Updates

What changes in Medicare year over year, and where to check

6 min read

Medicare changes every year. Sometimes it's small. A few extra dollars for Part B. Sometimes it's something that actually affects your parent's day-to-day. A drug drops off the plan's list, the doctor network shifts, or one of the office-visit copays goes up. Here's how to catch those changes in time, and when to act.

What federal Medicare changes (Part A and B)

Every fall, the government announces new rates for the coming year. The most common updates are:

Part B premium

Deducted from Social Security each month. Usually rises by a few to a dozen dollars per year.

Part A and B deductibles

The amount your parent pays out of pocket before the plan starts to cover.

IRMAA thresholds

Income-related surcharges on Part B and Part D for higher earners. If your parent's income from two years back went up, their required premium may change too.

Annual out-of-pocket cap on Part D drugs

Since 2025 there's a federal cap on what beneficiaries pay each year for prescription drugs, and that cap moves too.

These changes apply to everyone, regardless of which plan your parent has. The official announcement usually shows up in October or November at Medicare.gov.

What your parent's plan changes (Advantage or Part D)

Plan-level changes are more personal. Every private plan, both Medicare Advantage and standalone prescription drug plans, can change any of the following each year:

• monthly premium and deductible,
• copay for primary care, specialist visits, and ER trips,
• list of covered drugs (the formulary),
• doctor and hospital network, some providers join, others drop out,
• extra benefits (dental, vision, gym discount, over-the-counter card),
• annual out-of-pocket maximum.

The ANOC letter, what arrives in September

Every plan is required to send a notice of changes each September. It's called the Annual Notice of Change, or ANOC for short. It usually arrives as a thick envelope with a multi-page document inside.

Most clients set this letter aside. We get it. It looks like junk mail. But it's the one moment in the year when the plan tells you in writing, "starting in January, things will be different." Even reading just the first five pages is worth it. That's where the changes your parent will actually feel are spelled out.

What's worth checking each year, even if your parent likes their current plan

1. Whether your parent's doctor is still in network for the new year.
2. Whether all of your parent's medications are still on the plan's list, and in the same price tier.
3. Whether the specialist copay has changed (this is a common quiet increase).
4. Whether the plan's service area has shifted, important for snowbirds who spend winter in Florida.
5. Whether the extra benefits your parent uses (dental, vision, transportation) are still in the package.

This is exactly what we do in an annual plan review. It usually takes 20 to 30 minutes, it's free, and it ends with a clear answer. Stay on the current plan, or switch to a different one.

When to act

The fall AEP window (October 15 through December 7) is the standard time to change plans. If the ANOC shows the plan stopped covering your parent's doctor or one of their drugs, that's the moment to consider switching. After December 7, options narrow to the situations described in our guide on the Special Enrollment Period.