If your parent has a Medicare Advantage plan, there is probably a thick envelope somewhere on their kitchen table that says “Annual Notice of Change.” It is easy to skim, and it is the single most useful piece of mail they will get this fall. Open enrollment runs October 15 to December 7, 2026, and the notice tells you what is different about their plan next year.
This guide explains what to look for in that notice, what the new 2027 Star Ratings do and do not tell you, and what to do if the plan no longer fits. We are an independent research site, not Medicare counselors, and nothing here is personal advice. For your parent’s own situation, a free SHIP counselor is the right person to ask.
Key numbers at a glance
In this guide
What the Annual Notice of Change is
The SHIP National Technical Assistance Center, which supports the State Health Insurance Assistance Programs, says people with a Medicare Advantage or Part D plan should receive an Annual Notice of Change and an Evidence of Coverage by September 30. The notice lists the changes to the plan for the coming year. If your parent did not get one, SHIP says to contact the plan and ask for copies.
Fall open enrollment runs October 15 to December 7. Medicare says that during it your parent can change their Medicare health or drug coverage for 2027, if they decide to. Staying put is a valid choice. The point of the notice is to make that choice on purpose, not by default.
What to read in it, in order
SHIP names three areas to compare, and they are a good order to work in. Have a list of your parent’s medicines, pharmacy and doctors beside you.
- Drugs first. SHIP warns that a drug covered this year may not be covered next year, and that its cost can change even if it stays on the list. Check every medicine on your parent’s list, and the pharmacy they use.
- Doctors and hospitals. SHIP says doctors and pharmacies can fall out of a plan’s network, and out-of-network care may not be covered. Look up your parent’s own doctors, not just the plan’s general network.
- Costs. SHIP notes that deductibles and copayments can change, and that a plan with no deductible one year may have one the next. Look at copays for the services your parent actually uses, such as specialists.
- Extras. Look at dental, vision and any allowances your parent uses. The reporting we describe below suggests these are the benefits worth checking for changes.
- Anything that looks different. If a section is shorter, or a benefit your parent relies on is missing, that is the line to ask the plan or a counselor about.
Our own tip, not an official rule: use a highlighter. Mark every line that differs from this year, then take only those lines to the decision.
What the benefit-cut headlines do and do not tell you
Axios reported on September 10 that Medicare Advantage plans “appear” to be cutting benefits in 2027. According to the article, the benefits at risk include “giveback” benefits that help pay Part B premiums, major dental coverage, specialist copays and out-of-pocket drug costs, and some plans reportedly cap enrollment during the sign-up period.
It is worth knowing what that reporting is built on. Axios’s main source is an analyst note based on broker commentary, alongside a survey of 35 health plan leaders, of whom nearly 70% expected less rich benefit packages in 2027. The companies named declined to comment on the note. That is a reason to check, not proof that your parent’s plan has changed. The notice in your parent’s mailbox is the fact; the headline is the warning.
Our Medicare open enrollment checklist has the average premium and plan-count figures for 2027.
What the 2027 Star Ratings mean
CMS published the 2027 Star Ratings on Medicare Plan Finder on October 8. According to its fact sheet:
- The average overall rating for Medicare Advantage plans with drug coverage is 3.99 for 2027, down from 4.01 for 2026.
- About 71% of enrollees are in contracts projected to have four or more stars.
- The ratings measure the quality of the health and drug services enrollees receive, and they are meant to help people compare plans alongside benefits and costs.
Fierce Healthcare, reporting on the release, adds that about 44% of nonprofit plans earned at least four stars compared with 34% of for-profit plans, and that the number of rated contracts keeps shrinking (508 for 2027). It also notes that a court case over how scores are calculated is ongoing, so ratings may still change.
How to use a star rating as a caregiver. A 4.5 plan with the wrong network is the wrong plan for your parent, and a 3.5 plan with their doctors, their drugs and a low cost may be the right one. These are our suggestions, not CMS guidance: use stars to put a plan on or off your shortlist, then decide on drugs, doctors and total cost. The official Plan Finder lets you enter the real drug list and pharmacy.
Other fall mail worth opening
SHIP’s page on open enrollment mail lists several notices besides the Annual Notice of Change. Two matter for families.
- Plan non-renewal notice (October). SHIP says this is sent if a plan is leaving Medicare next year. Coverage ends January 1, so a parent who does nothing may face a gap.
- Consistent poor performance notice (late October). SHIP says this goes to people in plans rated three stars or fewer for three or more years in a row, and encourages looking at other options.
SHIP also notes that plans have rules about marketing, and cannot, for example, call or email people they have no relationship with. Treat unsolicited calls cautiously and confirm anything in Plan Finder or with a counselor.
