In his home country of Iran, retired police colonel Mohammad Mahdavi had to pay medical expenses out-of-pocket because the government had no health plan.

But since immigrating to Utah three years ago, the 67-year-old Mahdavi has been a "dual eligible" - happy to receive health care at a low cost with both Medicaid and Medicare benefits.

With Medicaid drug coverage ending this year, however, Mahdavi headed to Liberty Senior Center earlier this month to learn how to select one of the dozens of new Medicare prescription drug plans available in Utah.

As a dual eligible, the government would randomly assign him to a plan if he did not make a choice. But he wanted to find the best plan for his long list of medications: Mirapex and Carbid/Levod for Parkinson's disease, Actonel for osteoporosis, Clonazepam for anxiety, Prevacid for acid reflux and Lipitor for high cholesterol.

Alice Webber with Medicare Matters, an educational program that helps people understand the complex new drug benefit, helped Mahdavi navigate Medicare's Web site (http://www.medicare.gov) - the main tool to search for a plan.

"I wouldn't have been able to do it on my own," Mahdavi said, citing his inexperience with the Internet.

After about 90 minutes, with considerable computer delays and glitches, Webber came up with the three most affordable plans for him and printed them out.

Under two of the plans, Regence Life and Health Medicare Script and Aetna Medicare Rx Essentials, his annual drug cost would have been more than $400.

He decided on an Advantage Freedom Plan, for which he will pay no deductible. It is offered by Rx America for $240 in co-payments. On Medicaid, he paid $15 a month for his drugs.

His new coverage will begin on Jan. 1, but there are potential complications. He could encounter problems getting Lipitor and Prevacid because under his plan, those medicines are referred to as "step therapy," meaning that he might need to first try a substitute brand name or generic. He can appeal through his physician.

Mahdavi's friend John Firuz, 75, also from Iran, translated for him. The benefit "is confusing because of all of the plans," Firuz said.

chamilton@sltrib.com