Medicare Part D
Before you refill in January: how Glen Cove readers can decode the 2027 ANOC
GLEN COVE, N.Y. — The envelope usually lands in late September. It is thicker than the junk mail around it, and it has a name most people forget by October: the Annual Notice of Change, or ANOC. For anyone on a stand-alone Part D plan or a Medicare Advantage plan with drug coverage, this is the document that tells you how your 2027 coverage will differ from your 2026 coverage — including, importantly, what happens to the drugs you actually take.
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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.
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Key takeaways
- The ANOC arrives each fall and compares your current plan to next year's version, including formulary and utilization-management changes.
- Drug plans can move a drug to a different tier, add prior authorization, add quantity limits, or require step therapy at the start of a new plan year.
- The Annual Enrollment Period runs October 15 through December 7, which is your window to switch Part D or Medicare Advantage plans for 2027.
- The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, and the maximum deductible is $615 in 2026 and $700 in 2027. The Medicare Prescription Payment Plan lets you spread drug costs across the year.
Glen Cove is in Nassau County, where Part D plans are sold under the same federal rules that apply nationwide. The drug list (the "formulary"), the tier a drug sits on, and the paperwork attached to that drug can all shift from one plan year to the next. The ANOC is where those shifts are spelled out before they take effect on January 1.
What the ANOC actually is
The Annual Notice of Change is a plan-specific document your insurer is required to send before the Annual Enrollment Period. It puts this year and next year side by side: premium, deductible, cost-sharing, the pharmacy network, and — the part most people skim past — the drug list.
If you also get a fatter booklet called the Evidence of Coverage (EOC), that is the full rulebook. The ANOC is the short version that flags what is different.
How drug lists change from year to year
Part D formularies are not frozen. Between plan years, an insurer can:
- Move a drug to a different tier. Plans typically have 4 to 6 tiers, from preferred generics up through specialty drugs. A drug that sat on a lower tier in 2026 can land on a higher tier in 2027, which usually means a bigger share of the cost falls on you.
- Remove a drug from the formulary. The plan may drop a medication entirely, often when a generic or a preferred alternative becomes available.
- Add a drug. New medications, especially generics and biosimilars, get added throughout the year and at the plan-year turn.
- Change the rules around a drug it still covers. This is the part readers miss most often — same drug, same tier, new hoops.
Prior authorization, quantity limits, step therapy
These three tools are called "utilization management." They do not mean the drug is uncovered; they mean the plan wants something to happen before it pays.
- Prior authorization (PA) means your prescriber has to send the plan clinical information showing the drug is appropriate for you before the pharmacy can fill it under your Part D benefit.
- Quantity limits (QL) cap how much of a drug the plan will cover in a given period — for example, a set number of tablets in 30 days.
- Step therapy (ST) means the plan wants you to try a preferred, usually lower-cost drug first. If that drug does not work or is not appropriate, your prescriber can document that and move you up a step.
Any of these can be newly attached to a drug at the start of a plan year. The ANOC will note the change; the EOC and the plan's 2027 formulary will show the specifics.
How to read your ANOC without a headache
You do not need to read every page. Work in this order:
1. Find the "changes to the drug list" section. Compare it against the medications you actually take — not the ones you took two years ago. 2. Check the tier for each of your drugs. A tier bump is the single most common reason people are surprised at the January pharmacy counter. 3. Look for PA, QL, or ST notations next to your drugs. New paperwork on a familiar prescription is a change worth calling your prescriber about now, not in January. 4. Check the pharmacy network. "Preferred" pharmacies typically cost less than "standard" ones, and the list can be different in 2027. 5. Note the premium, deductible, and cost-sharing changes. Program-level guardrails: the Part D maximum deductible is $615 in 2026 and $700 in 2027, and the annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
If something in your ANOC does not match what you are seeing, call the number on the back of your plan card and ask them to walk you through it.
What to do if a change hurts
You have real options during the Annual Enrollment Period, October 15 through December 7. You can:
- Switch to a different Part D plan or a different Medicare Advantage plan for 2027.
- Stay put if the changes do not affect the drugs you take.
- Ask your prescriber about a therapeutic alternative that lands on a lower tier or has fewer restrictions on your 2027 plan.
If you are already enrolled in a Medicare Advantage plan on January 1, there is a second window — Medicare Advantage Open Enrollment, January 1 through March 31 — during which you can make one change.
New plans are also required to offer a transition fill early in the year — a temporary supply of a drug you were already taking, so you and your prescriber have time to request an exception or switch medications. Do not treat this as a permanent fix; treat it as a runway.
And if paying for drugs in any single month feels unmanageable, ask about the Medicare Prescription Payment Plan, the optional program that spreads your out-of-pocket drug costs across monthly payments instead of hitting all at once at the pharmacy.
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 Nassau County
(MA penetration in Nassau 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 should my ANOC arrive?
My drug is still covered but now needs prior authorization. What do I do?
Can my plan change my drug's tier in the middle of the year?
Where can I get unbiased help reviewing my ANOC?
- 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 Glen Cove
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This page was last updated: October 6, 2026.