Beginning today, Medicare recipients can start using new discount cards to get cut-rate prices on prescription drugs, but so far it appears that few seniors have chosen to sign up for what to many is an overly complicated system.

Don McLeod, a spokesman for the U.S. Department of Health and Human Services, said Friday it could be weeks before the government knows just how many beneficiaries have joined the program.

Medicare has approved 73 cards so far. Thirty-nine cards can be purchased nationwide; 33 are available regionally -- New York has the most local cards with five, Florida has four -- and one is available nationwide only to nursing home residents.

Advocates say the discount card program is a good deal for low-income seniors -- those with incomes below 135 percent of the poverty level -- $12,569

for individuals and $16,862 for married couples -- because each card comes with a $600 credit toward the purchase of medicine.

But the cards' benefits aren't so clear for people with higher incomes. And critics have noted several causes for confusion for people trying to decide whether they should spend up to $30 on a card. Medicare covers the cost of cards for low-income beneficiaries.

Tom Snedden, director of the Pennsylvania's PACE program, said fewer than 100 higher-income people have signed up for a discount card being offered by PACE. The discounts offered by the PACE card aren't as robust for higher-income seniors as those provided by many commercial cards, Snedden said.

But, Snedden said, he's heard commercial card sponsors say they haven't had many takers, either.

The Associated Press reported Friday that AARP, which has 35 million members, mailed out 26,000 enrollment kits, but had signed up only 400 people. A spokesman for Walgreen Co., another card sponsor, told the AP: "We prepared for a crush of seniors to come in beginning in May. That hasn't happened."

UPMC Health Plan is offering a card to beneficiaries throughout the state, but hadn't enrolled anyone as of Friday. That's because Medicare still hasn't approved the health plan's marketing materials. Bill Sawchak, spokesman for UPMC Health Plan, said 25 cards were ready to go once the approval comes in.

Another Pennsylvania company selling a discount card, Independence Blue Cross, did not have numbers to release, according to a spokesman.

Health plans have issued many more cards to seniors in their Medicare HMOs, but these cards typically carry no charge.

Pennsylvania's PACE program, which already provides prescription discounts for low-income seniors, received approval Friday to automatically enroll 18,000 people in a PACE-sponsored discount card. The PACE card will wipe away some co-payments for these seniors, while the $600 credits will help fund the state program -- possibly to the tune of more than $100 million. PACE expects to automatically enroll a total of 110,000 low-income seniors.

Angela Foreshaw, spokeswoman for AARP Pennsylvania, said several seniors in recent AARP forums in Altoona and Erie indicated that they had successfully used a government web site -- www.medicare.gov -- to consider their options. That suggests the confusion may be lifting, Foreshaw said.

Bob Kubit, the coordinator in Allegheny County for the Apprise program, which gives seniors advice about health insurance, said many seniors aren't confused so much as focused on shortcomings of cards.

"Once they hear that the discounts can change, and that the drugs covered by cards can change, that's turning them off," Kubit said. "I don't think many of them are enrolling in the program."

Kubit has spoken at roughly 12 educational forums about the cards, so far, and more are planned for June. One of the biggest points of confusion right now, Kubit said, is among seniors who are in Medicare HMOs that lack prescriptions benefits, and instead rely on PACE for their drugs. Depending on their health plan, some seniors in this position would not be eligible for the PACE discount card, but instead could only select a discount card offered by their health plan.

The Medicare law that created the discount cards in 2003 included this restriction, and seniors don't understand it, Kubit said. Snedden, the PACE program director, said the restriction shouldn't result in a financial problem for most folks, but it has created an administrative nightmare for the health plans and PACE.

The drug discount cards are a temporary measure to help the roughly 7. 3 million of Medicare's 40 million beneficiaries who do not have drug coverage. The card program is scheduled to expire by 2006 and be replaced by a more comprehensive Medicare drug benefit.