5 Red Flags in Your 2026 Medicare ANOC You Can’t Ignore

Your Annual Notice of Change (ANOC) shows up in September and spells out what your plan will look like on January 1st. Translation: it tells you whether you’re going to pay more, whether your drugs are changing, and whether your doctor or pharmacy is still in-network.

Read it. Highlight it. Act on it before Dec. 7th. Above all, watch for these five red flags.

1. Sticker Shock: Premiums, Deductibles & Cost-Sharing Jumping

If your ANOC shows higher premiums, deductibles, copays, or coinsurance, that’s a red flag. Here’s what I’m seeing for 2026:

• Part B (medical) projections: Standard premium projected at $206.50/mo and deductible $288. These are trustees’ projections, not final—but they’re directionally useful for budgeting. Final numbers typically land in late fall.
• Part D (drugs) standard benefit: Max deductible $615 and annual out-of-pocket cap $2,100 for 2026. That cap is new-ish under the drug law changes and doesn’t mean your plan is “bad”—but it does change how fast you hit protection.

What to do:

• Compare your ANOC’s new costs against at least two alternatives in your ZIP.
• If your premium shot up, look at plans with lower premiums but similar networks—or Original Medicare + Medigap if you want fewer surprises.

2. Drug List Shake-ups: Tiers, PA/QL, and Step Therapy

Your ANOC should flag formulary changes and point you to the full list. Watch for:

• A drug moving from Tier 2 → Tier 3 (copays often double).
• New prior authorization (PA), quantity limits (QL), or step therapy on meds you take.
• Pharmacies shifting to “standard” from “preferred”—your copays can jump.

What to do:

• Pull the plan’s 2026 formulary and search each of your drugs.
• If a move hurts your wallet, check other plans’ tiers—and remember the Part D $2,100 OOP cap in 2026 when comparing. 

Tip: If you used the Prescription Payment Plan in 2025 (the “pay monthly” option at the pharmacy), many plans auto-renew your election for 2026 unless you opt out—your ANOC/EOC explains how that works. 

3. Network Changes: Doctors, Hospitals, and Pharmacies

Plans tune provider networks every year. If your primary, specialists, or hospital move out-of-network, your costs can spike—or a service may not be covered at all.

What to do:

• Use the directory link in your ANOC and look up each provider you actually see.
• Call the office and ask, “Are you in-network for my 2026 plan listed on my ANOC?”
• Confirm your preferred pharmacy is still preferred, not just “in network.”
• If your network shrank, shop alternatives during Oct 15–Dec 7.

4. Shrinking “Extras”: Dental, Vision, Meals, and Allowances

Some plans are trimming or tightening supplemental benefits for 2026. CMS finalized guardrails on what counts as a Special Supplemental Benefit for the Chronically Ill (SSBCI) and even gave examples of items that are not allowed (think: non-healthy food, alcohol, tobacco, life insurance). If your ANOC shows reduced dental allowances, higher copays for routine vision, or fewer meals/OTC credits, that’s your sign.

What to do:

• If those “extras” mattered to you, compare competing plans’ 2026 summaries.
• Don’t overpay for a plan just for an extra that got cut—make sure providers and drugs fit first.

5. Plan Exit or Service-Area Changes: Non-Renewal = Move Now

If your ANOC (or a separate letter) says your plan is leaving or shrinking its service area for 2026, you get a Special Enrollment Period (SEP) to switch without penalty. Don’t wait for January—build your replacement plan now.

What to do:

• Note the dates in the letter and your SEP window.
• Line up a replacement Medicare Advantage, Part D, or Original Medicare + Medigap option that keeps your doctors and meds covered.
• If you don’t choose, you could get mapped to something that doesn’t fit you.

How to Triage Your ANOC in 20 Minutes

1. Circle the money changes first: premium, deductible, copays/coinsurance.
2. Search your drugs in the 2026 formulary (tiers + PA/QL).
3. Check your doctors and hospital in the 2026 network.
4. Scan “extras” you actually use (dental/vision/hearing/OTC/meals).
5. If anything big changed, shop during Oct 15–Dec 7. 

FAQs

So, What’s the Real Message Here?

Your 2026 Medicare ANOC is not junk mail. It’s the early-warning system for higher costs, drug list tweaks, network shifts, trimmed extras, and plan exits. Read it now, compare options, and lock your choice before Dec. 7 so January doesn’t surprise you.