Stay, switch, or ask for help
- The notice shows no problem. Drugs, doctors and costs look fine: staying is a legitimate outcome. Note the date you checked.
- One piece looks worse. Compare two or three alternatives in Plan Finder with the real drug list. Weigh the total yearly cost, not just the premium.
- Several pieces look worse, or the plan is leaving. Book a free SHIP counselor before December 7. They are independent and do not sell plans. Find yours at shiphelp.org, or call 1-800-MEDICARE (1-800-633-4227).
- You are past December 7. Medicare & You says that from January 1 to March 31 a person in a Medicare Advantage plan can change to a different Medicare Advantage plan or switch to Original Medicare. Confirm your parent’s situation with a counselor.
If you live far away, our long-distance caregiving guide explains how to get your parent’s written permission so you can speak to plans and counselors for them. If the review turns up questions about home care or home modifications, our Medicare coverage guide sorts common aging-in-place products into what is typically covered and what usually comes out of pocket.
A printable checklist
Print this page, or download the one-page PDF checklist, and tick it off with your parent.
- Found the Annual Notice of Change and the Evidence of Coverage (or asked the plan for copies)
- Wrote down every medicine, dose and pharmacy
- Checked each medicine against the plan’s 2027 drug list
- Checked each doctor, specialist and hospital against the 2027 network
- Compared deductibles and copays for the services used most
- Checked dental, vision and any allowances your parent uses
- Looked up the plan’s 2027 Star Rating in Plan Finder
- Marked every line that differs from this year
- Decided: stay, compare, or book a SHIP counselor (by December 7)
- Kept a copy of the final choice and the date
The Aging Parent Emergency Info Sheet
Medications, contacts and legal info on one page, ready for a paramedic or hospital.
Common questions
What is the Annual Notice of Change?
It is a notice from a Medicare Advantage or Part D plan listing what will change in the plan for the coming year. The SHIP National Technical Assistance Center says plans should send it, along with the Evidence of Coverage, by September 30. It is the quickest way to see what is different before open enrollment ends.
What if my parent never got the notice, or threw it away?
SHIP says to contact the plan and ask for copies. You will generally need your parent's permission to speak to the plan for them. The plan's member services number is printed on the back of the plan card.
Does a higher star rating mean a better plan for my parent?
Not necessarily. CMS says Star Ratings measure the quality of health and drug services that enrollees receive, and that they help people compare plans alongside benefits and costs. They do not tell you whether your parent's doctors are in the network, whether their drugs are covered or what the plan will cost them. Use the rating as one input, not the decision.
Are Medicare Advantage plans really cutting benefits for 2027?
Axios reported on September 10 that plans appear to be cutting benefits, but its reporting rests on an analyst note built on broker commentary and a survey of health plan leaders, not on a count of every plan. Whether your parent's plan is cutting anything is in their own notice. Read it rather than relying on the headline.
What if my parent picks a plan and regrets it?
Medicare's Medicare & You handbook says that if your parent is in a Medicare Advantage plan, they can change to a different Medicare Advantage plan or switch to Original Medicare from January 1 to March 31. During that period they cannot switch from Original Medicare to a Medicare Advantage plan. Rules differ by situation, so confirm with a SHIP counselor.
Can I do this for my parent without them present?
Generally the plan and Medicare will need your parent's permission before they discuss the account with you. Ask 1-800-MEDICARE or a SHIP counselor what is needed. Our long-distance caregiving guide covers written permission and who decides if a parent cannot.
One important caveat
This guide is general information for caregivers and is not medical, legal, or financial advice. Plans, prices and rules change and differ by plan and area. For decisions about your parent’s coverage, talk with a SHIP counselor or Medicare directly. We are not affiliated with any plan, and we earn nothing from plan enrollments.
Sources
CMS, 2027 Medicare Advantage and Part D Star Ratings fact sheet (averages, the 71% figure, what the ratings measure, publication date and open enrollment dates). Fierce Healthcare, CMS: about 71% of MAPD plan enrollees in coverage with four or more stars for 2027 (nonprofit versus for-profit shares, contract count and the ongoing court case). Axios, Medicare Advantage plans appear to be cutting benefits in 2027 (September 10). SHIP National Technical Assistance Center, open enrollment mail (notice timing, what to compare, other fall notices). Medicare & You handbook, medicare.gov (open enrollment and January to March rules, from the excerpt we could read). We opened each of these in October 2026. The reading order, the highlighter tip and how to use stars as a caregiver are our own suggestions. We welcome corrections through our contact page.