Q: I do not have prescription drug coverage and am not sure if I should sign up. I am thinking about doing nothing.

A: Doing nothing is making a decision … you are choosing not to enroll. The Medicare Prescription Drug plans are voluntary, and it is OK if you choose not to sign up. You do need to understand the consequences.

If you do not have prescription drug coverage that is as good as, or better than Medicare’s, you may be charged a penalty of 1 percent per month that you delay enrollment after May 15. The next annual open enrollment is Nov. 15 to Dec. 31 with coverage starting January 2007.

That is a seven-month delay if you do not sign up by May 15. That translates into a 7 percent penalty that you will always pay in addition to your premium. If you wait until 2007 open enrollment (Nov. 15 to Dec. 31, 2007 with coverage starting January 2008) your penalty would be an additional 12 percent (for the 12-month delay) plus the 7 percent from 2006 for a penalty of 19 percent in addition to your premium.

Perhaps a bigger concern than any possible penalties is being caught without coverage. Even if you currently do not take any medications, you never know when you may develop the need for expensive prescriptions. With limited signup periods, you could end up with costly prescription bills and no help to pay for them.

Another comment I frequently hear is a concern that the plans cost money (premium, co-pays, deductible). These plans are prescription insurance so you do have to pay a portion of the cost although most of the cost is actually paid by Medicare. Also, the more medications you use, the more you save. But even if you do not take many medications, signing up should still save you money.

If you take no medications, you need to consider the peace-of-mind factor. There are plans available for just over $12/month. For about $150 a year, you have coverage just in case you need any prescriptions and you would avoid any future penalties. Just like you buy homeowner’s insurance and hope you never have a fire, prescription insurance covers you and gives you peace of mind.

Once you choose a plan, remember you are only committed to that plan for the calendar year. You will have a chance to re-evaluate and switch plans every year during annual open enrollment (Nov. 15 to Dec. 31 with coverage starting the following January). I know many of you are suffering from the deer-in-the-headlights syndrome. You are stuck and can’t move. Remember, in-person, one-on-one help is available at your local SHIIP. (Call 1-800-452-4800 for your local number.)

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