Medicare Part D

Winona Part D in 2027: what your Annual Notice of Change is trying to tell you

WINONA, Minn. — The envelopes are on their way. Every fall, Part D drug plans and Medicare Advantage plans with drug coverage mail an Annual Notice of Change, or ANOC, that spells out what will be different in the plan year ahead. For Winona residents on a Medicare drug plan, the 2027 ANOC is the single most important piece of mail to open before the Annual Enrollment Period ends December 7 — because the drug list you leaned on this year may not work the same way next year.

What the ANOC actually is

The ANOC is a plain-language summary your plan mails each fall — usually by the end of September — that compares your 2026 coverage to your 2027 coverage. It sits alongside a thicker document called the Evidence of Coverage. The ANOC is the short one. Read it first.

It tells you four things that matter most for prescriptions: whether your monthly premium is changing, whether your deductible is changing, whether the drug list (the "formulary") is changing, and whether the rules attached to specific drugs are changing.

That last piece — the rules — is where most surprises live.

How a drug list can change from one year to the next

A Part D formulary is not fixed. Under CMS rules, plans can update their drug lists each plan year, and the changes generally fall into four buckets:

Tier changes. Most plans sort covered drugs into tiers (often five). A drug that was on a lower tier this year can move to a higher tier next year, which usually means a different cost share at the pharmacy. Your ANOC will flag tier moves for drugs the plan covers.

Prior authorization (PA). The plan may start requiring your prescriber to get approval before it will cover a drug it covered freely before. Same pill, new paperwork.

Quantity limits (QL). The plan may cap how much of a drug it will cover in a given time — for example, a set number of tablets per month. If your prescription exceeds the limit, your prescriber can ask for an exception.

Step therapy (ST). The plan may require you to try a lower-cost option first before it will cover the one you were on. Again, exceptions are possible with a doctor's request.

Prior authorization, quantity limits and step therapy are grouped together as "utilization management." The ANOC uses those exact terms, so it helps to know them going in.

How to actually read the notice

Set aside 15 minutes. Have your current medication list next to you. Then work through the ANOC in this order:

1. Check the premium and deductible section. Note the 2027 numbers. For reference, the Part D maximum deductible allowed is $615 in 2026 and $700 in 2027; plans can charge less. 2. Find the drug list change section. Look for a table or list of drugs being removed, moved to a different tier, or having PA, QL or ST added. 3. Cross-check every medication you take. Yes, every one. A drug can still be covered but come with new hoops. 4. Look for the pharmacy network section. In-network pharmacies can change, and some plans have "preferred" pharmacies with different cost sharing. 5. Note the effective date. Changes generally take effect January 1, 2027.

If nothing you take is affected, you may be fine to stay put. If something you take is affected, you have options.

What Winona-area readers can do about it

Winona is in Winona County, where Medicare beneficiaries can shop stand-alone Part D drug plans and Medicare Advantage plans that include drug coverage during the Annual Enrollment Period, October 15 through December 7. Coverage picked during that window starts January 1.

A few practical steps:

• Use the Medicare Plan Finder at medicare.gov. You can enter your medications and preferred pharmacy and see how each plan available in Winona County would handle your drugs — including any PA, QL or ST flags.
• Ask your prescriber about exceptions. If a drug you rely on is moved or restricted, your doctor can request a coverage determination or an exception. This is a formal process built into Part D.
• Know about transition fills. If you stay in a plan and it changes coverage of a drug you were already taking, or you switch plans and your new one handles a drug differently, Medicare requires a temporary transition supply — typically at least a one-month fill in the first 90 days — so you have time to work out a longer-term solution.
• Consider the Medicare Prescription Payment Plan. Starting in 2025 and continuing in 2026 and 2027, any Part D enrollee can opt in to spread drug costs across the calendar year in monthly payments instead of paying at the pharmacy counter. It doesn't lower costs, but it can help with cash flow.

Two other numbers worth keeping in mind: the Part D annual out-of-pocket cap is $2,100 in 2026, and IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.

If you miss the December 7 window

If you're in a Medicare Advantage plan, you get a second look. The Medicare Advantage Open Enrollment Period runs January 1 through March 31 and lets you switch to a different Medicare Advantage plan or return to Original Medicare with a stand-alone Part D plan. Stand-alone Part D enrollees generally cannot make changes in that window without a Special Enrollment Period.

Where to get help in Winona

For personalized help, Minnesota's State Health Insurance Assistance Program (SHIP) — known locally as the Senior LinkAge Line — offers free, unbiased counseling to Medicare beneficiaries. You can also call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week, or use the Plan Finder at medicare.gov.