Key Takeaways

• Reviewing your Medicare documents during the Annual Enrollment Period (AEP) helps you avoid surprise costs in the upcoming year.

• A few key papers contain essential details about coverage changes, cost updates, and plan rules that directly affect your budget and healthcare access.

Understanding Why These Documents Matter

The Annual Enrollment Period from October 15 to December 7, 2025 gives you one window to adjust your coverage for the year 2026. Even if you feel comfortable with your current plan, it can still change its rules, costs, and covered services. Reviewing specific documents gives you the clearest picture of what you may pay in the new year and helps you make confident decisions.

You want to protect your budget, keep coverage stable, and avoid paying more than you should. Carefully reading these materials ensures you catch small details before they turn into bigger financial issues.

Key Documents That Deserve Your Full Attention

AEP comes with several documents, but not all of them carry the same weight. The ones below provide the information that affects your wallet and your access to care in the year ahead.

Annual Notice Of Change (ANOC)

The ANOC arrives each year by late September. It outlines what is different in your current plan for the upcoming year. You want to review this document closely because it highlights changes that affect your costs and coverage.

Important sections to check include:

• Updates to monthly premiums

• Any changes in deductibles and copayments

• Adjustments to out of pocket limits

• Changes to covered services

• Updates to prescription drug costs and rules

This document allows you to compare your current plan’s 2025 structure with what it will offer in 2026. If anything seems unfamiliar or costly, you can use the AEP window to look at other options.

Evidence Of Coverage (EOC)

The EOC is longer and more detailed. It contains every rule related to your plan. You should read the parts that explain how different services are covered. This helps you avoid unpredictable charges.

Key areas include:

• What is considered in network or out of network

• Prior authorization rules

• Coverage limits for certain services

• Billing rules for repeated or long term care

• Details on emergency and urgent care benefits

The EOC helps you understand the full scope of what you can expect throughout 2026. You do not need to memorize the entire document. Instead, focus on sections tied to your commonly used services.

Provider And Pharmacy Directories

Provider directories help you confirm if your doctors, clinics, specialists, and hospitals remain in your plan’s network for 2026. Pharmacy directories list approved pharmacies and mail order options.

You want to check:

• Whether your primary care doctor is still listed

• Whether your preferred specialists will remain in network

• Whether your usual pharmacy is included

Seeing an out of network doctor or going to an out of network pharmacy can significantly increase your costs. The directories ensure your routine visits remain affordable.

Drug Formulary

The drug formulary is a list of medications your plan covers. Reviewing the 2026 formulary helps you stay aware of changes that affect your prescriptions.

Key things to look for:

• Whether your current prescriptions remain listed

• Tier changes that may affect your costs

• Prior authorization or step therapy requirements

• Quantity limits and refill rules

If a medication moves to a different tier or develops new coverage rules, you might pay more starting January 1, 2026. Understanding these changes early helps you plan.

What Should You Look For In These Documents?

Your goal when reading these documents is to identify anything that affects what you pay or how easily you access care. This means comparing what you currently use with what will be different next year.

Are Your Providers Still Covered?

Your doctors play a central role in your care. You want to confirm they remain part of your plan’s network for 2026. Losing access to a familiar doctor can lead to surprise bills or the need to switch physicians.

Make sure to check:

• Primary care

• Specialists

• Hospitals

• Labs or imaging centers

Are Your Prescriptions Still Affordable?

Prescription drug changes can lead to sudden cost increases if you do not notice them ahead of time. Check for new restrictions, tier changes, or removals.

You want clear answers to questions like:

• Does the plan still cover your daily medications?

• Are you responsible for a different cost share in 2026?

• Are any refills limited?

Will Your Out Of Pocket Spending Change?

Your plan may update its cost sharing rules each year. These changes directly affect your budget.

Review sections for:

• New deductibles

• Copayment and coinsurance adjustments

• Out of pocket maximum changes

These details help you plan your healthcare spending for the entire year.

Are There New Rules You Must Follow?

Plans may introduce new rules that affect how you receive care. You want to understand these before you schedule appointments in 2026.

Pay attention to:

• Prior authorization requirements

• Referral needs for specialist visits

• Limits on therapy or rehabilitation services

• Coverage rules for telehealth

How To Stay Organized While Reviewing Your Documents

Staying organized helps you make sense of the updates without feeling overwhelmed. Preparing a short checklist can help keep you focused.

What Should Your Checklist Include?

Your checklist may include:

• Check premium changes

• Confirm deductible and cost share updates

• Review your prescriptions

• Confirm your doctors remain in network

• Check pharmacy networks

• Review rules for specialist visits

• Review the plan’s formulary sections that matter to you

Using a checklist helps you compare plans and identify areas that matter most to your health.

How Much Time Should You Spend Reviewing?

Set aside at least one hour to review your ANOC and EOC. You can divide this into smaller sessions if you prefer. The goal is to read enough to understand your costs for the new year.

Once you finish reviewing, use the remaining AEP period until December 7 to explore your choices if something does not meet your needs.

When Should You Ask For Help?

You may reach a point where the information feels complex or unclear. This is common because Medicare documents use specific terms that may take time to understand.

You should seek help if you:

• Are unsure about cost changes

• Want help comparing multiple plans

• Notice your medications or providers are affected

• Want a second review to confirm your understanding

Asking questions early gives you enough time to make changes before the AEP deadline.

Making Informed Choices For 2026

Understanding your documents empowers you to make confident choices about your coverage. Plans change each year, and the details within these documents help you protect yourself from unnecessary expenses.

Reading these materials carefully, asking questions, and comparing options gives you the best chance to start 2026 with coverage that supports your health and fits your budget.

Staying Prepared For The Year Ahead

Your ability to prevent unexpected costs depends on how well you understand the updates in your Medicare documents. These materials provide clear explanations of what will change on January 1, 2026.

Always take the time to review:

• Your ANOC

• Your EOC

• Your formulary

• Your provider directory

Doing so helps you stay prepared for the year ahead.

Staying Confident With Your AEP Review

Your Medicare documents serve as your roadmap for the next year. When you understand them, you reduce uncertainty and stay in control of your healthcare decisions. If you feel uncertain or want guidance, reach out to any licensed agent listed on this website for support. They can help you understand your choices and make sure your plan aligns with your needs for 2026.