Seeing the long lists of drugs that some people are on does make me wonder how many of them are necessary. The other side of the coin is that a lot of those people would be worse off (or dead) without having control of their hypertension, blood sugar etc. Lifestyle and diet are certainly important, as are genetics and just plain luck. You'll hear about people who don't exercise, smoke and drink to excess and yet survive to old age with few problems. Most of us can't get away with that. I am similarly skeptical about people who proudly talk about how they don't need prescription drugs, have superior immune systems so they don't need immunizations etc. Their good fortune up till now is no guarantee against what they'll face in the future, without taking reasonable steps to lower risks of preventable health problems.

Early detection is key to cancer survival rates and England does not cover early screening as well as many other countries do and thus they are near the bottom of many cancer survival stats with the Us, Japan and France at the top of a 2008 study of five common cancers. In our country those on government healthcare fare much worse than those with private insurance, food for thought. It seems that poorer people everywhere fare worse than those with more. This article is very recent and informative for comparing life expectancy and treatments between countries. You may be surprised but if you take away accidental deaths(cars, violence, overdoses) guess which country has the highest life expectancy, yes the USA does. The new OECD ten year study has not been published yet and the chart in the link is the most recent data available so this might change but probally not that much. Here is a link that might be useful: wealth begets health

You really might want to consider the former employer's pharmacy plan - but where I'm a bit confused... if your husband goes for the pharmacy plan for drug coverage and that proves satisfactory - why would there be a need for a switch to the Medicare Part D in 2012? He would, in effect, be dropping his creditable coverage and that creditable status doesn't carry over to a new plan (ie Medicare Part D because they don't care what you might have had), and would be subject to the forever penalty. Creditable is just comparing what you have against whatever else is out there. An actuarial firm determines that your plan offers Rx coverage that is equal to or better than Medicare Part D. Should be easy enough for him to get the boiler plate notice of "creditable" insurance for drugs from his former employer to keep in his files if he goes with what they're offering. In fact, it's a requirement that the notice be sent each year. It's an unimpressive few sheets of paper stating simply: The Society (I'm retired from the Nat'l Geographic Society) is required to issue this annual notice to participants. Then it goes on to explain Medicare Part D, why I don't need it, why I can't be covered for drugs under more than one plan, and what happens if I drop what I have for something else. I still think that the Medicare Part D penalty is imposed whenever it is not signed up for when you initially become Medicare eligible at 65. Guess I would check with the former employer - HR there should be on top of what they offer. And I'd call Medicare too - or your closest SS office. I found the people at our Social Security office really helpful - on the phone and in person.

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'.