Medicare Part D
Perth Amboy Part D: how to read the 2027 Annual Notice of Change before Dec. 7
PERTH AMBOY, N.J. — The envelopes are landing in mailboxes across Middlesex County right now. If you have a Medicare Part D drug plan or a Medicare Advantage plan with drug coverage, your insurer is required to send an Annual Notice of Change (ANOC) each fall spelling out what will be different starting January 1, 2027. Buried inside those pages is the single most important detail for anyone who takes regular prescriptions: how the plan's drug list — called a formulary — is changing for the new year.
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Will your prescriptions still be covered in 2027?
Part D plans rewrite their drug lists every year — tiers move, pharmacies change, drugs drop off. One call checks your exact medications against the 2027 plans in your area.
- Every prescription checked, name by name
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Speak to a Licensed Insurance Agent
Click to call 855-729-3240Key takeaways
- The Annual Notice of Change arrives each fall and shows how your Part D drug list, tiers, and rules will change on January 1, 2027.
- Formulary changes can include tier moves, new prior authorization, quantity limits, or step therapy — even when a drug is still "covered."
- You can compare plans and switch during Annual Enrollment, October 15 through December 7, using Medicare's Plan Finder at medicare.gov.
- If you're new to a plan in January and your drug isn't covered the same way, you may qualify for a one-time transition fill while you sort out next steps.
You have until December 7 to switch plans during Medicare's Annual Enrollment Period. That makes the next few weeks the time to actually open the envelope.
What the ANOC actually is
The ANOC is a plain-language summary your plan mails (or emails) before the fall enrollment window. It compares your 2026 plan to the 2027 version of the same plan. It's separate from the much thicker Evidence of Coverage, and it's the document to read first.
Look for a section usually titled something like "Changes to our drug coverage" or "Changes to the Drug List." That's the part that matters most if you take medicine regularly.
The four ways your drug coverage can shift
A plan can still "cover" your medication in 2027 while making it noticeably harder or more expensive to fill. Here are the mechanisms to watch for in the ANOC:
Tier changes. Every Part D formulary sorts drugs into tiers, and higher tiers usually mean a bigger share of the cost falls on you. A drug that sat on a lower tier this year can move to a higher one next year, or vice versa. The ANOC will list drugs whose tier is changing.
Prior authorization (PA). This means your doctor has to get the plan's approval before the pharmacy can fill the prescription. A drug that filled with no questions asked in 2026 can require PA in 2027.
Quantity limits (QL). The plan caps how much you can get in a set period — for example, a certain number of pills per 30 days. New or tightened quantity limits can affect people who take higher doses.
Step therapy (ST). The plan asks you to try a preferred (usually less expensive) drug first. Only if that doesn't work will it cover the alternative. If step therapy is added to something you already take, you and your prescriber may need to document that you've already tried the earlier option.
Any of these can appear even if the drug's name is still on the formulary.
How to read your ANOC in about 15 minutes
1. Find the drug changes section. Note anything about your specific medications: tier moved, PA added, QL added, ST added, or removed from the formulary entirely. 2. Check the cost-sharing section for how your plan structures its deductible and copays or coinsurance by tier. Program-wide, the Part D maximum deductible is $700 in 2027, and the annual out-of-pocket cap is $2,400 in 2027. 3. Note whether your pharmacy is still in the plan's preferred network for 2027. 4. Confirm whether the plan still serves your area. Perth Amboy is in Middlesex County, and plan service areas are set at the county level.
What to do if a drug you take is changing
You have options — none of them require panic.
- Compare plans during AEP. Between October 15 and December 7, 2026, use the Plan Finder at medicare.gov to enter your medications and see how each available plan would handle them in 2027. If you're already enrolled in Medicare Advantage, you also have a second window — the Medicare Advantage Open Enrollment Period, January 1 through March 31, 2027 — to switch to another MA plan or return to Original Medicare.
- Ask your prescriber about alternatives. Sometimes a therapeutic equivalent sits on a lower tier or doesn't have utilization management attached.
- Request an exception. You (or your doctor) can ask the plan to cover a non-formulary drug, waive step therapy, or move a drug to a lower tier for medical reasons. Plans have a formal process and deadlines to respond.
- Use a transition fill if needed. New enrollees, and existing members whose drugs are affected by formulary changes, are generally entitled to a temporary transition supply early in the plan year while they work out an exception or a switch. Ask the plan directly how their transition policy works.
A few program-level facts worth knowing as you move into 2027
- The coverage gap (the old "donut hole") has been eliminated since 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
- The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across monthly installments during the year instead of paying at the pharmacy counter. Enrollment is optional and done through your plan.
- Higher-income enrollees pay an income-related surcharge (IRMAA) on Part B and Part D premiums. For 2026, IRMAA begins above $109,000 for single filers.
- CMS will publish the 2027 Part D figures ahead of the plan year; your ANOC should reflect them.
By the numbers
Medicare Part B premium, 2006–2026
The standard monthly Part B premium has climbed from $88.50 in 2006 to $202.90 in 2026. Hover any point for that year’s premium.
Source: CMS. Standard premium shown; in some hold-harmless years many existing enrollees paid less. Confirm at Medicare.gov.
By the numbers
How people get Medicare in Middlesex County
(MA penetration in Middlesex County)
MA penetration from CMS enrollment data; Medigap share is an estimate. U.S. average is about 54% Medicare Advantage. These are area-level figures, not plan-specific.
Key dates
Medicare enrollment periods at a glance
- Around your 65thInitial Enrollment PeriodA 7-month window around the month you turn 65 — your first chance to sign up.
- October 15 – December 7Annual Enrollment PeriodAnyone with Medicare can join, switch, or drop a Medicare Advantage or Part D plan.
- January 1 – March 31Medicare Advantage Open EnrollmentIf you're already in a Medicare Advantage plan, you can make one change.
- January 1 – March 31General Enrollment PeriodFor people who missed their first chance to sign up for Part B.
- VariesSpecial Enrollment PeriodTriggered by life events like moving or losing other coverage.
Dates are set by Medicare and apply nationwide. Confirm your personal windows at Medicare.gov or 1-800-MEDICARE.
Try it
How the 2026 Part D drug cap works
Slide to your estimated yearly prescription costs and see how the new $2,100 out-of-pocket cap protects you. This illustrates the standard Part D benefit; your plan may structure costs differently.
Once your out-of-pocket spending on covered drugs reaches $2,100, you pay nothing more for the rest of 2026. Confirm details at Medicare.gov.
Explore
When can you enroll? An interactive year
Enrollment windows are federal and the same nationwide. Confirm your personal dates at Medicare.gov or 1-800-MEDICARE.
Good to know
Frequently asked questions
When will I get my 2027 Annual Notice of Change?
What if my drug is being dropped from the formulary?
Do I have to do anything if nothing about my drugs is changing?
Where can I get free, unbiased help reviewing my options?
- CMS — Medicare Part D program rules (medicare.gov)
- CMS — Medicare enrollment periods (medicare.gov)
For personalized answers, contact Medicare.gov, 1-800-MEDICARE, or your local SHIP.
Also for Perth Amboy
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This page was last updated: October 6, 2026.