The Envelope That Decides Next Year

Somewhere in the mail this month may be a document that helps determine what your health care will cost next year.

It can arrive in a thick envelope and look easy to ignore.

Don’t.

Medicare Advantage plans and stand-alone Part D prescription drug plans are required to send members an Annual Notice of Change, or ANOC, before the start of Medicare Open Enrollment.

The notice explains what the plan will change for the coming year.

That can include premiums, deductibles, copays, drug coverage, pharmacy networks, and other plan rules.

For people in Medicare Advantage, it may also include changes involving doctors, hospitals, and other providers.

Not everyone on Medicare receives an ANOC.

People enrolled only in Original Medicare do not get one from Medicare in the same way, and Medicare supplement, or Medigap, policies follow different rules.

For people enrolled in private Medicare Advantage or Part D plans, however, the notice is one of the most important pieces of mail they may receive all year.

A drug that is covered now may move to a different tier or come off a plan’s formulary next year.

A preferred pharmacy may change.

A doctor or hospital may no longer be in a plan’s network.

A second document, called the Evidence of Coverage, may also arrive.

That is the longer, more detailed explanation of the plan’s benefits and rules.

The ANOC is the shorter summary of what is changing.

And there is one part many people miss:

Doing nothing is still a decision.

If a plan continues to be offered and a member makes no change, coverage generally continues under the plan’s new terms for the coming year.

That means new premiums, copays, drug coverage, and network rules can take effect even if the envelope was never opened.

Medicare Open Enrollment runs from Oct. 15 through Dec. 7.

Changes made during that period generally take effect Jan. 1.

People who want help comparing plans can contact their State Health Insurance Assistance Program, or SHIP, which provides free, unbiased Medicare counseling. They can also speak with a licensed local Medicare insurance agent or broker who can explain available Medicare Advantage and Part D options.

When working with an agent, it is worth asking which insurance companies and plans the agent represents, since not every agent offers every plan available in an area.

The lesson is simple.

Before throwing away that thick Medicare envelope, open it.

It may be the clearest preview you get of what next year’s health care will cost.