RELATED STORY Suit aims to block automatic enrollment
	Click to special report on Part D

Only a fraction of those eligible signed up for the new Medicare prescription drug plan in its first month, according to figures released yesterday.

In their first report on enrollment in the program, federal officials said more than 21 million Medicare recipients will benefit from the new program known as Part D, which begins Jan. 1, or other federal programs.

But about 20 million of those recipients already have drug coverage through their former employers, state Medicaid programs, Medicare Advantage plans, or other sources.

Only a million of the signees had no coverage.

About 43 million Americans participate in Medicare, a federal program for people 65 and older and certain people with disabilities.

Federal officials said they were pleased with the totals, which include people who enrolled from Nov. 15 to Dec. 13, those whose former employers will receive government subsidies through the new program, and retirees with coverage funded by other government programs.

"We're seeing a lot of momentum," Health and Human Services Secretary Michael Leavitt said in a conference call with reporters. He noted that another 500,000 are expected to be enrolled in Part D by the end of next month.

But consumer advocates said more than 20 million Medicare recipients who may be eligible have not yet signed up, in part because of confusion over the complex program.

"People with Medicare are frustrated and bewildered," said Robert Hayes, president of the Medicare Rights Center.

Part D is administered through private plans. In the Pittsburgh area, there are more than 60 private plans. Monthly premiums, deductibles, copays, the size of a coverage gap known as the doughnut hole, and covered drugs vary from plan to plan.

The initial enrollment period extends to May 15.

"It's not necessarily surprising that people are taking their time," agreed Ray Landis, associate state director for advocacy for AARP Pennsylvania.

More important, he said, is how many will be enrolled by May 15. Medicare recipients who do not already have coverage at least as good as Part D -- what is known as "creditable coverage" -- could be required to pay higher premiums if they join a plan after that date.

Many Medicare recipients covered by their former employers have creditable coverage, as well as recipients of PACE or PACENET, the state's drug assistance programs.

The totals announced yesterday included about 1 million people in so-called "stand-alone" Part D plans that provide only coverage of prescription drugs.

Another 4.4 million people have enrolled who will receive Part D through Medicare Advantage plans that also provide medical coverage. Many of those recipients were automatically enrolled in the new coverage unless they decided to leave those plans and opt for other coverage.

The totals also include about 6.2 million Medicare recipients who currently receive their drug coverage through Medicaid.

They are being automatically enrolled in a Part D plan if they do not choose one.

The totals include about 3.1 million military or other retirees from the federal government. In some cases, their drug coverage will not be directly supported by Part D, federal officials said.

They also include more than 6 million other Medicare recipients, including those whose former employers will receive subsidies from Part D.

Interest in the program has been stronger than expected among employers and unions seeking to keep retirees in their current coverage, said Dr. Mark McClellan, administrator for the Centers for Medicare and Medicaid Services.

Earlier this year, federal officials estimated that as many as 39 million Medicare recipients would be covered by Part D plans or through employer or union-sponsored retiree plans eligible for drug subsidies.

But yesterday, they emphasized the uncertainty of estimating enrollment in a new program that is voluntary for many people.