What's New

Every fall, Medicare Advantage and Part D enrollees receive a piece of mail that's easy to overlook, the Annual Notice of Change, or ANOC. Most people set it aside. That's a mistake.

The ANOC is your plan's official preview of what's changing on January 1. By law, your plan must send it by September 30 each year. Inside, you'll find updates to premiums, drug formularies, copayments, provider networks, and extra benefits like dental or vision. Any one of these changes could affect your healthcare costs or access to your doctors, and the ANOC is your only advance warning.

Why does it matter so much? Because your plan can change significantly from year to year, even if you've been satisfied with it. A medication that was covered last year may have moved to a higher cost tier. A specialist you rely on may have left the network. You won't know unless you read the letter.

The good news: Medicare's Annual Enrollment Period runs October 15 through December 7, giving you a full window to compare plans and make a change if needed. Any switch takes effect January 1. But if you ignore the ANOC and miss that window, you may be locked in for another year.

When your ANOC arrives, it will likely say something like “Important Plan Information” on the envelope. Open it immediately. Read through the entire letter to understand all the changes in Medicare and your plan that may affect you. Check your premium, your medications, and your key providers. Then visit Medicare.gov/plan-compare or call a licensed agent to see whether a better option is available. Your State Health Insurance Assistance Program (SHIP) also offers free, unbiased guidance.

The ANOC is one piece of mail that can save you real money and provide you the opportunity to get the best Medicare plan for your needs. Don't throw it away.

Each June, the Medicare Board of Trustees releases its annual financial outlook, and each year the headlines that follow tend toward alarm. The 2026 report, published June 9, projects that Medicare's Hospital Insurance trust fund will reach insolvency by 2033. So should beneficiaries be worried?

The honest answer is: the situation is serious, but it's not what it sounds like.

"Insolvency" doesn't mean Medicare disappears. It means the Part A trust fund, which covers hospital care and is funded by payroll taxes, would no longer have enough reserves to cover 100% of costs. After 2033, incoming revenues would cover roughly 89 cents of every dollar Medicare spends on hospital care. Benefits wouldn't vanish, but they could be reduced unless Congress acts first.

And that's the key context: Congress has never allowed Medicare to reach insolvency. Every time the program has approached a projected shortfall, lawmakers have stepped in. That's not a guarantee, but it is an unbroken pattern.

What is real right now: costs are rising. Medicare spending exceeded $1.2 trillion in 2025. The Part B premium crossed $200 per month for the first time in 2026. These trends affect beneficiaries today, regardless of what happens in 2033.

The most productive response isn't panic — it's preparation. Review your plan each Annual Enrollment Period (October 15 through December 7). Check whether you qualify for Medicare Savings Programs, which can help cover premiums and cost-sharing. Ask about Extra Help for prescription drug costs. A licensed agent or your State Health Insurance Assistance Program (SHIP) counselor can help you find savings you may not know exist.

The Trustees Report is a signal designed to prompt policymakers to act. For beneficiaries, it's a reminder to stay informed and plan ahead.

There's a financial risk built into ACA Marketplace coverage that most enrollees don't fully understand, and a 2026 rule change just made it significantly larger.

Here's how it works: when you enroll in a Marketplace plan and receive advance premium tax credits, the government bases your subsidy on your estimated annual income. At tax time, it reconciles your estimate against what you actually earned. If your income came in higher than expected, you repay the difference.

Under the rules that existed before 2026, repayment amounts were capped for lower-income enrollees, providing a safety net for people with unpredictable earnings. The One Big Beautiful Bill Act, enacted in 2025, eliminated those caps. Starting with the 2026 plan year, there is no ceiling on how much you may owe back, regardless of income level.

This change hits hardest for people with variable income: freelancers, gig workers, small business owners, part-time employees, or anyone who experiences a mid-year raise, a new job, or a change in household size. A good year financially can translate into an unexpected tax bill.

The good news is that this risk is manageable with awareness and a few practical habits. Report income changes to your Marketplace as soon as they happen — you can adjust your advance credit amount at any time. When in doubt, estimate your income slightly higher at enrollment: a smaller credit now means a refund at tax time rather than a debt. And if your income is complex or variable, it's worth talking to both a tax professional and a licensed insurance agent before you enroll.

The advance premium tax credit is still one of the most powerful tools in the ACA. Used carefully, it keeps coverage affordable. However, if you don't keep your income updated in the Marketplace, it can come with a costly surprise.