Confusion is top response at sessions on Rx plan

WASHINGTON — Enrollment in the new Medicare drug benefit begins on Tuesday, but even with President Bush hailing the plan on Saturday as "the greatest advance in health care for seniors" in 40 years, large numbers of older Americans appear to be overwhelmed and confused by the choices they will have to make.

"I have a Ph.D., and it's too complicated to suit me," said William Q. Beard, 73, a retired chemist in Wichita, Kan., who takes eight prescription drugs, including several heart medicines. "I wonder how the vast majority of beneficiaries will handle this. I fervently wish that members of Congress had to deal with the same health-care program we do."

Beard was interviewed at First United Methodist Church in Wichita, Kan., where he and 100 other members of an adult Sunday school class recently received a two-hour explanation of the drug benefit from a state insurance counselor.

Confusion was a dominant theme at education and counseling sessions held over the last two weeks in Wichita and in Glen Burnie, Md.; Fairfax, Va.; Urbana, Ohio; and Santa Rosa, Calif.

"The whole thing is hopelessly complicated," said Pauline H. Olney, 74, a retired nurse who attended a seminar at a hotel in Santa Rosa, north of San Francisco.

The drug benefit, estimated to cost $724 billion over 10 years, is the biggest expansion of Medicare since its creation in 1965 and is often described as Bush's biggest achievement in domestic policy.

Bush administration officials and other backers of the plan say the new program can cut drug costs in half for a typical beneficiary, to $1,120 a year, with much greater savings for low-income people. In his radio address on Saturday, Bush said, "If you or someone you love depends on Medicare, I urge you to learn about the new choices you have so you can make a decision and enroll."

Beneficiaries around the country are flocking to Medicare workshops, where experts present them with complicated descriptions of drug formularies, "tiered co-payments," "creditable coverage" and "true out-of-pocket costs," and caution about penalties for late enrollment.

In most states, beneficiaries have a choice of more than three dozen prescription drug plans. Premiums, deductibles, co-payments and covered drugs vary widely. Many retirees also have other options: getting drug coverage through former employers or through Medicare-managed care plans.

In Kansas, Medicare beneficiaries have a choice of 40 prescription drug plans charging premiums from $9.48 a month to $67.88 a month.