If you’re a Medicare beneficiary, keep an eye on your mailbox this September. Every year at this time, Medicare plans send out their Annual Notice of Change (ANOC) letters to all beneficiaries on their plan.
Annual Notice of Change Medicare Letter
This blog will help you understand what the Annual Notice of Change (ANOC) Medicare letter is, what it includes, and what to look for in order to make informed decisions about your healthcare coverage.
What is the Annual Notice of Change Medicare Letter?
The Annual Notice of Change (ANOC) Medicare letter is a document sent by your Medicare Advantage or Medicare Part D prescription drug plan provider.
The ANOC letter provides detailed information about changes to your plan. These changes can have big effects on your out-of-pocket costs, your plan network, the plan’s formulary of covered drugs, and changes to other covered benefits and programs.
What Kinds of Changes Should I Be Looking Out For?
In particular, be on the lookout for these changes:
Premiums. Check if there will be an increase in your monthly premiums. Rising premiums can significantly affect your budget, so it’s crucial to evaluate whether the new cost aligns with your financial situation.
Deductibles and copayments. Look for any changes to deductibles or copayments for medical services or prescription drugs. Higher deductibles or copayments may lead to increased out-of-pocket expenses, which could impact your ability to afford necessary care.
Formulary changes. The formulary is the list of prescription drugs your plan covers, and how much it costs for drugs at each tier level.
The first thing to do here is to verify that your current medications will still be covered under the plan, and that they still fall under the same pricing tier.
Changes to the formulary or drug tiers can result in higher costs or the need to switch to alternative medications. Ensure that your essential prescriptions remain accessible and affordable.
Network Providers. Pay attention to any modifications in the network of doctors, hospitals, or pharmacies. If your preferred healthcare providers are no longer in-network, you may face higher costs or need to find new providers. Maintaining access to trusted healthcare professionals is vital for continuity of care.
Benefits and Services. Review any changes to benefits and services offered by your plan. New benefits may be added, while others might be removed. Consider whether the changes align with your healthcare needs and if any missing services are critical for your well-being.
Why Might You Need to Change Plans?
Switching plans may be necessary if:
- Your current plan no longer meets your healthcare needs.
- The cost of your current plan has become unaffordable due to increased premiums, deductibles, or copayments.
- Your preferred healthcare providers are no longer in-network, making it challenging to receive care from trusted professionals.
- There are additional benefits or services offered by other plans that better suit your health requirements.
While it’s a good idea to do a full Medicare strategy review with a licensed Medicare expert every year or two, your Annual Notice of Change letter is an important mechanism to help alert you to potential critical changes in your coverage.
By carefully reviewing these changes and considering their impact on your healthcare and finances, you can make an informed decision about whether switching plans is necessary to ensure you have the most suitable coverage for the upcoming year.
What Are My Options for Changing Plans?
If you find that your current plan no longer meets your needs, you have several courses of action to choose from.
You can:
- Change from a current Medicare Advantage plan to another Medicare Advantage plan
- Change from Medicare Advantage to Medigap (switching to Original Medicare plus a Medicare Supplement insurance plan)
- Change to a low-cost Health Sharing plan (Medi-Share 65+)
Here is what you need to know about each of these options:
Option 1: Change from One Medicare Advantage Plan to Another
If you’re currently enrolled in a Medicare Advantage (Part C) plan and wish to switch to another Medicare Advantage plan, you have the flexibility to do so during the Annual Enrollment Period (AEP).
The AEP typically runs from October 15th to December 7th each year. During this period, you can compare different Medicare Advantage plans and choose one that better aligns with your healthcare needs and preferences.
Advantages:
- Ability to select a plan that offers more suitable coverage, including additional benefits or lower costs.
- Opportunity to join a plan with a preferred network of doctors, hospitals, or pharmacies.
- Potential for better coordination of care through a plan that aligns with your specific health conditions.
Disadvantages:
- Limited enrollment period, so you must make changes within the designated time frame.
- Switching plans may require adjusting to new networks or providers.
- Benefits and costs can vary significantly between plans, so careful evaluation is necessary.
Option 2: Change from Medicare Advantage to Original Medicare plus Medigap
If you want to transition from a Medicare Advantage plan to Original Medicare (Part A and Part B) combined with a Medigap (Medicare Supplement) plan, there are specific rules to consider:
You have the right to enroll in a Medigap plan if you’re within your Medigap Open Enrollment Period, which starts when you turn 65 and are enrolled in Medicare Part B. However, if you’ve had a Medicare Advantage plan for more than a year, you may be subject to medical underwriting or face limitations when applying for Medigap coverage.
That means you could be charged a higher premium or potentially be turned down for a Medigap plan due to your medical history.
