It is confusing, Mare...and that's what got me into trouble in the first place. Let me see if I can explain my particular issue to further clarify why I'm being charged a penalty. When my husband died a few years ago, all my benefits died with him due to an agreement he had made with the PBA long before he even knew me. His decision, unfortunately, was irreversible. Throughout our married life...all contact involving his benefits package had to be made by him even though I was covered under all his plans, therefor I was often left in the dark about what the plan included and who the carriers were. I was already enrolled in Medicare when he passed and knew that I would have to replace the supplemental policy he'd had for me with BC/BS. I did so immediately. What I didn't know was that I had to replace the Medicare D policy. I had never needed it and had no idea what it was let alone the fact that it existed as part of his benefits package. To make matters worse, the PBA didn't notify me that I had to replace this coverage with a policy of my own choosing. I went for almost 4 years without realizing that I was in default with Medicare. Fortunately, it was brought to my attention and I applied for a policy but in so doing, I learned that I was going to be penalized for the time that had lapsed between the loss of my husband's coverage for me and my "awakening". The penalty is based on a formula...1% of the policy monthly premium...times the number of months that one goes without coverage. It was a substantial amount to me and I had limited recourse. I contacted Medicare and filed a challenge. They agreed that I had a basis for my challenge. They reduced the penalty by 12 months...but said ignorance of the law was no excuse and I was left responsible for the remaining month's penalty. The penalty is NEVER removed. From now until the day I die...I will have that penalty added to whatever Medicare Part D plan I carry. My only hope to be relieved of this burden is that two US high courts agree with me...that the penalty, along with the Federal edict to force people to carry health insurance above and beyond Medicare...is illegal. If the Supreme Court agrees with the two lower courts, the entire forced insurance system will be reversed and my penalty will be dropped. Needless to say, I'm anxiously awaiting their decision. I hope this gives you a little more info. If you are already enrolled in Medicare, the booklet that they send out every year will give you more information. Or, you can call their office. I've found them to be very helpful...even thought I don't always agree with them. As long as you get Medicare Part D coverage as soon as you're eligible, you shouldn't have to worry about a penalty...unless somewhere along the line you decide to drop the coverage...and then pick it up again at some later date. You'd be penalized for the lapsed coverage time. HTH Anne

dedtired -- There are 'advantage' plans that are PPO's. DH's former employer offered us one from Aetna for 2012 and I seriously considered it because our expensive meds were much, much less for us under that plan. However...it left us open to 20% copays. (This one was basically Medicare benefits plus a drug plan.) Our MD and hospitals did accept this 'advantage' PPO. It paid the same for in- and out-of-network doctors. Look at what you will get just from Medicare. It covers a lot of 'normal' stuff, like an annual 'wellness visit' (mini-physical), mammograms, colonoscopy, flu shots, other 'preventive' services. You may not need enough more to warrant buying a supplementary policy, depending on your health. At 70 and 73, we decided to continue with the Aetna 'medigap' supplement we had for 2011. It's $744/year for both of us and pays the 20% Medicare doesn't pay. Example: The doctor bills $300 for a service, but he accepts Medicare assignment. The Medicare-approved cost of his service is $100. Medicare pays $80. Our Medigap policy pays $20. He can't bill for his 'missing' $200 because he's agreed to take Medicare assignment. Our medigap policy will also pay a bit more for the MD who 'balance bills'. This MD can bill 15% more than the Medicare-approved fee, and our supplementary policy will pay it. In 2011 we had zero doctor, lab or diagnostic bills. Medicare and our supplement paid everything. I think our 20% copays on our bills might not have totaled as much as we paid for the policy in 2011, but I don't want to gamble about 2012. (And, the premium actually DEcreased.) If you don't anticipate needing expensive prescriptions, take the cheapest-premium Part D plan. It you DO have expensive prescriptions, tally the premium and what your drugs will cost under a plan. As long as the insurance and pharmacutical companies own Congress, this is the way we have to live.

I am embarrassed that I didn't remember that the deductible was 'in there' as part of the annual premiums. (Maybe I'm old?) It's annoying to have to shop Part D *every year*. It's a rare year that one or both of us can stay with the same plan from year to year. Our medications change -- maybe go generic (hahaha). DH's doses change. One plan considers XYZ Med a Tier Two; another says it is Tier Three. Each plan has its 'preferred' pharmacy chain. (Most years our plans have *different* preferred pharmacies -- two trips required.) Mail order is often more, rather than less. In 2017 I discovered that one of DH's meds costs the same whether the tablet is a 2mg or a 5mg. His MD is fine with buying the 5mg and using a pill splitter to get four doses. BTW, I am giving up on finding a cheaper alternative to Advair. Symbicort is only $25 cheaper per month (retail); I don't know how I'd react to it; and I'm charged the same out-of-pocket for it as for Advair. Good thing I hadn't already spent my 'savings'.

You are required to have a Part D plan if you have Medicare. You will be penalized later if you haven't signed up for Part D coverage when you are eligible for it. If you have few meds or very inexpensive ones, take the plan with the cheapest premium. DH often goes a whole year without using half of a plan's scary-big 'deductible' (over $400 in recent years, and most plans have them). ALWAYS search the Part D plan offerings for the coming year, and check with the insurer to be certain the information on the Medicare.gov site is correct -- regarding the premium and the cost of each drug. "Mistakes are made," early on as the companies are submitting their information to Medicare. Other nations control the price of prescription medications without this nonsense of Part D insurance. They only people who benefit from the US system are the insurers and the pharmaceutical companies. Ours is also the only nation to permit advertising of prescription drugs. (Not certain if New Zealand still does this, but they were the only other one.) I have yet to find mail order to be less expensive than a local pharmacy by more than a few dollars.