Medicare Part D

Mukilteo Medicare: what your Part D plan's fall notice really says before 2027

MUKILTEO, Wash. — If you take a prescription drug and have Medicare Part D, the single most important piece of mail you'll get this fall is the Annual Notice of Change, or ANOC. It arrives by late September and spells out how your plan's drug list, tiers and rules will look starting January 1, 2027. For Mukilteo residents, reviewing it now — before the December 7 deadline — is how you avoid a surprise at the pharmacy counter in the new year.

Medicare Part DMukilteo, WA

Mukilteo is in Snohomish County, where Medicare beneficiaries choose among a range of stand-alone Part D plans and Medicare Advantage plans that include drug coverage. Every one of those plans can change its formulary from year to year, within rules set by the Centers for Medicare & Medicaid Services (CMS).

What the ANOC actually is

The ANOC is a plain-language summary your Part D or Medicare Advantage-with-drug-coverage plan is required to send you before each new plan year. It compares this year's coverage to next year's — premium, deductible, cost-sharing structure, and importantly, the formulary (the plan's list of covered drugs) and the rules attached to those drugs.

If you set the envelope aside every fall, this is the year to open it. Read it side-by-side with your current list of medications.

How drug lists can change from one year to the next

Formularies are not frozen. A plan can change the list — and the rules around specific drugs — within CMS guardrails. Here are the four changes to look for:

Tier changes. Most plans sort covered drugs into tiers, roughly from lower-cost generics up to specialty drugs. A drug can move from a lower tier to a higher one (or occasionally the reverse). The drug is still covered — but your share of the cost can be different.

Prior authorization (PA). Your plan may now require your doctor to send paperwork explaining why you need a particular drug before it will pay for it. A drug that filled with no questions last year can suddenly need approval.

Quantity limits. The plan caps how much of a drug it will cover in a given time period — for example, a set number of pills per month.

Step therapy. The plan asks you to try a preferred (usually lower-cost) drug first. If that doesn't work for you, the plan will then cover the drug your doctor originally prescribed.

None of these mean a drug is dropped. But each one can change what you pay, how quickly you can refill, or how much back-and-forth your doctor's office has to do.

How to read your ANOC in about 15 minutes

1. Pull out your current medication list — names, doses, and how often you take each one. 2. Find the formulary section of the ANOC (or the link to the 2027 drug list). 3. Check each of your drugs for: still covered? same tier? any new PA, quantity limit, or step therapy symbol next to it? 4. Look at the cost-sharing structure for the tier each drug now sits in. 5. Note the plan's 2027 deductible and premium.

If everything still fits, you may not need to do anything. If something has shifted, you have options during the Annual Enrollment Period (October 15 – December 7) to switch plans for a January 1, 2027 start.

Transition fills — a safety net, not a plan

If you stay in the same plan and a drug you already take is affected by a new rule on January 1, Medicare requires plans to provide a one-time transition supply (generally a 30-day fill) during your first 90 days in the new plan year. That gives you and your prescriber time to either request an exception or switch to a covered alternative. It's a bridge, not a long-term fix.

The 2026 backdrop worth knowing

Part D has changed a lot recently, and those changes carry into how you should think about 2027:

• The coverage gap (the old "donut hole") was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Part D out-of-pocket cap is $2,100 for 2026, with the annual deductible capped at $615.
• The Medicare Prescription Payment Plan lets you spread drug costs across monthly payments instead of paying large amounts at the pharmacy.
• IRMAA surcharges for higher-income enrollees begin above $109,000 for a single filer in 2026.

Your ANOC will reflect the 2027 versions of these figures once CMS finalizes them.

Where to get personalized help in Mukilteo

For one-on-one help reviewing your ANOC, Washington's State Health Insurance Assistance Program (SHIBA) offers free, unbiased counseling. You can also compare 2027 plans using the Plan Finder at medicare.gov, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week.