But depending on your situation, switching to Original Medicare plus a Medigap policy can work out very well – especially if you can afford the premiums and want more freedom to choose your own doctors.
Advantages
- Access to a broader network of doctors and specialists without needing referrals.
- Greater flexibility in choosing healthcare providers.
- Potential for lower out-of-pocket costs with comprehensive coverage offered by Medigap plans.
Disadvantages
- Medical underwriting or limited enrollment periods may apply if you’ve had a Medicare Advantage plan for more than a year.
- Medigap plans require separate premium payments in addition to your Part B premium.
- Prescription drug coverage is not included in Medigap plans, so you’ll need to enroll in a standalone Part D plan.
Option 3: Changing to a Health Sharing Plan
Another option to consider is switching to a health sharing plan, such as Medi-Share 65+.
These plans can offer significant cost savings compared to the more comprehensive Medigap plans like Plan G, F, C, and N.
Advantages:
- Potentially lower monthly costs compared to Medigap plans.
- Eligible medical expenses are shared among members according to the healthsharing guidelines.
- Flexibility to choose healthcare providers.
Disadvantages:
- Health sharing plans may have certain restrictions on coverage, such as limitations on pre-existing conditions or specific treatments.
- It’s important to review the guidelines and ensure they align with your healthcare needs before enrolling.
- Neither Medi-Share 65+ nor Medigap include prescription drug coverage. You will probably want to combine it with a Medicare Part D prescription drug plan.
Who Should Consider a Health Sharing Plan Instead of Traditional Medigap?
If you are looking for an alternative to traditional Medigap plans, consider a health sharing plan like Medi-Share 65+.
Health Sharing plans provide cost-sharing among members for eligible medical expenses and can offer significant cost savings compared to Medigap Plan G.
Medi-Share 65+ shares nearly all out-of-pocket costs for Medicare Part A (hospitalization costs) and Part B (physician’s charges, lab fees, durable medical equipment, etc).
With Medi-Share 65+, there is no coinsurance or copays. Your Medicare Part A and Part B costs are limited to just $500 per household per year.
How Much Can Health Sharing Save Versus Your Current Medigap Plan?
Medi-Share 65+ costs just $99 per month for enrollees aged 65 through 74, and $150 per month for those aged 75+.
Currently, Medi-Share is offering a price lock-in until age 75 for all enrollees ages 65 to 74. That means there will be no further price increases for current enrollees under this program to age 75.
Note: Medi-Share 65+ is not a health insurance plan. Instead, it’s a health sharing plan –– a non-profit, voluntary association of like-minded individuals who agree to help share the medical bills of other plan members.
If Medi-Share 65+ looks like it will save you money, click here to learn more details. You can also self-enroll in just minutes.
There’s no “open enrollment period.” You can enroll in Medi-Share 65+ at any time.
If you want to speak with one of our expert Personal Benefits Managers, or get a personalized analysis and recommendation, click here to make an appointment.
Consultations are always free. And we could save you hours of research and stress!
Schedule Your Annual Medicare Strategy Review Today
If you need assistance understanding your ANOC letter or exploring alternative plans, consult with experts like Medigap Advisors.
We specialize in helping Medicare beneficiaries navigate their options and find the best plan to meet their unique needs. Take control of your healthcare coverage and make informed decisions based on the changes outlined in your ANOC letter.
Medigap Advisors: Your Expert in Medicare Solutions
Medigap Advisors is a nationally recognized expert in serving Medicare beneficiaries.
Our experienced Personal Benefits Managers specialize in helping Medicare beneficiaries find affordable private solutions that help protect them from high out-of-pocket costs, reduce risk, and improve access to healthcare.
Click here to make an appointment with your Personal Benefits Manager at Medigap Advisors and ensure you have the right coverage for your needs.
Annual Notice of Change Medicare Conclusion
As a Medicare beneficiary, understanding your Annual Notice of Change letter is crucial for making informed decisions about your healthcare coverage.
Review the changes outlined in the letter, consider switching plans if necessary, and consult experts like Medigap Advisors to ensure you have the best plan to meet your needs.
Need help? Don’t hesitate to reach out! You can schedule a free, no-obligation consultation by clicking here.
Here are some additional articles on the topic: Medicare MSAs or the Medi-Share 65+ Healthsharing Plan – Which is Better for Medicare Beneficiaries?3 | MediShare 65+ Health Sharing Plan vs. Medigap Plan G
Here are some additional pages related to this article: Medicare Supplement Plan G | Medi-Share 65+
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Frequently Asked Questions About Annual Notice of Change Medicare Letter
What is an ANOC letter and why is it important for Medicare beneficiaries?
The Annual Notice of Change (ANOC) letter is a document sent by Medicare Advantage and Part D prescription drug plans to their members every year.
