Table of Contents:

  1. Coverage
  2. Cost
  3. Service Area

Those enrolled in Medicare can expect to receive an Annual Notice of Change (sometimes abbreviated ANOC) in the mail before the end of September. The Annual Notice of Change is sent by providers to alert beneficiaries of any adjustments being made to their plans. Notices are required by law to be sent out by September 30 each year, as the Annual Enrollment Period begins on October 15. The changes disclosed therein will not go into effect until January 1 of the forthcoming year.

Technically, no action is required upon receiving a Notice of Change, since it is strictly informative. Individuals who do nothing during the Annual Enrollment Period will simply be re-enrolled in their current plan for the upcoming year. It is always in a beneficiary’s best interest, however, to review their notice of change. Any changes made to a plan could have significant effects on covered care and your costs.

The three main elements to look out for on an Annual Notice of Change are: coverage, cost, and service area. These are the aspects of health plans that tend to be most in flux, and we’ve broken down exactly what each aspect entails and how changes might affect you.

Coverage

Coverage refers to the healthcare a beneficiary is entitled to receive through their plan. Any service that is “covered” is something that a plan will help you pay for (either fully or partially). What is important to remember about coverage is that does not spell out precise costs you will incur through health-related transactions; it simply states what care is covered, not to what extent.

When reviewing types of care covered by a plan, it makes sense to think in terms of routine expenses. For example, if you use your Medicare Advantage plan to pay for vision care, and vision care is being removed from your plan’s coverage in the forthcoming year, you may wish to shop for a new plan or a supplemental plan to cover vision.

Cost

Cost refers to how much a beneficiary will pay for their plan and accompanying care received through the plan. Total cost will be a combination of several factors. First, there is the premium, which is the monthly payment made towards a plan. Other costs include copayments and coinsurance, deductibles, and out-of-pocket limits associated with a plan.

An out-of-pocket limit refers to the maximum amount of money paid toward healthcare in a given benefit period. Often, a beneficiary will only reach an out-of-pocket limit in the event of a major surgery requiring inpatient care, but when an out-of-pocket limit does apply, it may help beneficiaries avoid medical bill-related financial hardship.

Predicting how copayments and deductibles affect out-of-pocket expenses can be tricky. The best way to approach this task is to look at overall costs from the previous year, as well as overall healthcare usage, and compare these numbers to any forthcoming changes to the plan.

Service Area

The final thing to consider when you receive an Annual Notice of Change is a modification to your service area. A service area is generally the geographic region where a beneficiary can get non-emergency healthcare services through their health plan. Service area varies based on residency, so if a beneficiary moves, their service area will likely change as well.

Keep in mind that doctors and hospital systems do not accept all plans. Your Annual Notice of Change will not inform you whether your doctor will accept a plan in the upcoming year, as this is determined by the healthcare provider, not the insurance provider. To find out if your doctor(s) will accept your plan, contact your healthcare provider directly.

If you don’t receive an Annual Notice of Change by the start of the Annual Enrollment Period on October 15, contact your plan directly for this information.

 

Information adapted from the Centers for Medicare & Medicaid Services