I'm 72 and don't have Part D. I don't take any medications at this time.
You're a very healthy 72-yr-old! Congrats!
I think what stopped me was the fact that I could have chosen a plan and then been put on some expensive drug that wasn't on the plan . I then would have to pay out of pocket for the drug until the next enrollment period to change to the plan that did have that drug.
That's a potential problem, but it really doesn't come up all that often. When it does, there are provisions for both "formulary exceptions" and "tiering exceptions." If you need a drug that is not on the carrier's formulary, you request a formulary exception. Here's what CMS (the agency that runs Medicare & Medicaid says about that:
Exceptions requests are granted when a plan sponsor determines that a requested drug is medically necessary for an enrollee. Therefore, an enrollee's prescriber must submit a supporting statement to the plan sponsor supporting the request.
See
Exceptions.
And then there is the donut hole that you have to pay full price out of pocket until you are eligible again. I researched this a few years ago so this all may have changed.
In 2017, the "coverage gap" ("donut hole") begins when you (via deductibles -- if any -- and co-pays) and your insurer have
together paid $3,700 for prescription drugs. While you are in the coverage gap, you usually pay 40% of the plan’s cost (that's their negotiated cost with the pharmacy/manufacturer/distributor,
not the retail price) for brand-name drugs and 51% of their cost for generic drugs. That continues until your out-of-pocket costs hit $4,950 (this year). After that, you're in the "catastrophic coverage phase" and from then until the end of the year, you pay only a small co-pay for covered medications.
See
The Medicare Part D Coverage Gap (“Donut Hole”) Made Simple (not official, but very good info).
Also, it's a really good idea to call your
State Health Insurance Assistance Program, for good answers to most questions!
