Millions of America's senior citizens can take advantage of the nation's new Medicare Part D prescription drug coverage starting New Year's Day. But to do so they have to choose between a dizzying array of insurance plans.

"It's very confusing to the general public," said elderly Cape Girardeau resident Doyle Sample as he ate lunch at the local senior center on Wednesday.

Across the nation, 17 companies are offering a combined total of 42 different prescription drug plans.

Sample, who currently spends about $3,000 annually on prescription medicine, has enrolled in one of the plans. He expects to cut his drug bill nearly in half in 2006.

It's estimated that 21 million elderly and disabled people will begin using the drug plans starting Monday.

Americans began enrolling in the new drug plans on Nov. 15. The U.S. Department of Health and Human Services expects about 28 million people to sign up by May 15 when the initial enrollment period ends.

Those who sign up after the deadline will be charged higher premiums, amounting to a 1 percent penalty for each month they delay, according to the government.

But local pharmacists, social service organizations and even the elderly themselves say there's no single plan that fits everybody's need.

Americans enrolled in these plans typically must pay a $250 deductible as well as a monthly premium.

Brandi Hamm, office manager for Broadway Prescription Shops Inc., has spent much of her work days since Dec. 1 advising elderly customers on which plans would serve them best.

"It's crazy around here," she said

Hamm said she's met with nearly 100 senior citizens this month. Most have enrolled in drug plans, she said.

Even those with low prescription drug costs may benefit, Hamm said.

One elderly woman currently spends $588 a year on five prescription drugs. Hamm said enrolling in a drug plan will save the woman about $100 a year.

For those with high prescription expenses, the savings could be substantial, Hamm said.

A person spending $10,000 a year on prescription drugs could lower his or her bill to about $4,000, she estimated.

Ben Tally, who manages Medicap Pharmacy in Cape Girardeau, suggests the Medicare drug plans likely won't benefit those have less than $2,000 a year in prescription drug costs.

Many plans subsidize drug purchases up to $2,250, but then senior citizens must pay the full cost of the rest of their drug bill until they have spent $3,600. After that, the plan begins paying 95 percent of the drug costs and the beneficiary pays 5 percent.

Plans vary on the savings they provide on different medications. "You have to make sure the card covers your medicine," he said.

Duane Hunt of Cape Girardeau researched six plans. He didn't sign up for any of them because he has better prescription benefits through the Veterans Administration.

Retired teacher Opal Collins of Cape Girardeau said she won't enroll in any of the Medicare plans.

She said she has prescription drug coverage through her former employer, the Webster Groves, Mo., school district. "I'm not covered by Medicare," she said.

mbliss@semissourian.com

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