5 things to look out for in your ANOC Letter

When reviewing your ANOC, you’ll want to keep an eye out for five important areas:

1. Deductible changes
2. Premium changes
3. Copay and/or coinsurance changes
4. Formulary changes
5. Provider and/or pharmacy network changes

1. Deductible changes

A deductible is the amount you must pay for health care or prescriptions before the insurance begins to pay.

Medicare Advantage and Part D drug plans have deductibles, with exact costs varying by plan. It's typical to see a slight increase each year, but if there's a big jump, please call us so we can help you shop the market.

2. Premium changes

Premiums are the monthly fee that Medicare beneficiaries pay. If you have a Medicare Advantage plan, you may notice your premium going down, as has been the trend in recent years.

However, sometimes a plan will be terminated, and the insurance company will port you over to an entirely different plan. In these circumstances, you may see a massive premium increase. We see this happen with at least one carrier every year.

If this happens to you, don't sit back and let it happen! Be proactive and call us so we can run a new plan comparison for you.

3. Copay and/or coinsurance changes

Your copay, or copayment, is an amount you may be required to pay as your share of the cost for a medical service or supply. You may have copays for doctor visits, hospital outpatient visits or prescription drug costs.

Copayment can be a set dollar amount, but they can also be a percentage, referred to as coinsurance. For example, you might pay a $25 copay for a doctor’s visit or 33% coinsurance for a specific prescription drug tier.

Each year, copayments and coinsurance percentages for services and prescriptions can change.

In this ANOC letter example, we can see the copays for an inpatient hospital stay changed quite dramatically. This is the kind of change we want to understand so we can shop the market and potentially find a more competitive plan option.

It’s important to review each section of your ANOC to see if any specific copayment information has changed for any specific area of care.

4. Formulary changes

A formulary is your plan’s list of covered prescription drugs. Each plan has its own formulary, and plans also place drugs into tiers of coverage. Lower tiers have lower costs to you, while higher tiers have higher costs.

When you receive your ANOC, be sure to check your plan’s formulary to ensure all of your prescriptions are still covered. You should also confirm what tier they may be changing to in the upcoming year.

This can get confusing, but we are here to help. We run drug plan comparisons for our customers every year, and if you need help, we are here to be your Medicare allies. That's why we chose this as our company name!

5. Physician and/or pharmacy changes

There’s nothing worse than going to refill your prescriptions in January just to find out that your insurance no longer has good prices with that pharmacy.

Your provider networks might experience changes, and it’s important to be aware of these network changes.

In almost all cases, you will have to take extra steps to confirm that your pharmacy and physicians or specialists are still in your network for the next year. It's rare to see any big changes without your physician informing you, but it never hurts to double check.

When you receive your ANOC, you’ll want to go through your providers and preferred pharmacy to ensure your coverage in those important areas stays to your preference.

What to do after you review your ANOC

After you have carefully reviewed your ANOC, you may have discovered some information that makes your current plan less appealing for the future. Luckily, if you’re no longer satisfied with your coverage, you have options.

The reason the ANOC is sent out in September each year is to give you enough time to review it before the Annual Enrollment Period (AEP) for Medicare begins. AEP goes from October 15th to December 7th each year and is your opportunity to make changes to your current coverage. Any changes you make during AEP will go into effect on January 1st.

During the Annual Enrollment Period, you can:

• Drop an Advantage Plan and return to Original Medicare
• Elect to change from one Advantage plan to a different one
• Change from Original Medicare to an Advantage plan
• Elect to change from one Part D prescription drug plan to another
• Cancel your current Part D plan
• Pick up a Part D plan if you currently do not have one

The bottom line

The ANOC gives you crucial insight into the future of your current insurance coverage. It lets you know about any major changes you can expect in the upcoming year. Carefully reading the ANOC is essential for understanding the future of your Medicare coverage.

Still not sure? We can help you review your ANOC and review your coverage options. Reach out for a plan review. We can help you understand your coverage changes and help you make plan comparisons if you’re interested in making a change to your Medicare this AEP.