"If you choose a plan, are you tied into it?" the 74-year-old St. George resident asked Leavitt at a meeting at the Gayle and Mary Aldred Senior Citizens Center. "Are you able to change it?"

Leavitt, U.S. secretary of Health and Human Services, fielded about a dozen pointed questions from skeptical or nervous seniors in this southern Utah retiree destination while kicking off the western portion of Medicare's national mobile bus tour.

It is part of his mission to educate Medicare recipients about the prescription plan, which begins in January. Between June to September, the posh bus outfitted with the latest office equipment will visit 30 states.

"Health care is complicated, so we're starting early to help recipients understand and encourage them to choose a plan that works for them," Leavitt said.

"This is a brand new program, and, in time, people will be comfortable with it. On January 1, 2006, people will no longer have to worry that their savings are going to be eroded by prescription drug costs."

There are roughly a quarter-million Medicare beneficiaries in Utah, and experts on aging believe many are perplexed by the benefit. That certainly was true at the senior center in St. George.

Eating turkey and mashed potatoes with Moorefield earlier in the afternoon, none of the seniors at her lunch table was certain about the program's details. That is precisely why Leavitt came to town, he said.

First, he wants recipients to know that every person with Medicare, no matter how they have existing drug coverage, is eligible. But to enroll, beneficiaries will have to choose from at least two - and possibly 10 - different plans, comparing drug lists for the brand names or generic prescriptions they need, and weighing the costs of each plan.

People who don't meet enrollment deadlines or make the right choices could face higher premiums.

Moorefield said the meeting was informative. She learned that recipients can change their plans every year during open enrollment, from Nov. 15 to Dec. 31.

Because it is so new, recipients this year have a longer time period to enroll, from Nov. 15 to April 15. Information about what companies will participate in the plans won't be available until October.

Seniors with limited assets and earning less than $1,197 a month - or $1,604 for a married couple - may qualify for extra help paying for premiums and co-pays. Health officials estimate that 100,000 Utahns are eligible for the discounts, but many of them may be unaware of that.

Under the guidelines, Herman Krum, 77, and his wife, Hope Krum, 78, of St. George apply for the discounts because they receive less than $1,600 from Social Security a month.

Hope Krum signed up for Medicare's temporary drug discount card to help pay for her expensive name-brand medications to treat depression and insomnia. She used to fork out more than $200 a month for the anti-depressant Effexor and Ambien, a sleeping pill. Now, with the discounts, she pays about $20 a month for both.

"I think we need to learn more about it," she said. "I received a form that was four or five pages long in the mail, but I don't know if I need to fill it out."

Leavitt said every Medicare recipient will receive a brochure explaining the program that lists the available plans.

He believes having the private sector involved will increase competition and force the drug companies to reduce prices. He also praised the new benefit as a fundamental change in how the government approaches health care.

"We think of health care as treating people when they're sick," he told the audience of about 200 people. "We really should think of health care as keeping people healthy."

Terry Dan Hawks attended the meeting to better understand the benefit. He is a consumer advocate for Red Rock Center for Independence, a nonprofit group that helps disabled and elderly people in nine southern Utah counties.

"People are asking us what they should do when they receive notices," he said. "We're not in a position to tell them what to do. We're telling them they have a choice. That's kind of new for government - to give people choices."

Moorefield hopes the program brings an end to seniors having to scrimp and save to afford expensive drugs. She has traveled to Mexico to get cheaper medications for a lung condition and osteoporosis.

"If the competition gets stiff enough between the plans, maybe we won't have to go to Mexico anymore," she said.

chamilton@sltrib.com