If your Medicare Part D plan sends notice of a higher premium, a different drug list, new restrictions, or changed pharmacy costs, do not judge the change by the premium alone. Read the plan’s Annual Notice of Change (ANOC), check every prescription you take, compare the deductible and cost-sharing at your pharmacy, and confirm when the change starts.
For most people, the main opportunity to change plans is Medicare Open Enrollment, October 15 through December 7, for coverage beginning January 1. Extra Help, Medicaid, and other circumstances can create additional options. If a plan will not cover a medicine you need, request a written coverage determination and ask your prescriber whether an exception is medically justified.
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Start with the notice: identify exactly what changes
Medicare says a Medicare plan sends an Annual Notice of Change (ANOC) each fall, usually in September. The notice describes changes that take effect in January, including premiums, deductibles, copays, coinsurance, covered drugs, pharmacy networks, and coverage rules. Medicare’s official wording says the ANOC includes “any changes in coverage, costs, and more that will be effective in January.”
Read the ANOC together with the plan’s Evidence of Coverage. The ANOC is a change summary; the Evidence of Coverage contains the operative rules and definitions. If the ANOC does not arrive, call the plan using the number on your membership card. Medicare’s notice information also distinguishes general plan-change notices from cost-change and Extra Help notices, so make sure you have every document addressed to you.
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Make a one-page change list
- New monthly premium and whether it recurs every month.
- New deductible and the point at which cost-sharing changes.
- Each prescription’s formulary status, tier, copay or coinsurance, and utilization rules such as prior authorization, quantity limits, or step therapy.
- Whether your current pharmacy remains in network and whether another participating or preferred pharmacy has a different price.
- The effective date, normally January 1 for ANOC changes, and any instructions for selecting a replacement plan.
Do not assume a drug remains covered because the plan covered it this year. A formulary, pharmacy network, or cost-sharing design can change for the new plan year.
Compare total annual drug cost, not just the premium
The lowest premium is not necessarily the lowest-cost plan for your prescriptions. Compare each candidate plan using the same medication list, quantities, strengths, refill frequency, and pharmacy. Include the premium, deductible, prescription cost at the pharmacy you actually use, and any coverage restrictions.
Prepare an accurate medication and pharmacy profile
- Write down every prescription, including generic or brand name, strength, dosage, quantity, and how often you refill it.
- Include medicines filled only occasionally; a drug used a few times a year can still be expensive if it is not covered or is subject to a high tier.
- Record your preferred pharmacy and one practical alternative. A plan may charge different amounts at preferred, standard, mail-order, and out-of-network pharmacies.
- Note any current prior authorization, quantity limit, or step-therapy requirement so you can check whether the rule continues.
Use a consistent comparison table
| Comparison item | What to verify | Why it matters |
|---|---|---|
| Monthly premium | Amount charged each month under the new plan year | A low premium can be offset by higher prescription costs. |
| Deductible | Amount paid before ordinary cost-sharing begins, and which drugs are subject to it | Two plans with similar premiums can differ sharply early in the year. |
| Drug coverage | Formulary status, tier, copay or coinsurance, and utilization rules for every medicine | A nonformulary drug or restriction can make a plan impractical. |
| Pharmacy network | Whether your pharmacy participates and whether preferred-pharmacy pricing is available | The same prescription can cost different amounts at different pharmacies. |
| Effective date | When new coverage begins and whether the old plan ends automatically | Confirming the date prevents an unintended gap. |
Medicare’s official plan-comparison service can estimate costs using your medicines and location. You can also ask Medicare or the plan to explain a result. A plan ranking cannot be determined without your county or service area and your actual prescriptions.
Know when you can change plans
Annual Open Enrollment
For most beneficiaries, Medicare Open Enrollment runs from October 15 through December 7. A request received by December 7 generally produces coverage effective January 1. During this period, you can join, switch, or drop a Part D plan and can change between Original Medicare and Medicare Advantage. If you move to Original Medicare, you may need to join a separate Part D plan.
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When you enroll in a new drug plan during an allowed enrollment period, the old drug coverage ends when the new coverage starts. Medicare says you generally do not need to cancel the old plan separately, but verify the new plan’s start date and keep confirmation of your enrollment.
Avoid an unintended coverage gap
Going 63 days or more without Part D or other creditable prescription drug coverage can result in a late-enrollment penalty or leave you waiting for an enrollment period. Do not cancel a plan until you know when replacement coverage begins, and do not treat a plan’s notice of a future change as proof that you are uninsured today.
Special enrollment opportunities
Your circumstances may provide another enrollment period. People receiving Medicaid or Extra Help may be able to change drug coverage once per month. Other Medicare enrollment rules depend on the event and the person’s current coverage, so ask Medicare or the plan which period applies before submitting a change.
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Extra Help assists eligible people with Part D premiums and other costs. Eligibility can arise automatically through Medicaid, a Medicare Savings Program, or Supplemental Security Income, or through an application and later reapplication when circumstances change.
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Reassignment Notice
A late-October Reassignment Notice may say Medicare will move you because your plan is leaving Medicare or its premium is above the amount covered by your subsidy. Check the assigned plan’s formulary, pharmacy network, and coverage start date rather than assuming it matches your current plan.
