Every September, people enrolled in Medicare Advantage and Medicare Part D plans receive an Annual Notice of Change (ANOC), spelling out changes in coverage, costs and other plan rules that will take effect the following January. Depending on the plan, that can include changes to premiums, deductibles, drug formularies, pharmacy or provider networks, and cost-sharing. It’s a dense, table-heavy document, and it’s easy to skim or skip entirely.
If you’re a federal retiree, whether you receive an ANOC — and how important it is — depends on exactly how your Federal Employees Health Benefits (FEHB) coverage and Medicare coverage fit together. That’s become more complicated as some FEHB plans have added Medicare Advantage options and Medicare Part D prescription drug coverage for Medicare-eligible members.
Here’s a scenario-by-scenario answer.
Scenario 1: You have FEHB only, no Medicare
You won’t receive a Medicare ANOC because you aren’t enrolled in a Medicare health or drug plan. Your coverage runs through your FEHB plan. Your task each fall is reviewing your FEHB carrier’s updated plan brochure and Open Season information, not waiting for a Medicare plan notice.
Scenario 2: You have FEHB and Medicare Part A only
Medicare Part A by itself doesn’t generate an ANOC. Many federal retirees enroll in Part A when they’re eligible because they qualify for premium-free coverage while continuing their FEHB enrollment.
But there’s an important wrinkle: having only Part A on your Medicare card doesn’t necessarily mean you have no Medicare Part D coverage.
Some FEHB plans automatically enroll eligible Medicare beneficiaries in a Medicare Part D Employer Group Waiver Plan (PDP EGWP), generally with an opportunity to opt out. The rules vary by FEHB plan. That means you could have FEHB and Part A and also be enrolled in Medicare Part D through your FEHB carrier.
If that’s your situation, pay attention to the Medicare drug-plan materials you receive as well as your FEHB plan’s annual brochure and Open Season information.
Scenario 3: You have FEHB and Medicare Parts A and B
For most retired federal employees with Medicare Parts A and B, Medicare is generally the primary payer and FEHB is secondary. Some FEHB plans waive or reduce deductibles, copayments and coinsurance when Medicare pays first, which can make the combination significantly different from FEHB coverage alone.
Whether you receive an ANOC depends on your specific FEHB plan and Medicare arrangement.
If you simply have Original Medicare Parts A and B plus traditional FEHB coverage, without Medicare Advantage or Medicare Part D plan enrollment, there generally isn’t a Medicare health or drug plan ANOC to review. Your FEHB brochure and other annual plan materials remain your primary documents for FEHB changes.
But some FEHB plans offer Medicare Advantage options specifically for their Medicare-eligible members, and some provide Medicare Part D coverage through a PDP EGWP. If you’ve enrolled in — or been enrolled in — one of those Medicare arrangements through your FEHB carrier, you may receive separate Medicare plan materials describing changes for the coming year.
Don’t assume that because you never went out and purchased a Medicare Advantage or Part D plan yourself, you don’t have Medicare plan coverage beyond Parts A and B. Check your FEHB plan documents and Medicare-related mail to see exactly how your coverage is structured.
Scenario 4: You have FEHB plus an individual Medicare Advantage or stand-alone Part D plan
Now the ANOC definitely deserves your attention. If you’re enrolled in a Medicare Advantage or stand-alone Part D plan, review its ANOC carefully, particularly changes to premiums, deductibles, drug formularies, pharmacy or provider networks, and cost-sharing.
You should also review your FEHB plan’s annual brochure and Open Season materials separately because FEHB remains part of your coverage picture as long as you maintain the enrollment.
There is another important FEHB rule to know if you enroll in Medicare Advantage. Federal annuitants may be able to suspend FEHB while enrolled in an eligible Medicare Advantage plan rather than canceling FEHB outright. Suspension can preserve the ability to return to FEHB later, though generally only at the next Open Season, unless you involuntarily lose the Medicare Advantage coverage or move out of its service area. Canceling FEHB as an annuitant, by contrast, is generally permanent.
Scenario 5: You no longer have active FEHB and rely on Medicare Advantage, or Original Medicare plus Part D
If you no longer have active FEHB coverage, the annual Medicare notices become even more important.
If you have a Medicare Advantage plan, its ANOC tells you what is changing for the following year. If you use Original Medicare and a stand-alone Part D prescription drug plan, the Part D ANOC tells you what’s changing with your drug coverage. Remember that Part D by itself is prescription drug coverage — it is not a substitute for Medicare Parts A and B or a Medicare Advantage plan.
Pay particular attention to changes affecting the drugs you take, your pharmacy, your doctors and hospitals if you’re in a network-based plan, and your expected out-of-pocket costs.
And if you’re considering leaving FEHB for Medicare Advantage, understand the distinction between suspending and canceling FEHB before making the change. An eligible annuitant who suspends FEHB for Medicare Advantage can generally return to FEHB at the next Open Season, or sooner in limited circumstances, under OPM’s rules. An annuitant who simply cancels FEHB generally cannot return at all.
| Your coverage | Do you get an ANOC? | What to review |
|---|---|---|
| FEHB only | No | FEHB brochure and Open Season materials |
| FEHB + Medicare Part A only | Depends — see note below | FEHB brochure and Open Season materials; also check for Part D auto-enrollment |
| FEHB + Medicare, with an FEHB-linked Part D plan | Yes, Medicare plan materials apply | Medicare drug-plan materials and FEHB materials |
| FEHB + Medicare Parts A & B, with no Medicare Advantage or Part D plan | Generally no Medicare plan ANOC | FEHB brochure and Open Season materials |
| FEHB + FEHB-linked Medicare Advantage coverage | Yes, Medicare plan materials apply | Medicare Advantage and FEHB materials |
| FEHB + individual Medicare Advantage or stand-alone Part D plan | Yes | ANOC and FEHB materials |
| No active FEHB + Medicare Advantage | Yes | Medicare Advantage ANOC |
| No active FEHB + Original Medicare + stand-alone Part D | Yes, for the Part D plan | Part D ANOC and Medicare materials |
Note: Having only Medicare Part A doesn’t rule out Part D coverage. Some FEHB plans automatically enroll eligible Medicare beneficiaries in a Part D plan (a PDP EGWP) with Part A alone, so check your mail for Part D materials even if you’ve never shopped for a drug plan yourself.
If you’re not sure which scenario fits
The most common mistake may not be ignoring an ANOC. It may be not knowing exactly what Medicare coverage you have.
That’s particularly important for federal retirees because some FEHB plans now coordinate with Medicare through Medicare Advantage or Medicare Part D arrangements. In some cases, eligible members may be automatically enrolled in a Part D plan unless they opt out. So the fact that you never personally shopped for a Part D plan doesn’t necessarily mean you aren’t enrolled in one.
If you’re uncertain, check your FEHB plan brochure, Medicare-related plan materials and Medicare coverage information before Open Season. The important question isn’t simply whether you received an ANOC. It’s what coverage you actually have, what is changing next year, and whether that combination still makes sense for you.