If you’re enrolled in a Medicare Advantage (Part C) or prescription drug (Part D) plan, you’ll receive an annual EOC form. If you have Original Medicare (Parts A and B), you won’t receive an EOC form because your benefits, costs, and copayments are standardized.
The form explains your coverage for the upcoming year, which may have slightly changed from the previous year. It’s important to carefully review this form to ensure your plan still meets your needs.
While the formatting and organization of EOC forms may vary across different insurance companies, each should include:
- the amount you’ll pay each month for your premium
- your out-of-pocket costs for coinsurance, deductibles, and copayments
- a list of covered and noncovered services
- cost differences between in-network and out-of-network providers or pharmacies
- where you can find a listing of in-network providers and pharmacies as well as the plan’s formulary (a list of covered drugs)
Medicare requires Part C and Part D companies to send EOC information to enrollees by October 15, the beginning of the open enrollment period.
How you receive the form will depend on how you told your benefits company to communicate with you. Some will send a printed copy by mail, whereas others may send an electronic copy via email.
It might be helpful to think of an ANOC form as a highlight reel of any changes from the previous year. It’s usually only a few pages long.
An EOC is designed to help you understand the costs and benefits associated with your plan. The EOC can be hundreds of pages long and includes details on premiums, deductibles, copayments, and coinsurance.
EOC and ANOC forms are typically mailed or emailed together.
Once you receive these documents, you can evaluate whether your coverage still meets your needs. Here are some of the actions you can take.
If your plan is ending
Sometimes, the ANOC informs you that your plan will no longer contract with Medicare or provide coverage in your service area.
If so, you can switch to Original Medicare or select a new Part C and/or Part D plan.
If your coverage doesn’t meet your needs
If you determine that your plan’s coverage for the upcoming year no longer meets your needs, you can search for a new Part C and/or Part D plan.
Medicare’s open enrollment period is from October 15 through December 7 every year. During this time, you can select a new Part C and/or Part D plan or switch to Original Medicare.
If your prescription drug coverage is bundled into your Medicare Advantage plan and you want to switch to Original Medicare, you must enroll in a Part D plan.
If you’re happy with your current coverage
If you don’t wish to change your current coverage, you don’t have to take any extra steps. Your coverage will continue as outlined in your EOC document.
If you didn’t receive your EOC form by October 15, contact your plan provider. They should be able to quickly issue you another EOC document.
If you have an online account with your Part C or Part D company, they’ll usually include this information as part of your account documents.
Even if you aren’t sure whether you’ll change your Part C or Part D plan, you can evaluate other available plans to comparison shop.
To get free health insurance counseling, contact your local State Health Insurance Assistance Program (SHIP). To find a program near you, call the SHIP National Technical Assistance Center at 1-877-839-2675.
If, for any reason, your Part C or Part D company refuses or fails to issue you an EOC document, you should report this to Medicare.
You can call Medicare at 1-800-633-4227 (TTY: 1-877-486-2048) 24 hours a day, 7 days a week, excluding some federal holidays.
Use the EOC, along with your ANOC, to determine whether you want to change your health plan or keep it as is for another year.
You have from October 15 through December 7 to enroll in a new plan or switch to Original Medicare. If you’re happy with your current coverage, you don’t need to do anything.