LIS Choosers Notice
An early-November Low-Income Subsidy (LIS) Choosers Notice may tell someone who selected a plan that part of the premium will be owed unless they select a new plan with a $0 premium after Extra Help. Compare the proposed plan with your medicines before accepting the change.
Reassign Formulary Notice
A December Reassign Formulary Notice describes which previously used prescriptions the newly assigned plan will cover. Use it to identify a medicine that needs a prescriber’s intervention or an exception request before the new plan year.
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When a needed medicine is not covered or becomes harder to obtain
You can ask the Part D plan for a written coverage determination. This is the plan’s first decision about whether it covers a drug, whether a coverage rule is satisfied, or what you must pay.
When to request an exception
- The medicine is absent from the plan’s formulary.
- A rule such as prior authorization, step therapy, or a quantity limit should not apply to you.
- The plan places the medicine on a higher tier, but lower-tier alternatives are unsuitable.
An exception request requires a statement from your prescriber explaining the medical reason. The explanation should address why covered alternatives are ineffective, unsafe, or otherwise inappropriate for your condition.
How to submit the request
- Call the plan or submit the plan’s written coverage-determination form. You or your prescriber can start the request.
- Tell the plan whether you are requesting coverage of a nonformulary drug, a waiver of a restriction, or a lower tier.
- Ask your prescriber to send the required medical explanation and supporting records.
- Request an expedited review if waiting could seriously jeopardize your life or health. For a prescription you have not yet obtained, standard and expedited requests can be made by phone or in writing.
- Keep copies of the request, the prescriber’s statement, and every decision notice. Follow the plan’s instructions and deadlines if you need to appeal.
A coverage determination is different from simply asking a pharmacist to override a rejection. The plan must make the formal decision, and a written determination gives you the explanation needed for any next step.
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Understand the current Part D figures without misreading them
Medicare’s current figures provide context, but they do not predict your plan’s premium or your personal annual bill. Plan premiums, formularies, pharmacy contracts, and assistance amounts can vary by year and location.
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| Figure | What it represents | Qualification |
|---|---|---|
| $2,100 in 2026 | Annual Part D out-of-pocket threshold | Medicare’s 2026 figure; it is an annual drug-cost limit, not a monthly premium. |
| $2,400 in 2027 | Annual Part D out-of-pocket threshold | Medicare’s 2027 figure; covered Part D drugs have no out-of-pocket cost in the catastrophic stage for the rest of that calendar year. |
| $38.99 in 2026 | National base beneficiary premium used in Medicare’s late-enrollment-penalty calculation | It can change annually and is not the price of every Part D plan. |
| $0 premium and $0 deductible in 2027 for qualifying Extra Help recipients | Program figures at participating pharmacies | Subject to Extra Help rules and plan availability. |
| Up to $5.80 for a generic and $14.40 for a brand-name prescription in 2027 | Extra Help cost figures at participating pharmacies | These are program amounts, not universal retail prices. |
| $2,400 in 2027 total drug costs for the Extra Help page’s threshold | Point after which it says the person pays $0 for covered drugs | Includes certain payments made on the beneficiary’s behalf and remains subject to program rules. |
Do not confuse the annual out-of-pocket threshold with the premium shown on your ANOC. The threshold concerns covered drug spending during a calendar year; the premium is a recurring charge for enrollment.
Get help before you make an expensive change
Medicare and your plan
Call the plan for a missing ANOC, formulary question, pharmacy-network issue, premium discrepancy, or coverage determination. Call Medicare when you need help comparing available plans, understanding an Extra Help level, or correcting a cost error.
State Health Insurance Assistance Programs
State Health Insurance Assistance Programs (SHIPs) provide free counseling. A counselor can help you compare plans using your prescriptions and location and explain enrollment choices without selling you a plan.
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Your prescriber can identify clinically suitable alternatives and supply the medical explanation for an exception. Your pharmacist can confirm whether a rejection is caused by the formulary, a prior authorization, a quantity limit, or the pharmacy’s network status; the formal coverage decision still comes from the plan.
A practical timeline for the next plan year
- When the ANOC arrives: mark every premium, deductible, drug, pharmacy, and rule change, then retrieve the Evidence of Coverage.
- Before comparing plans: assemble your complete medication list, preferred pharmacy, and any current authorization information.
- During October 15–December 7: compare total costs and coverage, ask questions, and submit a replacement-plan enrollment request if needed.
- Before January 1: confirm the new plan’s effective date, obtain refills if your prescriber recommends it, and resolve any formulary or authorization problem.
- After the new plan starts: check the first pharmacy claim and premium bill. If a needed drug is denied or priced incorrectly, request a written coverage determination and preserve the notices.
Common mistakes to avoid
- Choosing solely by monthly premium.
- Failing to check a drug’s new formulary tier or utilization rule.
- Assuming the current pharmacy remains preferred or in network.
- Ignoring an Extra Help reassignment or formulary notice.
- Dropping coverage without confirming the replacement start date.
- Waiting to involve the prescriber after a new plan year begins.
- Treating a national figure, such as the $38.99 2026 base beneficiary premium, as your plan’s actual premium.
Plan information and annual figures can change. Use the current ANOC, Evidence of Coverage, Medicare information, and plan materials for the year in which you are enrolling.
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