WASHINGTON -- On Jan. 1, the biggest change in the Medicare system since it began in 1965 will go into effect.

Part D prescription drug benefit, which offers savings to some seniors, will be open to everyone who is eligible for Medicare.

But some say the choices of coverage are confusing, reported WRC-TV in Washington, D.C.

Eula Mials is a retired teacher. She meticulously records each medication she takes. But as organized as she is, she found the choice of a Medicare prescription drug plan bewildering.

"I just can't identify the programs, there are so many different ones. And it's supposed to be a program where all the medicines are cheaper. Is that what it's all about?" Mials said.

There is no simple formula or single plan that will work for all seniors. But officials say it is easier to find the cheapest plan if you know the right questions to ask.

"Such as -- are the drugs that they take covered under a program? What will their co-payments be? Will they be able to use the pharmacy that they use today in their community or their local networks?" said Ron Geiserhaur, of UnitedHealth Group.

Geiserhaur's group has a Web site that walks Medicare enrollees through those questions and helps find answers.

Critics of the new Medicare plan have concerns beyond the confusion factor. A perspective article published in Thursday's issue of the New England Journal of Medicine suggests the new plan may actually be harmful to the health of the poor, elderly and disabled.

Stephen Soumerai, of Harvard Medical School, wrote that eligible beneficiaries were only given six weeks to choose and transition to a new drug formulary, which may leave some lost in the mix.

Soumerai said that another potential long-term problem is that beneficiaries may stop using essential medications because of increased copayments for drugs in many states. There is also the risk that some essential drugs are now not covered, which could create health problems in the future.

However, another editorial in the journal said the Medicare plan would have a beneficial side effect -- it will collect data on the prescription use of millions of beneficiaries, providing a valuable resource for understanding how drugs are used, as well as their risks and benefits, especially among the elderly and chronically ill.

To help navigate the new Medicare drug options, United HealthCare published a "Show Me Guide," a booklet that's available in many languages to help people with frequently asked questions.

The book offers several helpful facts such as:

• The plans aren't free. You must pay a portion and the government covers about 75 percent of the enrollment costs.
• Plans are run by private companies that differ in what drugs they cover and what pharmacies you can use.
• You'll have access to discount prices on medications.
• You can enroll by May 15, 2006. After that date, you will have to pay a late fee of about 1 percent of your premium for each month you delay.

Officials say the AARP is another good source of information.

More Information:

• New England Journal of Medicine
• Medicare.gov
• AARP.org
• MedicareRXInfoSource.com