Q: All the information I have read about Medicare Part D says there will be a 1 percent penalty if a person doesn't sign up before May 15.

My question is: 1 percent of what? Is it 1 percent of the monthly premium of the plan the person chooses, or of the average national monthly premium? Will the penalty accumulate each month?

A If you're eligible for Medicare but don't enroll in a drug plan by May 15, you cannot enroll until the Nov. 15-Dec. 31 enrollment period for a policy that would take effect Jan. 1. You would be penalized 1 percent a month, or 7 percent for June through December.

The penalty would be based on the average national monthly premium, which for 2007 is expected to be about $25. That means you would pay an extra $1.75 or so each month on top of whatever premium your plan charges for as long as you buy Part D coverage.

If you waited until the open enrollment period at the end of 2007, your penalty would be 19 percent in addition to whatever the average national monthly premium is for 2008.

Q: I am older than 65, have no major health problems, take few or no drugs, and have no idea what health problem will befall me in the future.

Should I choose a plan with the "dartboard technique" in order to prevent the 1 percent monthly late enrollment penalty from kicking in?

With more than 50 plans and variations to choose from here in Central Texas, all with different formularies, co-pays, deductibles and penalties, the odds are greatly against my selecting a plan that will benefit anyone except the insurers.

A: A good place to start might be a Web site sponsored by Medicare Access for Patients Rx, a coalition of nonprofits. It provides answers to common questions and worksheets to help compare plans.

The site (www.maprx.info) should be used in conjunction with Medicare's official site (www.medicare.gov).

The cheapest drug plan I found in your area costs $10.31 a month with a $250 annual deductible. There also is one for $14.13 with no deductible. You might consider these two to get you into the program at a relatively low cost. You could change later without penalty.

The threshold question for you is whether to sign up for any program. If you live long enough, the odds are you will need the coverage, and if you wait a long time, it will be much more expensive.

Q: My mom has been prescribed a drug named Revlimid. This drug was approved by the FDA last month, but as of yet isn't listed on any of the 37 Ohio drug plans. She has yet to sign up for a plan and is waiting to see which plan will cover the drug. There is no generic version.

Is there any way we can find out which plan will eventually cover it?

A: There is no way of knowing in advance which plans will cover a new drug.

Under the Medicare law, each plan must decide within 180 days of FDA approval whether to include a drug on its list of covered medications.

Meanwhile, plans must make the new drug available through the exceptions and appeals process if it is determined to be "medically necessary."

Q: An earlier column implied that Humana would not provide prescription coverage out of the plan's coverage area.

When we signed up for the standard coverage, I specified that we would be out of our plan area for up to five months, and was told that I could get covered at any Humana-approved drugstore in the United States, or items could be mailed.

A: Your Humana plan can be used in any of the 52,000 Humana-participating pharmacies in 46 states (not Alaska, Hawaii, Maine and New Hampshire) if you live within your plan's area for at least six months.

If you live in another area for six months or more, you would have to drop your current plan and enroll in a plan in that area.

Q: If I get a policy with a low premium, can I change in November to a new policy with a different company without incurring the 1 percent penalty? I found a low-cost premium (Humana PDP Standard) of $4.43 per month. Most of the other policies for my area (in Cherry Hill, N.J.) were in the $25-per-month range.

A: Yes, the Humana PDP Standard is a valid policy. The monthly premium is low because the plan imposes a $250 deductible and doesn't cover drug costs once you reach the "doughnut hole" — generally between $2,250 and $5,100 of expenditures.

You may switch to a different plan during the open enrollment period in November without incurring a penalty. You also could switch plans once between now and May 15 without paying a penalty.

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