It highlights changes in plan coverage, costs, and benefits that will be effective on January 1st of the following year. It is crucial for beneficiaries to carefully review this letter to understand how it may impact their healthcare needs and costs.
Can I switch from one Medicare Advantage plan to another?
Yes, you can switch from one Medicare Advantage plan to another during the Annual Enrollment Period (AEP) from October 15th to December 7th each year.
During this period, you can compare different plans’ benefits, costs, and pharmacy networks to find the one that best suits your needs. Any changes made during AEP will take effect on January 1st of the following year.
Can I switch from Medicare Advantage to Medigap (Medicare Supplement) plan?
Yes, you can switch from Medicare Advantage to Medigap, but the process may have certain restrictions and deadlines.
If you have been enrolled in a Medicare Advantage plan for less than 12 months, you may have guaranteed issue rights, meaning you have the option to enroll in a Medigap policy without medical underwriting. However, if you have been enrolled in a Medicare Advantage plan for more than a year, you may be subject to medical underwriting, which could result in higher premiums or even denial of coverage.
How can I enroll in Medigap after the initial enrollment period?
After your initial enrollment period, which usually lasts for 6 months starting from the month you turn 65 and are enrolled in Medicare Part B, you may still be able to enroll in a Medigap plan.
However, after the initial enrollment period, the availability of Medigap plans may be subject to underwriting, and insurance companies can deny coverage or charge higher premiums based on your health conditions. However, under certain circumstances, such as losing employer group coverage, you may have guaranteed issue rights which allow you to enroll in Medigap without underwriting.
What is the Annual Enrollment Period (AEP) for Medicare Advantage and Part D?
The Annual Enrollment Period for Medicare Advantage and Part D plans occurs from October 15th to December 7th each year.
It is the period when you can make changes to your existing coverage or enroll in new plans. Any changes made during AEP will take effect on January 1st of the following year.
Can I switch from Medicare Advantage to Original Medicare during the Annual Enrollment Period?
Yes, you have the option to switch from Medicare Advantage to Original Medicare (Part A and Part B) during the Annual Enrollment Period. Additionally, you can choose to enroll in Part D prescription drug coverage during this period.
It is important to carefully review your healthcare needs before making any changes to ensure you have the appropriate coverage.
If I switch to a new Medicare Advantage plan, will I lose my existing healthcare providers?
Possibly.
That’s why you should check the new plan’s network of preferred healthcare providers before switching to a new Medicare Advantage plan.
If your current providers are not in the new plan’s network, you may need to switch doctors or pay higher out-of-network costs.
Can I switch Medicare Advantage plans outside the Annual Enrollment Period?
In most cases, you can only switch Medicare Advantage plans during the Annual Enrollment Period.
However, certain circumstances may qualify you for a Special Enrollment Period (SEP), allowing you to make changes outside the regular enrollment period. Examples of SEPs may include moving to a new area, losing eligibility for Medicaid, or receiving Extra Help for prescription drug costs.
What is the difference between a Medicare Advantage plan and a Medigap (Medicare Supplement) plan?
Medicare Advantage plans are all-in-one alternatives to Original Medicare (Part A and Part B).
These plans are offered by private insurance companies approved by Medicare and typically include additional benefits, such as prescription drugs, dental, vision, and hearing coverage.
Medigap (Medicare Supplement) plans, on the other hand, work alongside Original Medicare by filling in coverage gaps and helping to pay for certain out-of-pocket costs, such as deductibles and coinsurance.
Can I have both a Medicare Advantage plan and a Medigap plan at the same time?
No.
It is illegal for insurance companies or agents to sell you both a Medicare Advantage plan and a Medigap plan at the same time. Therefore, you must choose between one or the other.
If you need help deciding whether to enroll in a Medicare Advantage plan or stay with Original Medicare plus a Medigap plan (or the Medi-Share 65+ health sharing plan), contact a Personal Benefits Manager. We’ll be happy to help you explore your options and enroll you in a plan that works for your needs and budget. Click here to schedule a free consultation.
Can I switch Part D prescription drug plans during the year?
Generally, the Annual Enrollment Period (October 15th to December 7th) is the primary time to switch Part D prescription drug plans.
However, if you qualify for a Special Enrollment Period (SEP) due to specific circumstances like moving out of your plan’s service area, receiving Extra Help, or losing creditable drug coverage, you may be eligible to switch Part D plans outside the regular enrollment period.
What are the consequences of not switching Medicare plans if my current plan is no longer meeting my needs?
Failing to switch plans when needed may result in inadequate coverage, higher out-of-pocket costs, and limitations in accessing necessary healthcare services.
If you received your ANOC letter because your plan is being canceled altogether, you could be left without important coverage entirely, and face huge Medicare deductibles and copays.
Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage.