, because it isn’t on a government page yet and the numbers circulating are projections. Your letter will have it, and your letter is authoritative for your plan.
The same goes for the drug deductible. In 2026 no plan may charge more than $615; the 2027 maximum will be in the letter.
Confirmed: you’ll get more sales calls this year
CMS’s rules for the 2027 plan year, finalized in April 2026, removed restrictions on when and how licensed agents and brokers may contact people about Medicare plans.
The reasoning is that it gets help to people who want it. The practical effect on your phone is more calls, starting in October.
An agent can be genuinely useful — many are. What matters is knowing the boundary: nobody from Medicare will call you out of the blue, no legitimate call requires you to read out your Medicare number to someone who rang you, and no real plan is available only if you decide today. If you want an agent, find one and call them. Treat the reverse direction with suspicion.
Confirmed: the plan star ratings changed shape
Medicare’s 1-to-5 star quality ratings dropped eleven administrative measures for 2027 and added a depression screening measure. If a plan’s star rating moved a little between last year and this year, that may be the rating system moving rather than the plan.
Not yet: the 2027 Part B premium and deductible
This is the number most people want, and it doesn’t exist yet.
For 2026, the standard Part B premium is $202.90 a month and the deductible is $283. CMS normally announces the following year’s figures in November — after your plan letter arrives, and before the December 7 deadline.
Everything published so far about 2027 Part B is a projection. Some of the projections are careful and some aren’t, and none of them is the number. It shows up in November, and it applies whether you switch plans or not, so it isn’t something to wait on before making a decision about your plan.
What to do now
Allow about an hour, spread over two sittings — one when the letter comes, one after October 15 when the comparison tool is loaded with next year’s plans.
Step 1: Find the letter (through September 30)
It’s a thick envelope from your plan, not from Medicare. The words on it are “Annual Notice of Change,” sometimes shortened to “ANOC.” A second, much fatter document called the “Evidence of Coverage” usually comes with it — that’s the full contract, and you can set it aside.
If it hasn’t arrived by early October, call your plan at the customer service number on the back of your plan card and ask them to send it. Many plans also post it in the online account, if you have one.
If you get a letter saying your plan won’t be offered in 2027, that’s the non-renewal notice, and it’s a different document. It means you need to choose a plan for next year. It does not mean you’re losing Medicare, and it doesn’t affect Part A or Part B at all.
Step 2: Go to the comparison table (10 minutes)
Skip the greeting. Look for a table with two columns headed 2026 and 2027, in the first few pages, usually under a heading like “Summary of Important Costs.”
What you’ll see: a row-by-row comparison — monthly premium, yearly deductible, doctor visit copay, specialist copay, hospital stay, the maximum you’d pay out of pocket in a year. Old number on the left, new number on the right.
Read down the right-hand column and note anything that moved. Most rows won’t have.
Step 3: Write down your own list (15 minutes)
Before you can tell whether the changes matter, you need to know what you’re checking against. On one piece of paper:
- Every prescription you take — the exact name, the dose in milligrams, and how many you get per fill. The dose matters. A plan can cover one strength of a drug and not another.
- Every doctor you want to keep, including specialists you see once a year.
- The pharmacy you actually use.
Then find the drug list section of the letter. It tells you whether any of your medications were removed for 2027 or moved to a different tier — a tier change is a price change, and it’s the single most common unpleasant surprise in January.
Step 4: From mid-October, compare (30 minutes)
The official comparison tool is medicare.gov/plan-compare. Next year’s plans and prices load onto it in early October, and enrollment opens October 15. Before the new data goes up, the site shows this year’s plans — which is a confusing thing about it, and a reason not to start too early.
The tool asks for your ZIP code, then your drug list, then your pharmacy. Enter all three. The cost estimates are only as accurate as what you type in, and skipping the pharmacy step is the usual reason two people get different numbers for the same plan — a plan’s “preferred” pharmacies cost less than its ordinary in-network ones.
What you’ll see at the end: a list of plans with an estimated total yearly cost — premium plus drugs plus expected copays — rather than a premium alone. That total is the number worth comparing. A plan with a $0 premium and the wrong drug list can cost more over a year than one with a monthly premium.
Step 5: Decide by December 7
Three outcomes, all legitimate:
- Stay. Do nothing. Your plan renews into its 2027 version automatically.
- Switch to another Medicare Advantage or drug plan. Enrolling in the new one automatically ends the old one — you don’t cancel anything, and you shouldn’t try to, because that can leave a gap.
- Move between Original Medicare and Medicare Advantage in either direction. Read the catch below before you leave a Medicare Advantage plan for Original Medicare. That direction has a consequence the others don’t.
If you want a second pair of eyes, the free option is better than the paid one. Your State Health Insurance Assistance Program — shiphelp.org — is federally funded counseling, staffed largely by trained volunteers, and they don’t earn commission on any plan. They are also extremely busy from mid-October onward. Calling in September, before the enrollment window opens, is the difference between an appointment and a waiting list.
The catch
Leaving Medicare Advantage for Original Medicare does not guarantee you a Medigap policy. This is the most consequential thing on this page and the least often said out loud.
You can switch back to Original Medicare during open enrollment, freely. What you may not be able to do is buy the supplemental Medigap policy that covers Original Medicare’s deductibles and the 20% coinsurance. Outside your one-time six-month Medigap window — which starts when you’re 65 and enrolled in Part B, and does not come round again — insurers in most states may ask about your health history, charge you more, or decline you. Medicare’s own guide puts it plainly: “After this period, you may not be able to buy a Medigap policy, or it may cost more.”
There are exceptions, called guaranteed issue rights, and two of them are trial rights worth knowing: if you joined a Medicare Advantage plan when you first became eligible at 65 and want out within the first year, or if you dropped a Medigap policy to try Medicare Advantage for the first time and want to go back within a year, you generally have that right — typically within 63 days of the coverage ending. A handful of states also give their residents broader rights than federal law does.
Because that varies by state, the correct move is a phone call, not an assumption. Ask your State Health Insurance Assistance Program or your state’s insurance department before you make the switch, not after.
The negotiated drug price is not automatically your price. Covered above, and worth repeating, because the coverage of this has been genuinely misleading.
The extras are the easiest thing to shop on and the least reliable. Dental, vision, hearing, and the over-the-counter benefit card sell a lot of plans. Read what the allowance actually is, what it can be spent on, whether it expires each quarter, and which dentists take it. A “$2,000 dental benefit” that covers cleanings in full and implants at 20% is a different product from what the headline suggests.
A plan can change its drug list during the year. The Annual Notice of Change covers what changes in January. Plans can also make certain formulary changes mid-year with notice. It’s uncommon, and it’s the reason the letter isn’t a guarantee for all of 2027.
January 1 to March 31 is a partial second chance — and only for some people. If you’re in a Medicare Advantage plan, you get one switch in that window: to a different Medicare Advantage plan, or back to Original Medicare. You cannot use it to join a Medicare Advantage plan for the first time, and there is no equivalent window for standalone drug plans. If you’re on Original Medicare with a Part D plan, December 7 is your deadline, full stop.
Autopilot is a decision with a cost. Roughly speaking, the plans that were the best value last year are frequently not the best value this year — that’s how the market works, and it relies on people not looking. Doing nothing is fine when you’ve checked and nothing moved. It’s expensive when you haven’t checked.
Amounts, rules and plan availability change, and Medicare is the final word. Every figure in this post is linked to its source below, and the 2027 figures I haven’t printed are the ones that weren’t published when I wrote this.
The bottom line
Don’t throw away the thick envelope that arrives before September 30. That’s the whole thing.
When it comes:
- Find the two-column table — 2026 on the left, 2027 on the right.
- Check three rows — the premium, your drugs, your doctors and pharmacy.
- If nothing you rely on moved, you’re done. Do nothing and your plan continues.
- If something moved, compare at medicare.gov/plan-compare after October 15, with your full drug list and your pharmacy entered.
- December 7 is the deadline, and shiphelp.org is the free, unbiased second opinion — call them in September, before the queue forms.
The letter is badly designed for reading and perfectly designed for compliance, which is a fair description of most of the mail that matters. You didn’t miss anything obvious. It takes twenty minutes and someone telling you which two pages to look at.
Related: Did You Get the $6,000 Senior Deduction? Here’s How to Check. — the other post this month about money you may already be entitled to. And if the envelope you got says your plan is being discontinued, that’s a different letter with a much less alarming meaning than it sounds — that one’s coming next.
I’ll update this post in October once the 2027 figures are published and the comparison tool is live. If your letter contains something confusing, tell me what it says — the odd ones are how the next post gets written.
Sources
- Medicare — Open Enrollment
- Medicare — Plan Annual Notice of Change (ANOC)
- Medicare — Medicare costs (2026 Part A and Part B figures)
- Medicare — Costs for Medicare drug coverage (2026 deductible maximum and out-of-pocket cap)
- Medicare — Joining a plan: enrollment periods
- Medicare — Get ready to buy a Medigap policy
- Medicare — Choosing a Medigap Policy: guaranteed issue rights (PDF)
- Medicare — Your Yearly Medicare Review (PDF)
- Medicare — Plan Compare
- CMS — Guide to consumer mailings from CMS, Social Security, and plans (PDF)
- CMS — Contract Year 2027 Medicare Advantage and Part D Final Rule
- CMS — CMS Delivers Savings for Seniors on 15 Major Drugs for Cancer and Chronic Disease
- CMS — New Lower Drug Prices Under the Medicare Drug Price Negotiation Program (PDF)
- CMS — Selected Drugs and Negotiated Prices
- State Health Insurance Assistance Programs — shiphelp.org