Medicare Part D

Before your pharmacy surprises you in January, read the ANOC

LEAWOOD, Kan. — If you take a regular prescription and get your drug coverage through Medicare, an envelope arriving this fall deserves more than a glance. It's called the Annual Notice of Change, or ANOC, and it spells out exactly how your Part D plan — whether it's a stand-alone drug plan or the drug piece of a Medicare Advantage plan — will work differently starting January 1, 2026, heading into the 2027 plan year decision window that opens this October.

For Leawood residents, that notice is the earliest and clearest signal of what your drugs will cost and what hoops you may have to jump through next year. Here's how to read it.

What the ANOC actually is

The Annual Notice of Change is a document your Part D or Medicare Advantage plan is required to send each fall, usually by late September. It compares what your plan looked like this year to what it will look like next year. Think of it as a "before and after" snapshot.

It covers premiums, the deductible, the drug list (called a formulary), the tier each drug sits on, and any rules the plan uses to manage how drugs are prescribed. It's not marketing — it's the plan telling you, in writing, what's shifting.

Leawood is in Johnson County, where residents typically have many Part D and Medicare Advantage options to choose from during Annual Enrollment. But before comparing plans, it helps to first understand what your current plan is doing.

Why "still covered" is not the same as "still affordable"

Part D plans sort covered drugs into tiers — usually five or six of them. Lower tiers are generally preferred generics; higher tiers hold brand-name and specialty drugs. Your share of the cost is tied to the tier.

Here's the catch: a drug can stay on the formulary and still cost you more next year if the plan moves it to a higher tier. The ANOC will show tier changes side by side. If you see one of your medications jumped a tier or two, that's worth a closer look.

The utilization management rules to watch for

Even when a drug stays covered on the same tier, the plan can add rules that control how you get it. There are three main ones:

• Prior authorization means your doctor has to get the plan's approval before the prescription is filled.
• Quantity limits cap how much of a drug you can get in a given time — for example, a certain number of pills per month.
• Step therapy requires you to try a lower-cost drug first before the plan will pay for a more expensive one.

None of these mean the drug is off-limits, but each adds paperwork or a delay. The ANOC lists which of your drugs will have these requirements added — or dropped — in the new year.

What's new at the program level for 2026

A few pieces are set by Medicare, not by your specific plan:

• The Part D out-of-pocket cap is $2,100 for 2026. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum deductible any Part D plan can charge is $615.
• The coverage gap ("donut hole") is gone as of 2025 — there are now just three payment phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across monthly bills instead of paying big amounts at the pharmacy counter. It's optional and free to join.
• IRMAA surcharges — extra amounts higher-income enrollees pay — begin above $109,000 in income for a single filer in 2026.

These rules apply no matter which plan you're in, so read the ANOC with them in mind.

How to read your ANOC in 20 minutes

Grab the notice and a list of your current prescriptions, then:

1. Find the section comparing this year's premium and deductible to next year's. 2. Look up each of your drugs. Note the tier for 2025 and the tier for 2026. 3. Check the columns for prior authorization, quantity limits, and step therapy — for each drug, both years. 4. Skim the pharmacy network section. If your preferred pharmacy is no longer "preferred," your costs there can change. 5. If anything surprises you, call the plan's member services line listed on the notice, or compare other plans at medicare.gov during Annual Enrollment (October 15 – December 7).

If your plan changes drop a drug you take

Plans are required to offer a transition fill — usually a one-time supply — when you're new to a plan or when a drug you were taking is removed. That gives you and your prescriber time to either request an exception, switch to a covered alternative, or pick a different plan during the enrollment window.